Mississippi is still in poor health, still rejecting Medicaid expansion | McClatchy Washington Bureau

Mississippi’s legacy of poor health continued in 2015 as the Magnolia State finished 49th among the 50 states in the annual “America’s Health Rankings,” released Thursday by the United Health Foundation.

In the 26 years that the annual report on resident health status has been released, Mississippi has finished dead last or next to last 24 times. In 1998 and 1991, the state ranked 48th. In this year’s edition, only Louisiana had a worse ranking.

Mississippi was rated worst among all states for adult physical inactivity, the rate of adolescent immunizations, low birth weight babies, preventable hospitalizations, infant mortality, cardiovascular deaths, cancer deaths and premature deaths.

Mississippi ranked next to last for the rate of salmonella cases, adolescent Tdap immunizations against tetanus, diphtheria and pertussis, and primary care physicians and dentists.

For the fourth straight year, Hawaii was ranked the nation’s healthiest state, followed by Vermont, Massachusetts, Minnesota and New Hampshire.

The nine most unhealthy states were all in the South. After Louisiana and Mississippi, the most unhealthy states were Arkansas, West Virginia, Alabama, Oklahoma, Kentucky, Tennessee and South Carolina. North Carolina showed the largest improvement, jumping to 31st this year from 37th in 2014.

Nationally, the report noted declines in preventable hospitalizations and physical inactivity among all Americans and increases in child and adolescent immunizations. The report also found continued declines in cigarette smoking, cardiovascular deaths and lower rates of infant mortality.

By virtue of a U.S. Supreme Court decision, the Affordable Care Act gives states the option of extending Medicaid coverage to working-age adults who earn at or below 138 percent of the federal poverty level – $27,724 for a family of three.

The federal government pays the entire cost to cover newly eligible Medicaid recipients under the health law in 2014, 2015 and 2016. Some 17.6 million Americans have gained health insurance coverage since the Affordable Care Act became law in 2010, dropping the nation’s uninsured rate to 12.6 percent, the lowest level ever.

In Mississippi, Gov. Phil Bryant and Republican state lawmakers have vehemently opposed expanding Medicaid as too costly even though states would pay no more than 10 percent of medical costs for newly eligible enrollees after 2016.

The state rankings by the United Health Foundation, a nonprofit arm of insurer United Health Group, are based on four health determinants: behaviors, community and environment, policy, and clinical care. The scoring methodology was developed and reviewed by public health experts.