U.S. health report card ranks Washington at No. 10

Newborns in Washington have a better chance of reaching their first birthday than babies in any other state, while Washington adults have the nation's sixth-lowest smoking rate.

At the same time, the share of Washington residents who binge drink or are obese is going up. And the state's vaccination rate for young children is among the nation's worst.

That mixed snapshot emerged from a new report card released Wednesday offering a state-by-state checkup on key health measures. The 19th annual America's Health Rankings Report found that Americans' overall health is stagnating as they grow heavier, lose their health insurance and continue to smoke.

The rankings, the oldest of their kind nationally, are issued by United Health Foundation, the American Public Health Association and the Partnership for Prevention.

Washington ranked 10th healthiest in the country, up two spots from 2007. Since 1990, when the rankings began, Washington's total score has improved more than any other state except Vermont, Oregon, Idaho and Alaska.

Washington's ranking was buoyed in part by its low infant-mortality rate, its relatively low percentage of children living in poverty and a decline in smoking among adults.

But the state ranks 48th in the nation for childhood vaccination, with more than a quarter of the state's toddlers and preschoolers failing to receive prescribed shots against measles, whooping cough and other infectious diseases. Western states have historically lagged behind other regions in vaccination rates. Washington also was one of the last states to require that children get chickenpox vaccinations to attend school.

Washington's high-school-graduation rate is almost as dismal; the state ranked No. 32 in that category, with only 75 percent of ninth-graders eventually earning a diploma.

"We've got some pretty significant challenges in the state," said Greg Vigdor, president and chief executive of Washington Health Foundation, a Seattle nonprofit whose aim is to make Washington the nation's healthiest state.

Vigdor said some solutions may be fairly straightforward. Childhood immunizations, which Vigdor said yield one of the best returns for health dollars, could be encouraged a variety of ways — from boosting payments to doctors to making it harder for parents to opt out of vaccines for their children.

Other challenges are more complex.

Obesity is one, said Dr. Kim Pittenger, medical director of Virginia Mason Medical Center, Kirkland. A record 26.3 percent of American adults are obese. For a person who's 5 feet 6 inches tall, for example, a normal weight range would be 115 to 154 pounds; 186 pounds or heavier would be considered obese.

Combating obesity requires balancing genetic factors with personal responsibility and societal forces, said Pittenger, a family physician.

Pittenger said Americans won't make meaningful gains in their health until the nation moves away from "complaint-reimbursed care," under which patients seek medical attention for each assorted ailment, and doctors get paid for individual treatments. An alternative is to emphasize prevention, and for patients and doctors to more aggressively manage chronic conditions such as diabetes and high blood pressure.

For the second consecutive year, Vermont ranked as the nation's healthiest state, up from 16th place in 1990.

Washington rose from 23rd that year to 10th this year. Following Vermont this year were Hawaii, New Hampshire, Minnesota and Utah.

Louisiana was the least-healthy state, followed by Mississippi, South Carolina, Tennessee and Texas.

Kyung Song: 206-464-2423

or ksong@seattletimes.com