Public Health Funding Archives - Page 23 of 29

Cincinnati Children’s Hospital Medical Center Community and Population Health Initiative

In 2010, Cincinnati Children’s Hospital Medical Center (CCHMC) started the Community and Population Health Initiative to tackle the most prevalent, challenging, and burdensome health issues facing children and families in southern Ohio. By creating partnerships within the community and focusing on the pillars of the Institute for Health Care Improvement’s Triple Aim framework, the Community and Population Health Initiative has reduced the negative impact of social determinants like education, housing, and the environment on health outcomes. To date, CCHMC has seen a reduction in asthma admissions, improved social and environmental risk screening during both inpatient and outpatient care, and substantial increases in connections between families and key resources in the community. The initiative began with funding from CCHMC, as well as funding from federal agencies and foundations. To read more about this innovative program, see this brief summary [link].

Changing the Narrative About What Creates Health—Essential Steps in Improving Population Health in Minnesota

The goal of Changing the Narrative about What Creates Health— Essential Steps in Improving Population Health is to bring about critical change to effectively address the social determinants of health and achieve health equity. Launched in 2011 by the Minnesota Health Department, this initiative shifts the responsibility for health to a community level to address the conditions in which all people can be healthy through policy, systems, and environmental changes. Key strategies include: the creation of a Healthy Minnesota 2020 framework that engages partners in all sectors; community engagement via the Healthy Minnesota Partnership, establishment of cabinet-level committee on Health in All Policies; a State Health Improvement Program that outlines policy, systems, and environmental changes; and creation of Accountable Communities for Health. By focusing the narrative on what creates health (beyond the health system), community agencies and groups have become involved in health policies contributing to policy changes including: anti-bullying law; minimum wage increase; smoke-free campuses and apartments; and complete street ordinances. Minnesota has also shown decreasing rates of childhood obesity and youth tobacco use, and increasing rates of breastfeeding. This initiative is funded by State Health Department grants. To read more about this innovative program, see this brief summary [link].

Nearly Half of States Score 5 or Lower out of 10 on Substance Misuse Prevention Report Card

Youth Drug Overdose Death Rates more than Doubled in 35 States in Just Over a Decade

Washington, D.C., November 19, 2015– According to a new Trust for America’s Health (TFAH) report, Reducing Teen Substance Misuse: What Really Works, 24 states scored five or lower out of 10 on key indicators of leading evidence-based policies and programs that can improve the well-being of children and youth and have been connected with preventing and reducing substance – alcohol, tobacco or other drugs – misuse.

Four states tied for the lowest score of three out of a possible 10 – Idaho, Louisiana, Mississippi and Wyoming – while two states achieved 10 out of 10 – Minnesota and New Jersey. The indicators were developed in consultation with top substance misuse prevention experts.

The Reducing Teen Substance Misuse report includes an analysis of the most recent drug overdose death rates among 12- to 25-year-olds, finding that:

Current rates were highest in West Virginia (12.6 per 100,000 youth) — which were more than five times higher than the lowest rates in North Dakota (2.2 per 100,000).
Males are 2.5 times as likely to overdose as females (10.4 vs. 4.1 per 100,000).
In 1999-2001, no state had a youth drug overdose death rate above 6.1 per 100,000. By 2011-13, 33 states were above 6.1 per 100,000. In the past 12 years:
- Rates have more than doubled in 18 states (Alabama, Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Kentucky, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Oregon, South Carolina and Tennessee);
- Rates have more than tripled in twelve states (Arkansas, Delaware, Indiana, Iowa, Michigan, Minnesota, Missouri, New Hampshire, New York, Oklahoma, Utah and West Virginia); and
- Rates have more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming).

“More than 90 percent of adults who develop a substance use disorder began using before they were 18,” said Jeffrey Levi, PhD, executive director of TFAH. “Achieving any major reduction in substance misuse will require a reboot in our approach – starting with a greater emphasis on preventing use before it starts, intervening and providing support earlier and viewing treatment and recovery as a long-term commitment.”

The increase in youth drug overdose deaths is largely tied to increases in prescription drug misuse and the related doubling in heroin use by 18- to 25-year-olds in the past 10 years – 45 percent of people who use heroin are also addicted to prescription painkillers.

In addition, youth marijuana rates have increased by nearly 6 percent since 2008 and more than 13 percent of high school students report using e-cigarettes. Youth from affluent families and/or neighborhoods report more frequent substance and alcohol use than lower-income teens – often related to having more resources to access alcohol and drugs.

The report highlights 10 indicators of the types of policy strategies that can help curb substance misuse by tweens, teens and young adults:

Limiting Access:
- 37 states and Washington, D.C. have liability “dram shop” laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals.
- 30 states and Washington, D.C. have smoke-free laws prohibiting smoking in public places, including restaurants and bars.

Supporting Improved Well-being of Tweens, Teens and Young Adults:
- 30 states had rates of treatment for teens with major depressive episodes above 38.1 percent.
- 29 states and Washington, D.C. increased funding for mental health services in Fiscal Year 2015.
- 21 states have comprehensive bullying prevention laws.
- 35 states have at least an 80 percent high school graduation rate.
- 31 states and Washington, D.C. have taken action to roll back “one-size-fits-all” sentences for nonviolent drug and other offenses.

Improving Counseling, Early Intervention and Treatment and Recovery Support:
- 32 states and Washington, D.C. have explicit billing codes for Screening (questionnaires/conversations), Brief Intervention (short counseling) and Referral to Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs, yet currently fewer than half of pediatricians report talking to teen patients about alcohol and other drug use.
- 31 states and Washington, D.C. have laws in place to provide a degree of immunity from criminal charges or mitigation of sentencing for an individual seeking help for themselves or others experiencing an overdose.
- 30 states and Washington, D.C. provide Medicaid coverage for all three medications approved by the Food and Drug Administration for the treatment of painkiller addiction.

“The case for a prevention-first and continuum-of-care approach is supported by more than 40 years of research, but the science hasn’t been implemented on a wide scale in the real world,” said Alexa Eggleston, senior program officer, domestic programs, Conrad N. Hilton Foundation. “It’s time to bring innovations to scale and invest in more proactive and sustained approaches that promote positive protective factors, like safe, stable families, homes, schools and communities and intervene early to address youth substance use before addiction develops.”

Reducing Teen Substance Misuse identified a set of research-based approaches and recommendations to modernize the nation’s strategy to prevent and reduce substance use and support a full continuum-of-care, including:

Putting prevention first, using evidence-based approaches across communities and in schools. Each state should have an end-to-end network of experts and resources to support the effective community-based selection, adoption, implementation and evaluation of evidence-based programs;
Strategically investing in evidence-based programs that show the strongest results in reducing risk factors for substance misuse, poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that often emerge during teen years and young adulthood;
Integrating school-based and wider community efforts, via multisector collaboration – and effectively collecting data to assess community needs, better select programs that match with those needs and improve accountability. Schools cannot and should not be expected to solve the problem on their own;
Renewing efforts to gain support for the adoption and implementation of evidence-based and sustained school-based programs – moving beyond decades of ineffective approaches;
Incorporating SBIRT as a routine practice in middle and high schools and healthcare settings – along with other regular health screenings – even brief counseling and interventions can have a positive impact; and
Increasing funding support for sustained and ongoing mental health and substance use treatment and recovery.

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation.

Score Summary:

A full list of all of the indicators and scores, listed below. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

10 out of 10: Minnesota and New Jersey

9 out of 10: California, Connecticut, Maine, Maryland, New Mexico, New York and Vermont

8 out of 10: Delaware, District of Columbia, Massachusetts, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin

7 out of 10: Colorado, Iowa, North Carolina and Pennsylvania

6 out of 10: Alabama, Illinois, Missouri, Rhode Island and Utah

5 out of 10: Arkansas, Florida, Hawaii, Kansas, Kentucky, Michigan, Montana, North Dakota and Oklahoma

4 out of 10: Alaska, Arizona, Georgia, Indiana, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Texas and West Virginia

3 out of 10: Idaho, Louisiana, Mississippi and Wyoming

STATE-BY-STATE YOUTH DRUG OVERDOSE DEATH RANKINGS

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 50 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

1. West Virginia (12.6); 2. New Mexico (12.5); 3. Utah (12.1); 4. Pennsylvania (11.8); 5. Nevada (11.6); 6. New Jersey (10.7*); 7. Kentucky (10.5); 8. (tie) Arizona (10.2*) and Colorado (10.2*) and Delaware (10.2*); 11. Wyoming (9.8*); 12. Indiana (9.6); 13. Missouri (9.5*); 14. Oklahoma (9.4); 15. New Hampshire (9.3); 16. Ohio (9.1*); 17. Wisconsin (8.8*); 18. Maryland (8.5); 19. Arkansas (8.4); 20. Connecticut (8.3); 21. Illinois (8.2*); 22. Michigan (8.1*); 23. Massachusetts (7.8); 24. Alaska (7.2); 25. North Carolina (7.1); 26. (tie) Montana (7.0) and Tennessee (7.0**) and Vermont (7.0); 29. (tie) New York (6.9*) and Washington (6.9); 31. Oregon (6.5); 32. (tie) Alabama (6.2) and Louisiana (6.2**); 34. (tie) Rhode Island (6.0) and Texas (6.0); 36. (tie) Kansas (5.9) and Virginia (5.9); 38. (tie) Idaho (5.8) and South Carolina (5.8); 40. (tie) Florida (5.7**) and Minnesota (5.7*); 42. Georgia (5.2); 43. California (4.9*); 44. Maine (4.7**); 45. Hawaii (4.6); 46. Iowa (4.3); 47. (tie) Mississippi (3.7**) and Nebraska (3.7); 49. South Dakota (3.3); 50. North Dakota (2.2).

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Reducing Teen Substance Misuse: What Really Works

New TFAH Report Focuses on Priority Policies for Reducing Toxic Stress and Adverse Childhood Experiences

Washington, D.C., November 3, 2015— A new report, A Healthy Early Childhood Action Plan: Policies for a Lifetime of Well-being, released today by the Trust for America’s Health (TFAH), highlights more than 40 policy target areas that are key to achieving national goals of reducing toxic stress and Adverse Childhood Experiences (ACEs) and improving the lives of millions of children.

Living with prolonged stress and/or adverse experiences can significantly increase a child’s risk for a range of physical, mental and behavioral problems – increasing the likelihood for hypertension, diabetes, heart disease, stroke, cognitive and developmental disorders, depression, anxiety and a range of other concerns.

Currently, around one-quarter of children ages 5 and younger live in poverty and more than half of all children experience at least one ACE. According to research from the Centers for Disease Control and Prevention (CDC), more than one-quarter of children experience physical abuse (28.3 percent) and substance abuse in the household (26.9 percent) while sexual abuse (24.7 percent for girls and 16 percent for boys) and parent divorce or separation (23.3 percent) are also prevalent.

“More and more studies show investing in early childhood pays off in a lifetime of better health and well-being,” said Jeffrey Levi, PhD, executive director of TFAH. “There are dozens of policy levers we can and should be pushing to ensure all children have high-quality preventive healthcare; safe, stable, nurturing relationships, homes and communities; good nutrition and enough physical activity; and positive early learning experiences.”

The report calls for increased public health engagement in early childhood areas, with a series of recommendations including to:

Build beyond the traditional healthcare system by integrating health and other social supports, including accountable health communities for children, by:

Ensuring every child has access to high-quality and affordable healthcare;
Building systems to help identify and provide support for children’s needs beyond the traditional medical system, but that have a major impact on health;
Focusing on a two generation approach to healthcare – and social service support;
Modernizing and expanding the availability of mental health and substance misuse treatment services – for both parents and children;
Expanding the focus of a trauma-informed approach across a wider range of federal, state and locally supported services; and
Improving services and care coordination for Children and Youth with Special Healthcare Needs (CYSHCN).

Promote protective, healthy communities and establish expert and technical assistance backbone support to help spread and scale programs nationally and in every state, by:

Improving the collection, analysis and integration of child health, well-being and services data to better assess trends and target services and programs;
Strengthening the role of federal, state and local health departments as the chief health strategist in communities; and
Establishing a support organization in every state that provides expertise and technical assistance.

Increase investments in core, effective early childhood policies and programs, by:

Making programs and services that promote early childhood well-being a higher priority to ensure they can be delivered on a scale to help all families (ranging from home visiting programs to child welfare services to increasing economic opportunity for families to child care and early education); and
Better aligning systems and financial resources to improve the effectiveness and efficiency of health, social services and education services.

The report includes a series of maps showing the status of different states on key trends and policy areas and case studies of evidence-based and model programs, organizations and initiatives—which are putting these recommendations into action—including the Nurse Family Partnership, Family Check Up Models, Abriendo Puertas/Opening Doors, Good Behavior Game, Child-Parent Center Program, Crittenton Children’s Center at Saint Luke’s Health System, Wholesome Wave, Community Asthma Initiative at Boston Children’s Hospital and many others.

“If we work together across sectors – bringing together the collective energy and resources of diverse partners – we will have a better chance of achieving the common goal of a healthy start for all of America’s children,” said Gail Christopher, chair of TFAH’s Board of Directors and vice president for policy and senior advisor at the WK Kellogg Foundation. “This report shines a light on many promising policies and programs. But the question remains whether we can garner the public will to turn the potential into the promise that improves the lives of our next generation.”

The full report was supported by a grant from the Robert Wood Johnson Foundation.

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A Healthy Early Childhood Action Plan: Policies for a Lifetime of Well-being

TFAH Commends President Obama and Congressional Leadership for Securing the Bipartisan Budget Act of 2015

Washington, D.C., October 28, 2015 – The Trust for America’s Health (TFAH) commends President Obama and Congressional leadership for the Bipartisan Budget Act of 2015, and is pleased to announce its support for this legislation. The following is a statement from Jeffrey Levi, PhD, executive director of TFAH.

“This agreement is an important step toward ensuring the nation has adequate resources to help people be healthy, happy and productive. TFAH calls on Congress to pass the Bipartisan Budget Act.

By largely replacing sequestration’s harmful cuts—which forced historically low and grossly inadequate funding for critical public health programs—Congress is now able to increase investments in vital public health and other domestic programs that keep Americans healthy, safe, and secure.

TFAH recommends Congress use this funding to invest in programs that build a public health system that focuses on preventing disease in the first place by restoring funding to chronic disease programs—such as Partnerships to Improve Community Health, Racial and Ethnic Approaches to Community Health and Tips From Former Smokers—at the Centers for Disease Control and Prevention. These programs support proven strategies that prevent and control the development of numerous chronic diseases.

We also urge Congress to pass appropriations bills that do not include ideologically driven, partisan policy riders that could threaten the implementation of this historic deal.

Every American deserves to be healthy. By maintaining funding for the Prevention and Public Health Fund and passing this Act, the nation’s leaders will have finally signaled that they are serious about providing the support needed to keep Americans healthy and happy.”

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TFAH Supports the EPA and Obama Administration in Beginning to Address the Serious Health Consequences of Ground-level Ozone

Washington, D.C., October 1, 2015 – The Trust for America’s Health (TFAH) is pleased that the Environmental Protection Agency (EPA) has announced it will finalize an update to the National Ambient Air Quality Standard (NAAQS) for Ground-level Ozone. The following is a statement by Jeffrey Levi, PhD, executive director of TFAH.

“Today the EPA and Obama Administration announced they will finalize a long overdue update to the ground-level ozone standard. TFAH commends EPA for meeting the latest deadline and finalizing a ground-level ozone standard of 70 parts-per-billion (ppb)—far more in line with the current scientific evidence and an important improvement over the flawed 2008 standard.

However, as we have made clear in public statements to EPA, TFAH strongly believes that a standard of 60 ppb would best meet the expectations of the Clean Air Act and would give our nation’s families an ozone standard that protects their health.

EPA’s own science is clear that even healthy adults can experience adverse health effects from ozone at 65 ppb. And, research has told us for years that elevated levels of smog can cause asthma attacks, shortness of breath, trips to the emergency room and even premature death. Now, we are beginning to see research link low birth weight babies, negative neurological effects, and many additional health hazards to ozone.

At a time when obesity levels are stabilizing at an unspeakably high level and we are encouraging more and more Americans to be active, we aren’t providing clean air to breathe. In reality, the Americans—young children, the elderly, and those who already suffer from certain chronic diseases—who are most likely to benefit from being active outdoors are unfortunately those who are most vulnerable to the dangers of dirty air and ground-level ozone.

Improving the standard to 70 ppb is undoubtedly progress towards cleaner air and a healthier nation – however it also represents a missed opportunity for EPA to act on the best available science and truly protect the public’s health.”

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Trust for America’s Health Releases Letter Detailing Strong Opposition to the Reconciliation Instructions Proposed by the House Energy and Commerce Committee

Eliminating the Prevention and Public Health Fund—which has the support of more than 900 organizations—would set Public Health back by a Decade

Washington, D.C., September 29, 2015 – Trust for America’s Health (TFAH) released a letter detailing strong opposition to the Reconciliation Instructions proposed for consideration by the House Energy and Commerce Committee, stating that eliminating funding for the Prevention and Public Health Fund would set public health back by a decade.

The letter also notes that more than 900 state and national organizations have already pledged their support for the Prevention Fund and details the successes of the Fund.

The letter, in part, reads:

“In the first six years since its inception, the Prevention Fund has invested nearly $5.25 billion in resources to states, communities, tribal and community organizations in support of community-based prevention, including tobacco use prevention, healthy eating and active living, as well as childhood immunizations and clinical prevention. Decimating the Prevention Fund in this manner would dramatically impede efforts underway to improve health, including:

The Preventive Health and Health Services Block Grant, which was doubled under the Prevention Fund and provides all 50 states, the District of Columbia, two American Indian tribes, and eight U.S. territories with flexible funding to address their unique public health issues at the state and community level.
Expanding Access to Cancer Screenings: In FY 2015, the Fund provided $104 million for the National Breast and Cervical Cancer Early Detection Program, which is helping states across the country provide cancer screenings to high risk women who are uninsured or underinsured.
The successful Tips from Former Smokers campaign, which in just its first three months inspired more than 1.6 million people to try to quit smoking, and more than 100,000 smokers have quit for good.
Funding for the section 317 childhood immunization program, which has been vital to preventing and responding to measles outbreaks, and epidemiology and laboratory capacity in all states, which are key to preventing and containing infectious disease outbreaks.

“These are just a few examples of the work underway thanks to the Prevention Fund. Massively reducing the Fund would set back public health by a decade, and would slash life-saving investments in every state that are desperately needed. For example, chronic diseases such as cancer, diabetes, lung disease, heart disease, and stroke are now responsible for seven out of 10 deaths and account for 86 percent of health care spending in America. An approach to deficit reconciliation that cuts prevention may in fact have the opposite effect – less prevention of illness and disease and increased future health care spending.”

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New Report Finds 23 of 25 States with Highest Rates of Obesity are in the South and Midwest

Obesity rates at or above 30 percent in 42 states for Blacks, 30 states for Latinos, 13 states for Whites

Washington, D.C., September 21, 2015 – U.S. adult obesity rates remained mostly steady―but high―this past year, increasing in Kansas, Minnesota, New Mexico, Ohio and Utah and remaining stable in the rest, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

Arkansas had the highest adult obesity rate at 35.9 percent, while Colorado had the lowest at 21.3 percent. The 12th annual report found that rates of obesity now exceed 35 percent in three states (Arkansas, West Virginia and Mississippi), are at or above 30 percent in 22 states and are not below 21 percent in any. In 1980, no state had a rate above 15 percent, and in 1991, no state had a rate above 20. Now, nationally, more than 30 percent of adults, nearly 17 percent of 2 to 19 year olds and more than 8 percent of children ages 2 to 5 are obese.

Obesity puts some 78 million Americans at an increased risk for a range of health problems, including heart disease, diabetes and cancer.

“Efforts to prevent and reduce obesity over the past decade have made a difference. Stabilizing rates is an accomplishment. However, given the continued high rates, it isn’t time to celebrate,” said Jeffrey Levi, PhD, executive director of TFAH. “We’ve learned that if we invest in effective programs, we can see signs of progress. But, we still haven’t invested enough to really tip the scales yet.”

Other key findings from The State of Obesity include:

Obesity rates differ by region, age and race/ethnicity.
7 of the 10 states with the highest rates are in the South and 23 of the 25 states with the highest rates of obesity are in the South and Midwest.
9 of the 10 states with the highest rates of diabetes are in the South. Diabetes rates increased in eight states – Colorado, Hawaii, Kansas, Massachusetts, Missouri, Montana, Ohio and Pennsylvania.
American Indian/Alaska Natives have the highest adult obesity rate, 54 percent, of any racial or ethnic group.
Nationally, obesity rates are 38 percent higher among Blacks than Whites; and more than 26 percent higher among Latinos than Whites. (Obesity rates for Blacks: 47.8 percent; Latinos: 42.5 percent; and Whites: 32.6 percent.)
Adult obesity rates are at or above 40 percent for Blacks in 14 states.
Adult obesity rates are at or above 30 percent in: 42 states for Blacks; 30 states for Latinos; and 13 states for Whites.
Obesity rates are 26 percent higher among middle-age adults than among younger adults― rates rise from 30 percent of 20- to 39- year olds to nearly 40 percent of 40- to 59-year-olds.
More than 6 percent of adults are severely obese – more than a 125 percent increase in the past two decades. Around 5 percent of children are already severely obese by the ages of 6 to 11.
Among children and teens (2 to 19 years old), 22.5 percent of Latinos, more than 20 percent of Blacks and 14.1 percent of Whites are obese.
Prevention among children is key. It is easier and more effective to prevent overweight and obesity in children, by helping every child maintain a healthy weight, than it is to reverse trends later. The biggest dividends are gained by starting in early childhood, promoting good nutrition and physical activity so children enter kindergarten at a healthy weight.
Healthy communities can help people lead healthy lives. Small changes that make it easier and more affordable to buy healthy foods and beverages and be physically active can lead to big differences. The U.S. Centers for Disease Control and Prevention, The New York Academy of Medicine, and other experts have identified a range of policies and programs (e.g., improving school nutrition, physical activity and lifestyle interventions, health screenings, walking programs) that can help create healthier communities. Lower-income communities often face higher hurdles, and need more targeted efforts.

“In order to build a national Culture of Health, we must help all children, no matter who they are or where they live, grow up at a healthy weight,” said Risa Lavizzo-Mourey, president and CEO of RWJF. “We know that when we take comprehensive steps to help families be more active and eat healthier foods, we can see progress. Now we must extend those efforts and that progress to every community in the country.”

The State of Obesity also reviews key programs that can help prevent and address obesity by improving nutrition in schools, child care and food assistance; increasing physical activity before, during and after school; expanding healthcare coverage for preventing and treating obesity; making healthy affordable food and safe places to be active more accessible in neighborhoods, such as through Complete Streets and healthy food financing initiatives; increasing healthy food options via public-private partnerships; and creating and sustaining policies that help all children maintain a healthy weight and adults be as healthy as possible, no matter their weight.

This is the 12^th annual edition of The State of Obesity (formerly known as the F as in Fat report series) report. The full report, with state rankings in all categories and updated interactive maps, charts and graphs, is available at http://stateofobesity.org. Follow the conversation at #StateofObesity.

2014 STATE-BY-STATE ADULT OBESITY RATE

Based on an analysis of new state-by-state data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance Survey, adult obesity rates by state from highest to lowest were:

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity.

1. Arkansas (35.9); 2. West Virginia (35.7); 3. Mississippi (35.5); 4. Louisiana (34.9); 5. Alabama (33.5); 6. Oklahoma (33.0); 7. Indiana (32.7); 8. Ohio (32.6); 9. North Dakota (32.2); 10. South Carolina (32.1); 11. Texas (31.9); 12. Kentucky (31.6); 13. Kansas (31.3); 14. (tie) Tennessee (31.2) and Wisconsin (31.2); 16. Iowa (30.9); 17. (tie) Delaware (30.7) and Michigan (30.7); 19. Georgia (30.5); 20. (tie) Missouri (30.2) and Nebraska (30.2) and Pennsylvania (30.2); 23. South Dakota (29.8); 24. (tie) Alaska (29.7) and North Carolina (29.7); 26. Maryland (29.6); 27. Wyoming (29.5); 28. Illinois (29.3); 29. (tie) Arizona (28.9) and Idaho (28.9); 31. Virginia (28.5); 32. New Mexico (28.4); 33. Maine (28.2); 34. Oregon (27.9); 35. Nevada (27.7); 36. Minnesota (27.6); 37. New Hampshire (27.4); 38. Washington (27.3); 39. (tie) New York (27.0) and Rhode Island (27.0); 41. New Jersey (26.9); 42. Montana (26.4); 43. Connecticut (26.3); 44. Florida (26.2); 45. Utah (25.7); 46. Vermont (24.8); 47. California (24.7); 48. Massachusetts (23.3); 49. Hawaii (22.1); 50. District of Columbia (21.7); 51. Colorado (21.3).

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Trust for America‘s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

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