Factors such as a low rate of preventable hospitalizations and ready access to adequate prenatal care have helped Vermont muscle Minnesota out of first place in a widely followed state health ranking program.

Researchers at the UnitedHealth Foundation, an affiliate of UnitedHealth Group Inc., Minnetonka, Minn., say Vermont climbed to first place for the first time this year after starting out in 16th place when the ranking program was started, back in 1990.

Researchers consider factors such as personal behavior, including the extent of smoking or binge drinking among residents; policy issues, such as the availability of health insurance and immunizations; community qualities, such as the level of violent crime and the number of children living in poverty; and the availability of health services such as prenatal care.

Vermont ranked first in terms of overall health status even though it ranked 41st in terms of per-capita public health spending, the researchers report.

As usual, the least healthy states were Mississippi and Louisiana.

Mississippi has high scores in areas such as access to prenatal care and public health spending, but it ranks at or near the bottom on measures such as prevalance of obesity, infant mortality and the percentage of children living in poverty, the UnitedHealth researchers report.