Arkansas’s Ranking Unchanged as 48th Healthiest State for 4th Consecutive Year

The 2024 America’s Health Rankings report, released Tuesday, Jan. 28, by the United Health Foundation, ranks Arkansas as the 48^th healthiest state in the nation, the same position the state held in the past three years’ reports. Arkansas’s highest-ever ranking in the annual report was 40^th, its position in the 1993 and 2009 installments, and its lowest-ever ranking was 49^th, which it received in the 1998, 2013, and 2014 reports. This is the 35^th year the report has been released.

State summaries included in the report analyze 53 distinct measures across five categories of health— social and economic factors, physical environment, clinical care, behaviors, and health outcomes — with the objective to inform and drive action to build healthier communities. Arkansas is ranked below the national average on 36 of the 53 measures in the state summary. Despite low rankings in many categories, Arkansas scored higher than the national average on 12 of the measures and tied with the national average on one measure. The report does not provide a national average for four of the measures.

The “Key Findings” section of the Arkansas summary highlights four measures that have seen statistically significant changes in recent decades, either for better or worse. Among the improved measures is the state’s uninsured rate, which fell by 25% between 2014 (11.8%) and 2023 (8.9%). Arkansas was the first Southern state to expand Medicaid coverage under the Affordable Care Act — implemented through the state’s innovative premium assistance model — which  increased insurance coverage among low-income adults and helped to stabilize Arkansas’s rural hospitals.

Arkansas’s adult smoking rate decreased by 39% between 2014 (24.7%) and 2023 (15%). Continued investments in tobacco cessation programs have contributed to reduce smoking rates. As we noted in another post, Arkansas received an improved grade for tobacco cessation efforts in the 2025 State of Tobacco Control report by the American Lung Association. That report attributed the improved grade to the state increasing its investment in cessation services, which was estimated at $1.93 per smoker in last year’s report and $3.75 per smoker in the 2025 report.

The 2024 America’s Health Rankings report highlights worsening trends in Arkansas for two important measures. The state’s homicide rate rose from 7.6 deaths per 100,000 people in 2011-2102 to 11.2 deaths per 100,000 people in 2021-2022, a 47% increase. The report also notes that the percentage of adults reporting frequent mental distress increased by 35% between 2014 (14%) and 2023 (18.9%). ACHI recently launched a dashboard exploring the data on acute behavioral health events with the aim of helping policymakers, healthcare providers, and community leaders better understand the state’s behavioral health landscape and explore opportunities to improve care.

Northeastern states New Hampshire, Vermont, and Massachusetts rank, as the first, second, and third, respectively, healthiest states in the U.S., while Southern states Louisiana (50^th), Mississippi (49^th), and Arkansas (48^th) rank as the states with the most opportunity for improvement.

This year’s report also ranks states according to the U.S. Census Bureau’s Economic Hardship Index, defined as, “an index of…economic conditions based on crowded housing, dependency, education, income, poverty and unemployment.” Values range from 1 to 100, with higher values representing poorer economic conditions. The report gives Arkansas an Economic Hardship Index value of 88 and a ranking of 44^th among the states in this measure, with the first-ranked state being the state with the least economic hardship.

The report also includes maps indicating variations between counties’ Economic Hardship Index values. Notably, only a few counties in Arkansas, primarily in the central and northwestern parts of the state, have relatively low levels of economic hardship.