A national health advocacy group has once again put Nevada near the bottom of its ranking of states for overall health.
UnitedHealth Group, a Minneapolis-based health maintenance organization, placed Nevada 45th out of all states for the health of its residents. In the 11 years the company has published its annual study, Nevada has placed near or at the bottom.
The nadir for Nevada came in 1996, when the state placed dead last. The best showing came in 1992, when the state was 43rd. In 1990, the first year of the ranking, Nevada came in at 46th.
The latest study said factors contributing to the relative ill health of Nevadans include high prevalence of smoking, lack of health insurance, incidence of infectious diseases and premature death.
Among all factors the study gives the incidence of smoking the highest weight.
''We're not going to move out of the bottom until we reduce our smoking rate,'' said said Dr. Mary Guinan, state health officer for the Nevada Health Division.
The federal Centers for Disease Control reported Nov. 2 that Nevada has the highest rate in the country, with 31.5 percent of the population smoking. In contrast, Utah had the lowest rate, with 13.9 percent smoking, and came in third overall in the health rankings this year.
Guinan said the prevalence of smoking can be tied to other substance abuse problems, and the combination contributes to a poor showing in other areas of the health ranking.
The state ranked 47th worst in the nation for prenatal care, defined in the study by visits by expectant mothers to doctors. Guinan said pregnant women who smoke or abuse drugs or alcohol are less likely to visit a doctor, even though government and private-sector programs exist to help them.
The state health division is studying why pregnant women avoid trips to the doctor and how to encourage them to make those visits, Guinan said.
She said the state also is working to increase access to health care and health insurance for everyone, particularly children.
A big part of the problem is that parents usually don't think about the need for insurance for children except when they are sick, Guinan said.
One improvement for the state's young people and infants: the teen pregnancy rate, highest in the nation in 1997, dropped to fourth in the nation by last year, Guinan said.
