Missouri and the Nation Missouri Health Overview, 2004 The United Health Foundation recently released reports on the health of states across the nation. Missouri is 36th this year; it was 33rd in 2003. The state's strengths continue to include high access to adequate prenatal care with 82.9 percent of pregnant women receiving adequate prenatal care, a low rate of uninsured population at 11.0 percent and strong support for public health with 7.4 percent of the state health budget allocated to public health. Challenges for the state include a high prevalence of smoking at 27.2 percent of the population and a high rate of deaths from cardiovascular disease at 370.5 deaths per 100,000 population. Health disparities in Missouri are present, as illustrated by the differences by race for access to adequate prenatal care and premature death rates. For example, the black non-Hispanic population experiences 14,277 years of potential life lost before age 75 per 100,000 population, compared to white non-Hispanics, who lose 7,491 years. Missouri ranks 34th for the combined measures of risk factors and 40th for the combined measures of outcomes, indicating that the state should be able to reverse its decline in relative healthiness in the future. In the past year, per capita public health spending increased from $44 to $76 per person, and the infant mortality rate increased from 7.3 to 7.9 deaths per 1,000 live births. Since 1990, the prevalence in smoking has only declined from 27.7 percent to 27.2 percent of the population, a decrease much lower than in other states. The infant mortality rate has declined from 10.5 to 7.9 deaths per 1,000 live births, and the rate of deaths from cardiovascular disease has declined from 400.7 to 370.5 deaths per 100,000 population, but both of these declines are also slower than the improvements experienced nationally. The percentage of children in poverty has declined from 19.4 percent to 14.7 percent of persons under age 18. The overall rankings are based on a combination of “Risk Factors” and “Outcome Measures.” To see what these indicators are and the associated measurement data and trends for each for 1990, 2003 and 2004 see: http://www.unitedhealthfoundation.org/shr2004/states/Missouri.html State Health Rankings are intended to provide useful information for creating the environments necessary for optimal health status.