The American Public Health Association, Partnership for Prevention and United Health Foundation are pleased to present the 20th Anniversary Edition of America`s Health RankingsTM: A Call to Action for Individuals and Their Communities. The longest running report of its kind, America`s Health RankingsTM presents a unique historical and comprehensive view of the health of the nation and an annual ranking of the healthiness of each state.

The inclusion of prevention in a discussion of our nation`s health system stands as a departure from the status quo. Although there is a wealth of evidence supporting the value of prevention as both a way to save money and save lives, the overwhelming majority of every health dollar goes toward treating illness, leaving very little to work with to prevent those illnesses from occurring. This disproportionate allocation of resources is particularly shortsighted when one considers that the leading causes of death and disability in the United States are chronic diseases-like heart disease, cancer and diabetes-that are largely preventable.

This year`s report again documents a persistent stagnation in improving the nation`s healthiness. While the health care system has made notable progress in treating disease, we continue to fall short in the important work of preventing disease and premature death. For example, cardiovascular death rates are declining, but the incidence of the risk factors for cardiovascular disease is increasing at an alarming rate. The consequences of an increasing number of people becoming ill with a chronic disease, combined with medical interventions that permit them to live with their disease, will inevitably result in economic consequences that our society cannot possibly sustain. America`s Health RankingsTM provides compelling evidence of the need for much greater attention to health promotion and disease prevention by all segments of our society. America`s Health RankingsTM has evolved from a print-only publication to a multi-media effort to stimulate local actions and informed discussion on critical issues. As in previous years, this report benefits from the insights of distinguished national health leaders. We hope their thoughts will stimulate change and showcase innovative models. Contributors include:

• Brian D. Smedley, Director, Health Policy Institute, Joint Center for Political & Economic Studies
• Deborah Deatrick, Vice President, Community Health, MaineHealth and Andrew Coburn, Professor and Director, Population Health and Health Policy, Muskie School of Public Service, University of Southern Maine
• Richard Hofrichter, Senior Analyst, Health Equity, National Association of County & City Health Officials
• Andrew Webber, President and CEO, National Business Coalition on Health
• Pam Silberman, President and CEO, North Carolina Institute of Medicine and Elizabeth Walker, Project Coordinator, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill

America`s Health RankingsTM is governed by a scientific advisory committee, comprised of leading public health scholars charged with maintaining and strengthening the report`s methodological framework. We appreciate the leadership of Thomas Ricketts, Ph.D., who chairs the Committee and who serves as a Professor of Health Policy and Administration at the University of North Carolina. In addition, we want to recognize the dedicated efforts of public health, clinical and health policy professionals who work tirelessly every day on behalf of the people of this country.

An important element of the 2009 Report is the launch of an enhanced web site: www.americashealthrankings.org. In addition to finding 20 years of data for your perusal, you will also find the Healthy Actions Center which highlights resources for actions that can be taken to improve individual and community health. We invite you to share your ideas with us by emailing info@unitedhealthfoundation.org. If ever there was a time to work together to enhance the health of the nation, that time is now!