The United States usually has a hard time keeping up with Europe in health indicator rankings.
Europe may have an advantage in areas that have little directly to do with health care, such as overall poverty and income inequality rates.
In some cases, the United States may suffer in comparisons due to factors difficult for individual residents to control, such as the genes people have inherited from their ancestors, or the challenges that longtime smokers face when attempting to quit.
In at least one case, the United States may look bad compared to Europe because of a factor that, in theory, should be easy for residents to control: the likelihood that residents ages 18 and older are eating enough vegetables.
For this purpose, the official definition of “vegetables” excludes fried potatoes.
The vegetable consumption figure also may be a pretty good indicator of whether people are eating well. Diet can influence whether residents of a state will file health insurance, disability insurance, long-term care insurance, or unexpectedly early life insurance claims due to conditions such as diabetes, cancer or heart disease.
In 2013, when government researchers included a question about vegetable consumption in the Behavioral Risk Factor Surveillance System survey, they found that only 8.9 percent of the survey participants were eating what the government believes to be enough vegetables (other than fries) per day. The average participant was getting just 1.7 servings of vegetables per day.
The percentage getting enough vegetables ranged from 5.5 percent in one state up to 13 percent in California.
In addition to being a general nutrition indicator, vegetable consumption adequacy may be an indicator of how likely a state is to try to cooperate with federally-mandated health care programs.
When some states were fighting the start of the Affordable Care Act individual coverage ownership mandate system, for example, a judge compared the ACA penalty imposed on some individuals who fail to own minimum essential coverage to a federal law forcing people to eat broccoli.
Related: 11th Circuit on PPACA: Can’t Make ‘Em Buy Broccoli
The ACA-exchange-resisting states’ opposition to the exchange system seems to correlate with actual resident resistance to broccoli: None of the 10 states that rank at the bottom of the vegetable consumption adequacy table operated its own Affordable Care Act individual health insurance exchange in 2014. Seven of the 10 states with the highest vegetable consumption adequacy figures set up individual exchanges in 2014.
For a look at a list of the 10 states with the worst vegetable consumption figures in 2013, along with a chart showing the vegetable consumption adequacy figures for all 50 states and the District of Columbia, read on.
Noodles topped with bean and meat stew in a dish known as “Cincinnati Chili” are a staple in Ohio. (Photo: iStock)
10. Ohio
Ate enough vegetables: 7.1%.
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In Louisiana, the state vegetable is the sweet potato. (Photo: iStock)
9. Louisiana
Ate enough vegetables: 6.9%.
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Collard greens, the state vegetable of South Carolina, are an excellent source of vitamins and minerals. (Photo: iStock)
8. South Carolina
Ate enough vegetables: 6.8%.
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Grilled or fried cubes of beef, mutton or venison called Chislic are a staple in South Dakota. (Photo: iStock)
7. South Dakota
Ate enough vegetables: 6.8 percent.