Health Improvement Score Drops 3.3%

By Allison Bell

The UnitedHealth Foundation national composite health improvement score has fallen to 14%, down from 17.3% in 2000.

The drop means that the country is scoring about 14% higher than it scored when researchers first began computing the national public health score in 1990, but 3.3% lower than it scored when researchers computed the national score last year.

But survey researchers warn against paying too much attention to a one-year drop in the national health score.

“I think the 14 percentage point increase is probably the more telling trend,” says Susan Hayes, the survey project director.

Survey researchers come up with health scores by gathering data on a variety of obvious health indicators, such as infant mortality, and subtler indicators, such as high school graduation rates. The less obvious indicators reflect the effects of education, poverty and other social factors on health.

The latest national score is down because of increases in smoking rates and premature death rates, and decreases in high school graduation rates and an indicator representing government financial support for public health programs, researchers say.

Researchers calculate ratings for individual states by setting the national average at zero, then comparing the performance of each state with the national average.

Minnesota beat out New Hampshire to lead the rankings with a composite score of 23.1.

Arkansas and Alabama were the states that showed the most improvement.

Arkansas increased its score to 9.3 from 13.7, thanks in part to a drop in the smoking rate and infant mortality rate. The state also cut the percentage of residents who lack health insurance to 14.7%, from 18.7%.

Alaska increased its score to 2.4, from 2, by cutting its smoking rate and infant mortality rate, and an indicator representing time lost due to health problems.

In theory, the state health survey report could provide corporate intelligence for the actuaries who help insurers project life and health claims rates.

In reality, the foundation publishes the survey report mainly to meet the needs of state public officials, physicians and individuals, Hayes says.

UnitedHealth Group Inc., Minnetonka, Minn., took over support of the survey series from ReliaStar Financial Corp., Minneapolis, in 1999, after ReliaStar got out of the major medical insurance business.

The managed care company formed the UnitedHealth Foundation, an independent, nonprofit group, in 1999 by giving it $50 million in UnitedHealth Group common stock.

UnitedHealth Group turned the survey over to the foundation this year.

The foundation also supports the production of health television programs aimed at consumers; U.S. distribution of Clinical Evidence, a British publication aimed at doctors; and the Foundation for Health Care Policy and Evaluation, a health policy research institute.

UnitedHealth is just one of many insurers that have made major efforts to support public health programs.

Back in the early 1900s, companies such as MetLife Inc., New York, and Prudential Insurance Company of America, Newark, N.J., mounted major campaigns to support the pasteurization of milk and educate the public about prevention of diseases such as tuberculosis.

In recent years, managed care companies and managed care quality groups have tried to improve public health by using quality measurement programs to increase vaccination rates for children and improve care for conditions such as diabetes.

This year, worries about anthrax and other diseases that could be used as weapons have put national public health officials in the spotlight.

“Now, more than ever, people are really appreciating our public health infrastructure,” Hayes says.

The UnitedHealth report is about what the infrastructure does on a day-to-day basis, Hayes adds.

The authors of the health survey report emphasize the importance of taking a broad, long-term approach to improving public health.

“Healthiness for individuals, families and communities is a composite of at least three essential elements,” the authors write in their introduction to the report. “The personal behaviors and decisions that individuals and families make that affect their health status; the decisions made by community policy leaders regarding the availability of social resources devoted to the promotion and protection of a communitys health; and the community environment that shapes the possibilities for healthiness.”

Keeping citizens healthy requires the active and informed participation of all U.S. residents, the authors write.