Jackson Free Press

The number of binge drinkers in Misssissippi is significantly lower than the national average, state residents are pretty good about wearing seatbelts, and we are third in the nation for the number of beds in community hospitals in the state. Otherwise, the state brought up the rear in the "Health Care State Rankings 2008," published by CQ Press in March—earning the dubious honor of being named the nation's unhealthiest state.

The report determines each state's ranking based on 21 factors, three positive and 18 negative, which look at a population's overall health, access to and affordability of health care, and each state's emphasis on preventive care.

First, the positive. Mississippi ranks fairly high for the number of beds in community hospitals (No. 3), the percentage of children from 19 to 35 months old immunized (No. 36) and falls within 8 percentage points of the national average for seat belt use at 73.6 percent.

Mississippi even has three relative bright spots in the negative factors. The percentage of binge drinkers in the state is significantly lower than the national average, at 9.5 percent of adults (the average is 15.4 percent); health insurance premiums for families is lower than average at $9,987 annually; and the estimated rate of new cancer cases is slightly lower than average with 428.4 cases per 100,000 population. For those factors, Mississippi ranks in the top 10.

But overall, Mississippi earns the title of "unhealthiest state" by sinking to No. 50 on seven of the 18 negative factors, and ranking in the bottom 10 on five others. We have the highest percentage of low birth-weight babies, the highest teen birth rate, the highest overall death rate and the highest infant death rates, the highest rate of sexually transmitted disease, overweight adults and adults who do not exercise. The state has landed in the eight unhealthiest states since 1995, coming in dead last seven times in the last nine years.

Liz Sharlot, director of communications for the Mississippi Department of Health, indicated that the issues are complex, but not new. The state Legislature mandates MDH to address specific public health issues, she said, such as infant mortality and communicable diseases, but limited resources continue to hamper significant progress.

Given the way Mississippi's lowest factors relate to one another, a handful of preventive measures could make a big difference: adequate sex education for young people, pre-natal education and care, and lifestyle education beginning in the schools regarding healthy food choices and the benefits of exercise. Mississippians could also make significant, positive progress in their own health by not smoking (25 percent of us do), exercising (31 percent of us don't) and eating right to keep our weight under control (31 percent of Mississippians are obese).

We can also support healthier policies.

"While I haven't heard of (the CQ report), I'm not surprised by it at all," said Jacquelyn Weatherspoon, program manager for the Mississippi Health Advocacy Program. "It's pretty consistent with what we've heard historically. It's more of the same. From our perspective, what we try to do here is get people engaged in the policy-making process. That really is the key."

Take the way the state taxes food. MHAP advocates dropping the tax on healthy foods, while retaining the current 7 percent tax on "junk" food. The Mississippi Legislature, however, has not been able to gain consensus regarding any change in the grocery tax, annually debating the merits of taxing cigarettes instead of food, a measure that Gov. Haley Barbour, a former tobacco lobbyist, opposes. The state is one of only seven states that levies the same sales tax on food as all other goods, and one of only 14 that taxes food at all.

MHAP advocates funding the state's Medicaid program through an increase in cigarette taxes. The current tax rate, 18 cents per pack, is the lowest in the U.S. for states that do not have a tobacco industry.

"Why not tax things that are putting people in the hospital, and costing Medicaid over $200 million a year?" Weatherspoon asked. She estimated that the Mississippi Medicaid price tag for tobacco-related illnesses at around $264 million. "It's a natural fit," she said, adding that more than 80 percent of Mississippians surveyed support such an increase.

MHAP has also surveyed Mississippians about what they want to see in terms of health care for the next 10 years. "Overwhelmingly, there has been support for universal health care," Weatherspoon said.

The winner of the "healthiest state" award for 2008 is Minnesota, unseating Vermont, which has won the award for six of the last eight years. Overall, 21 states lost ground and 20 showed improvement, while nine states retained their rank from the 2007 report.