Minnesota ranks best in the U.S. in child, women's health despite disparities, stress

Minnesota is top-ranked among U.S. states for the health of women and children, despite rising stress, racial disparities and a bit of a drinking problem.

United Health Foundation's annual ranking raised particular concern about increasing stress and anxiety in all states, including Minnesota, where 19.7% of young adult women reported frequent mental distress in 2019-2020. That was an increase from 12.2% five years earlier, according to the report released Wednesday morning.

Comparable increases in child depression and anxiety prompted the Minnetonka-based foundation to announce $3 million in pilot funding for programs in middle schools in Minnesota, North Carolina and Florida that increase mental health awareness and reduce stigma.

"Rates are rising and we know that the majority of mental health issues first present at a very, very young age," said Alison Malmon, executive director of Active Minds, a nonprofit mental health awareness and suicide prevention program that will participate in the funding initiative. "We cannot be waiting until people are adults or even until their 20s to be talking about mental health."

United Health's report was a mixed bag of news as always for Minnesota, which had ranked in the top 10 in prior years. The report collates the latest health data from various government and health sources into composite state rankings. United Health publishes similar reports for seniors and the population as a whole.

Minnesota's top state ranking this year was buoyed by the above-average levels of physical activity and sleep among women and children. The state also posted some of the nation's lowest levels of illicit drug use and high blood pressure in women and of asthma, obesity and low birthweights in children.

The state's biggest weakness was the nation's worst racial disparity in high school graduations and the third-worst racial disparity in child poverty.

"All states have their strengths and all states have their opportunities where they can improve," said Dr. Rhonda Randall, a chief medical officer of United Health's employer and individual commercial insurance programs.

Nearly one in four female adults in Minnesota reported excessive drinking, ranking the state fifth-worst on that measure. Excessive is defined as four drinks in one episode among women in the past 30 days, or eight or more drinks per week. Wisconsin had the nation's worst ranking, with Iowa close behind.

Trends offer context behind the rankings. Minnesota improved its ranking since 2019 through reductions in the rate of teen births and the percentage of children who are overweight or obese.

The worsening mental health rates drew concern, though, and were only partly explained by the stress and isolation of the COVID-19 pandemic. The latest data for frequent mental health distress in women 18 to 44 was based on 2019-2020 survey results, reflecting only the outset of the pandemic.

The percentage of Minnesotans age 3 to 17 reporting depression rose from 3.3% in 2017-2018 to 4.1% in 2020-2021, the report showed. Minnesota had the 18th-lowest rate of child depression in the most recent two-year period, which was mostly during the pandemic.

"It's going to take several more years to see the full impact of the COVID-19 pandemic in this data," Randall said.

The United Health funding will expand Active Minds programs primarily from high schools into middle schools, arming them with the knowledge about how to identify and respond to mental health concerns among peers.

Most children who are struggling "tell a friend before they tell anybody else," Malmon said. "We have an opportunity to make change for each other, simply by knowing the right words to say."