How Healthy Could a State Be?

Improving health determinants to achievable levels could reduce mortality rates in U.S. states by as much as 44 percent.

Health determinants are the categories that determine the mortality rate. There are various methods for calculating the mortality rate, according to the Centers for Disease Control and Prevention. Behavioral factors, genetics and the social environment are factors that contribute to death; America’s Health Rankings adds public health policy as an additional factor.

There are great differences in population health among U.S. states. One route to improving the health of each state’s population is to improve the health determinants that affect mortality rates.

This study predicted the lowest mortality rate every state could expect if its health determinants were at optimal levels. The optimal level for a given determinant was the best value that any state had achieved in that category at the time of the investigation. The authors calculated the change in the number of deaths per 100,000 people under the age of 75 years. For several modifiable determinants (smoking, education level and percent uninsured) the authors modeled the percentage change to the mortality rate of each state.

Key Findings:

  • The proportion of people who lack health insurance had the greatest impact on mortality rates. A 1 percent increase in people with insurance results in an 8 percent decrease in the mortality rate.
  • Improving the level of education reduced mortality rates by 50 percent in Mississippi.

Policy-makers can decide what areas of public health to invest in by examining the factors that determine mortality rates. This study calculated the potential reduction to mortality rates in U.S. states if the health determinants of each state improved.