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    Tuesday, November 09, 2004

    Tennessee's Dragon: Tennessee spends a lot of money to insure the uninsured. So much, there Kerryesque program, TennCare, is known as the "dragon that eats everything." Like a dragon, it consumes a lot without giving much in return:

    The three healthiest states are Minnesota, New Hampshire and Vermont. Among other things, their high rankings reflect low rates of poverty and premature death, safer-than-average drivers and generous spending on public health. Minnesota has ranked No. 1 for nine of the past 15 years and has never been out of the top two.

    At the other end of the list are Tennessee, Mississippi and, as in 14 of the past 15 years, Louisiana in last place.

    Their low rankings arise from high rates of poverty, infant mortality and cancer; large numbers of smokers; and, with the exception of Tennessee, many people without health insurance.

    The North Country seems to be a healthier clime than the South, no? Actually, it's hard to tell. The survey measure health by giving different weights to various pre-selected health measures. Having a large population of smokers will cost a state dearly. Other measures, with less weight, are heart disease deaths, cancer deaths, infant mortality, the number of high school graduates, violent deaths, auto accident deaths, and the amount of money spent on public health. The more you spend, the healthier you are, right?

    The "healthiest" state is Minnesota"

    Strengths include ranking first for a low rate of deaths from cardiovascular disease at 259.2 deaths per 100,000 population, a low premature death rate with 5,595 years of potential life lost before age 75 per 100,000 population and a low rate of uninsured population at 8.7 percent. It is also in the top five states for high support for public health, a low percentage of children in poverty, a low total mortality rate, a low infant mortality rate, a low occupational fatalities rate and a high rate of high school graduation. Minnesota's biggest challenges are a high prevalence of obesity at 23.0 percent of the population and low access to adequate prenatal care with 76.0 percent of pregnant women receiving adequate prenatal care.

    Go figure. They're fat but healthy. Kind of runs against the grain of common wisdom, doesn't it?

    And here is Tennessee:

    Tennessee is 48th this year; it was 46th in 2003. Its strengths are a low rate of uninsured population at 13.2 percent and moderate access to prenatal care with 77.1 percent of pregnant women receiving adequate prenatal care. Challenges include a high infant mortality rate at 9.2 deaths per 1,000 live births and a low high school graduation rate with 56.7 percent of incoming ninth graders who graduate within four years. The state also ranks in the bottom 10 states on seven of the other individual measures, including a high prevalence of smoking, a high prevalence of obesity, a high violent crime rate, a high rate of deaths from cardiovascular disease, a high rate of cancer deaths, a high total mortality rate and a high premature death rate.

    Looks like TennCare isn't delivering much for its dollars.
    Assuming, that is, that these weighted measures really mean anything. A more honest portrayal of health would leave out the violent deaths, auto accidents, money spent, insurance rates, and high school graduation and concentrate on real medical diseases.

    posted by Sydney on 11/09/2004 08:15:00 AM 0 comments


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