The 2023 America's Health Rankings report is out, and the news is not great for the Golden State in three very different areas.

California ranks worst among the states for high school graduation, colorectal cancer screenings and air pollution. Advocates for cleaner air blame the state's pollution problems primarily on the transportation sector.

Mariela Ruacho, clean air senior advocacy manager for the American Lung Association-California, noted the Environmental Protection Agency is currently considering strict limits on emissions from cars and heavy trucks.

"By meeting our clean air and climate goals, we will also be improving public health," Ruacho contended. "Especially for Californians who live close to highways, major roadways and warehouses."

The state has generated maps of regions with high colorectal cancer rates to promote screenings in those communities. And school districts offer counseling to help struggling students make it to graduation. The report also praised California's strong climate policies, comparatively lower rates of mental distress, and a lower percentage of people with multiple chronic health conditions.

Nationally, however, the data show eight chronic conditions have reached the highest prevalence in the report's history. They include arthritis, asthma, cancer, cardiovascular diseases, chronic kidney disease, chronic obstructive pulmonary disease, depression and diabetes.

Dr. Rhonda Randall, chief medical officer of employer and individual for UnitedHealthcare, which sponsors the report, said the research revealed some bright spots.

"The number of mental health professionals in our country increased 7%," Randall outlined. "The number of dental professionals increased 7%. The percentage of uninsured decreased by 7%. Occupational fatalities went down. Smoking is now the lowest it's been. High speed internet is the highest we've measured it."

The report also found a 13% decrease in the number of primary care physicians during the pandemic.

As the new year unfolds, rural health providers in North Dakota and other states will continue to have extra latitude in using telehealth technology. But a temporary extension of key rules still leaves uncertainty.

When Congress avoided a government shutdown in late December, it approved a funding resolution that runs through mid-March. For the next few months, that plan keeps in place relaxed telehealth regulations for people on Medicare that started during the pandemic.

Even though telehealth use has declined since the COVID emergency ended, said Brad Gibbens, deputy director of the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences, this option is still useful in remote areas.

"People can not only stay in their own community and interact with a physician or another type of provider and not having to travel," he said, "they can actually, in many cases, do this right out of their home."

He added that because these interactions are timelier, telehealth cuts down on health-care costs by reducing hospital admissions. A number of health organizations want the relaxed rules made permanent, so providers can better plan for them and patients don't lose continuity.

Telehealth access has bipartisan support, but skeptics have voiced concerns about privacy breaches and lower quality of care.

Gibbens stressed that telehealth should not be seen as a replacement for in-person visits. When the situation allows, he said, doctors still prefer having a patient come see them.

"They feel they get more of a review of the patient by seeing their body language and how they react," he said, "and it's kind of the nature of medicine."

However, Gibbens disagreed with assertions that there's a dropoff in the level of care when the visit happens online. He said that for patents in areas with very limited provider access or transportation gaps, telehealth is better than no care at all. He added that broadband investments have helped smaller clinics overcome technology barriers in enhancing online appointments.


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Holidays are traditionally a slow time for blood donations, but recent events have made the need for people to give blood and plasma in the Magnolia State even more urgent.

Following the deaths and injuries from a terrorist attack in New Orleans in the early hours of New Year's Day, Mississippi officials have pitched in to supply blood for victims of the violence. As a member of the Blood Emergency Readiness Corps, Mississippi Blood Services is supporting the efforts of the Blood Center of New Orleans.

Kasey Dickson, Mississippi Blood Services' director of public relations and marketing, said they have immediate needs.

"We are desperately looking for individuals that are eligible to donate platelets," she said, "as well as individuals with the blood types of O, negative or positive, and B, negative or positive."

Dickson said the agency is contacting its list of regular donors as well as putting out a call for new ones. Donations can be made at the blood centers in Flowood, in Cleveland and Oxford, and at mobile vans around the state. To find one, look online at MSBlood.com or call 888-90-BLOOD (888-902-5663).
Dixon said donors need to be at least 17 years old, be in general good health and complete a health history questionnaire. Approved individuals can donate about every two months, platelets every seven days, and plasma once a month.

"Fortunately, the donors of Mississippi helped get our supply ready, and we were able to ship enough products to assist the Blood Center of New Orleans ahead of time," she said. "And now, we're wanting to replenish our supply, so we can continue those efforts to help them."

Dickson said it was an honor to help another state with blood in its time of need, but added that it's equally important to care for Mississippians. She said people need to remember that blood isn't created, it's given.

"Blood itself can only be donated," she said. "It cannot be manufactured in a tube or re-created in a tube, so it has to be given from person to person."


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With the 2025 legislative session around the corner, the nonprofit advocacy group Alabama Arise said it plans to take aim at poverty and systemic challenges that hit families the hardest.

Big issues like health care access, public transportation and unfair court fines often weigh on lower-income families.

Robyn Hyden, executive director of Alabama Arise, said it is time for state leaders to step up and tackle the concerns.

"Our state, because we underfund state government and we underfund our court systems, we heavily rely on fines and fees that really disproportionately hurt low-income families and working families," Hyden contended.

Hyden believes cutting court fines and fees could be life-changing for some, freeing up money for essentials like food and health care. She highlighted the need for Medicaid expansion, removing the grocery tax and protecting voting rights as top priorities for 2025. State legislators have so far refused to expand Medicaid.

One of the most pressing issues Alabama Arise wants to see addressed is health care during and after pregnancy since the state has among the highest rates of maternal and infant mortality. A new report from Pregnancy Justice shows Alabama led the nation with 104 prosecutions of pregnant people in the year following the Dobbs decision.

Hyden stressed she wants to see an end to the state criminalizing pregnancy-related issues and instead, improving access to prenatal care.

"We don't think that women should be prosecuted because they have a miscarriage," Hyden emphasized. "We believe that health care providers should be able to provide lifesaving care to women in those situations. And we believe that when women are given drugs during labor, which does happen, they should not then be incarcerated or have their children removed."

The legislative session begins in February. Hyden added Alabama Arise is planning an advocacy day in March to unite voices in support of low-income and working families.