By Erica Solvig
The Cincinnati Enquirer

While some health conditions in Ohio have improved, the state has slipped to 27th from 18th since 1990 in a national ranking of public health measures for 2002.

The annual study, by the UnitedHealth Foundation, ranks states on 17 factors that influence public health, including smoking rates, infant mortality, lack of health insurance and high school graduation rates.

STATE RANKINGS

• How the states stack up in the 2002 UnitedHealth Foundation report: OVERALL RANKINGS: 1. New Hampshire 2. Minnesota 3. Massachusetts 4. Utah 5. Connecticut 22. Indiana 27. Ohio 39. Kentucky 49. Mississippi 50. Louisiana IN THE PREVALENCE OF SMOKING: 46. Indiana 47. Ohio 50. Kentucky IN CANCER DEATHS: 40. Ohio 46. Indiana 49. Kentucky IN INFANT MORTALITY: 10. Indiana 29. Kentucky 37. Ohio

While Ohio improved in several categories, it fell in rankings in part because it failed to improve as much as other states, especially in smoking rates and other social measures.

Indiana ranked highest in the Tristate, coming in at 22nd. That was thanks to a more moderate mix of scores on several health risk factors.

Kentucky, which ranked poorly in 1990, moved only two spots since then to 39th. It has the nation's highest smoking rate - 30.9 percent of the population - which influenced the number of cancer deaths, risk of heart disease and other premature death measures.

Improving individual health choices is key to improving the rankings, some say.

"Hospitals are seeing a lot of patients coming with preventable diseases, and a lot of these are obesity or smoking-related illnesses," said Tiffany Himmelreich, an Ohio Hospital Association spokeswoman. "It's not that patients are making unhealthy choices on purpose. They just need to learn what their healthy choices are."

That includes more exercise and healthier eating, experts say. High smoking rates also continue to plague Ohio and Indiana.

Among the challenges:

The Tristate is above average in the percent of people at high risk of heart disease. Kentucky is 20 percent above national average, and ranked 47th in the category.

Ohio and Kentucky continue to have high numbers of cancer deaths. Ohio came in 40th and Kentucky ranked 49th.

High school graduation rates, the number of children in poverty and the lack of health insurance also factored into the area's overall rating.

But there was some good news for the Tristate.

Ohio was ranked eighth in prenatal care, providing care to 81 percent of pregnant women. Kentucky was ranked 11th in the category, with 80.2 percent of pregnant women getting care. Indiana ranked 31st.

The UnitedHealth report showed a 15.5 percent improvement in the nation's overall health since 1990, but a .9 percent decline since last year.

The state-by-state rankings look at 17 health measures, based on the most recent data available.

Some of the factors, such as infectious diseases, are based on averages of several years worth of data.

E-mail esolvig@enquirer.com