Dr. Robert N. Golden: Why is Wisconsin dropping in national health rankings?

May 16, 2019 GMT

We are thrilled when our favorite Wisconsin sports teams rise in the national rankings. But we might not be paying attention to other really important national rankings in which Wisconsin is moving in the wrong direction.

Wisconsin’s health ranking has dropped dramatically over the past quarter century, sliding from the top 10 states in the nation down to the 20s. And as recently reported in the Wisconsin State Journal, our state’s per-student spending on higher education had one of the largest declines in the country between 2013 and 2018 (only Oklahoma, West Virginia and Mississippi had worse decreases), according to a report from the State Higher Education Executive Officers Association.


Each of these rankings deserves serious attention and action. Their causes are complex and the potential solutions are difficult. But some common themes emerge, because the vitally important areas of health and education are interconnected.

The UnitedHealth Foundation began ranking each of the 50 states in 1990, using metrics that have changed somewhat over the years. Among the consistent metrics, several play a large role in Wisconsin’s drop.

For example, since 1990, our state’s investment in public health has dropped from ninth best in the country to 47th place. Wisconsin now spends less than $50 per person on public health. Minnesota spends $73, Iowa $105 and North Dakota $154. Another important metric with a horrible trend is children living in poverty, which has moved from ninth to 21st in the nation.

In other areas, we are making steady progress. For example, both our cancer death rates and smoking rates are moving in the right direction. But many other states are moving ahead of us with more rapid improvement.

The scope of “public health” has evolved in the past decades. While it still includes traditional public health services, such as immunization against infectious diseases and provision of safe drinking water, it now also emphasizes the social, behavioral and broader environmental determinants of health, such as affordable housing, access to nutritious food, and safe recreational places.

Multiple studies show a very powerful link between education and health. Whether one looks at life expectancy or more specific aspects of health or disease burden, higher levels of education are associated with better outcomes. We also know that developing a well-educated and healthy population leads to economic growth and development.


From this perspective, we should be very concerned about our state’s longstanding decline in support for higher education, compared to the rest of our nation. Even in the face of ongoing financial pressures, our state leaders should resist the temptation to cut corners in supporting the full continuum of education, from preschool through college.

Public support for education should not be viewed as a financial burden, but rather as a key component for improving the economic health of our state. And by supporting education, including higher education for a competitive workforce, we will be advancing the health of the public as well as the economic health of our state.

In this era of increasingly divisive and highly polarized politics, it is important that we identify nonpartisan areas in the best interest of everyone in the state. The opportunity to live a full, healthy life is important to everyone. Investing in public health programs that address the powerful social, environmental and behavioral determinants of health — including education — is a wise investment in the economic future of our state.

Let’s encourage our elected officials to support public health programs and education, so Wisconsin can rise to the top in the national rankings that matter the most.