Kentucky again 43rd in America’s Health Rankings, scoring lowest in behavior and health outcomes, high in having a care provider

By Melissa Patrick
Kentucky Health News

After not ranking states for two years due to the pandemic, America’s Health Rankings again placed Kentucky among the 10 unhealthiest states, ranking its healthiness 43rd, the same slot it had in the last rankings, in 2019.

Kentucky has found itself among the bottom 10 unhealthiest states since the rankings were first released in 1990, with the exception of 2008, when it ranked 39th.


The rankings by the United Health Foundation are meant to help state leaders determine health benchmarks that can help them inform actions as they work to improve the health of their communities.

The report examines a number of measures that influence health, broken into four categories: social and economic factors, physical environment, clinical care, behaviors, and health outcomes.

Kentucky ranked lowest, 46th, among states in the behaviors category.

Two measures in this category show that Kentucky adults don’t get enough exercise, with only 15.3% of them saying they meet the federal guidelines for exercise in the past 30 days and 30.5% saying they didn’t get any physical activity beyond their regular job in the past 30 days. For these measures, Kentucky ranked 49th and 45th, respectively.

In the same category, Kentucky continues to have some of the highest teen birth rates in the nation at 23.8 teen births per 1,000 females aged 15 to 19; the national average is 15.4. In rankings that put the highest numbers at the bottom, Kentucky ranked 45th for this measure.

Likewise, the state also continues to be a national leader in vaping and smoking, ranking 48th for adult use of electronic cigarettes and 45th for cigarettes (again, with higher numbers at the bottom). The rankings say 9.3% of Kentucky adults reported using e-cigarettes and 19.6% said they are regular smokers.

Kentucky also ranked 48th in sufficient sleep, with 39.6% of adults reporting that they get, on average, fewer than seven hours of sleep in a 24-hour period.

One of the Kentucky’s better rankings in the behavior category was 11th for fruit and vegetable consumption.

In the health outcome category, Kentucky ranked 45th. With higher numbers at the bottom, it scored in the bottom 10 states for drug deaths (49th), frequent mental distress (45th), non-medical drug use (41st), premature death (46th), frequent physical distress (48th), multiple chronic conditions (48th) and obesity (48th).

Though Kentucky ranked among the worst states in health outcomes, it does have a low prevalence of excessive drinking (fifth, with lower numbers at the top) and a low racial disparity in premature death (sixth).

In social and economic factors, the state ranked 39th, with some of its worst scores in food insecurity (42nd), adverse childhood experiences (46th), access to high-speed internet (44th) and volunteerism (46th).

The good news in this category is that Kentucky ranks fourth in the percentage of students who graduate from high school in four years and eighth in the difference between the high school graduation rates of white students and the racial/ethnic group with the lowest rate.

In the clinical-care category, where it ranked 31st, Kentucky was in the bottom 10 states for dental visits (49th), flu vaccinations (42nd) and preventable hospitalizations (47th).

Kentucky did not get any top-10 rankings in clinical care, but got top-20 rankings for its number of primary-care providers (16th), percent of uninsured population (13th), colorectal-cancer screenings (20th) and having a dedicated health care provider (13th).

The physical environment category was the state’s highest ranking, 15th, largely because it ranked first in two categories: drinking water violations and water fluoridation.

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