Connecticut ranks as the nation’s fourth “healthiest” state, according to a new report from the United Health Foundation and the American Public Health Association.

The report, which grades states annually on 87 measures of health compiled from 28 data sources, praised Connecticut for a low premature death rate, low rates of non-medical drug use relative to other states and high rates of immunizations for both children and adults.

Knocks against the state included high income inequality, high rates of asthma and a high percentage of housing with lead risk.

"When we look at Connecticut, it's a very positive story," said Dr. Ravi Johar, chief medical officer of UnitedHealthCare. "Connecticut is doing fantastic, and in a lot of areas they're actually ranked No. 1 in the country: childhood immunizations, dental visits, climate policies."

Dr. Manisha Juthani, Connecticut's public health commissioner, said she was pleased with the state's standing in the report but saw room for improvement in addressing inequity between wealthy residents and poorer ones.

"It is a good feeling that the positive things that are happening in the state are recognized in such a ranking," Juthani said. "But I do think it also does highlight the disparities that do exist in our state, and I think that is our that is our challenge as a health department and as a state."

Connecticut's relatively strong marks in the new report come amid concerning signs for the United States as a whole. According to the report, chronic conditions including arthritis, depression, diabetes, asthma, cancer, cardiovascular diseases all reached their highest level since the United Health Foundation began tracking, with large demographic disparities in each category.

Additionally, the rate of premature death rose 9 percent year-over-year, reaching a new high, as drug deaths, firearm deaths and homicides all increased.

"We've been looking at this for 34 years now, and unfortunately what we see is that America's health has really never been worse than it is right now," Johar said. "It's kind of shocking, in a way."

According to the Centers for Disease Control and Prevention, life expectancy nationwide dropped in 2020 and 2021 before rising again only slightly in 2022.

Connecticut hasn't been entirely immune to these trends, the United Health Foundation and American Public Health Association report shows. Like the U.S. as a whole, the state has seen increases over time in many types of chronic disease, though premature death dipped slightly in Connecticut even as it rose nationally.

Juthani said the rise increase in chronic disease could owe in part to people skipping preventative visits during the COVID-19 pandemic.

"A lot of this is getting back to basics, back to basic preventative health care, back to basic public health interventions," she said.

As is the case elsewhere, lower-income Connecticut residents had higher rates of chronic illness than wealthier groups, according to the new report. But Ayesha Clarke, executive director of the Hartford-based nonprofit Health Equity Solutions, notes that the report didn't include data on racial disparities, which are often stark in Connecticut and nationally.

"Yes we are [among] the healthiest, but I would love to see how we measure up if we were to dig deeper into the data," Clarke said in an email.

Connecticut's fourth place ranking matched its finish in last year's report. The state has previously ranked as high as No. 2 (in 2006 and 2008) and has placed in the top 10 in every version of the report since 1992.

This year, New Hampshire, Massachusetts and Vermont topped the rankings of healthiest states, while Louisiana, Mississippi, Arkansas, Oklahoma and Alabama were least healthy.

A separate United Health report this fall found that Connecticut ranked eighth among states in women's and children's health, with strong grades in prenatal care and childhood immunization but poor marks in unemployment among women and federal assistance coverage for eligible young children.