What Makes an Unhealthy State

In 2013, the National Research Council and the Institute of Medicine published a report showing that Americans die earlier and experience poorer health than residents of other high-income countries, such as Australia, Finland, and Japan. Though such international comparisons are concerning, health differences within the United States are even larger. Studies have found, for instance, that in many American cities life expectancy varies by as much as 20 years between neighborhoods.

A recent study by researchers at Virginia Commonwealth University (VCU) in collaboration with the Urban Institute, “The Health of the States,” takes a deep dive into these U.S. health disparities and the factors shaping them. The study examined states’ data on 39 different health outcomes, such as mortality, sexually transmitted diseases, and diabetes, and measured how strong they correlated with 123 health determinants, such as smoking, neighborhood walkability, and income level.