Jeffrey D. Allred, Deseret News
Tom Swanson bikes on the Bonneville Shoreline Trail Tuesday in Salt Lake City in the nation's second-healthiest state.

If you worked out, took the stairs, ate an apple or chose water over soda for lunch Tuesday, yours were among the millions of daily choices Utahns make to rank as the second healthiest state in the nation.

New data released in the United Health Foundation's 20th annual America's Health Rankings rate the Beehive State second only to Vermont in a broad measure of health and overall physical well-being. Utah ranked fifth last year, so the newest rating is a significant boost, health officials said.

The yearly report credited Utah with the lowest rates in the nation for smoking, cancer deaths, infant mortality and binge drinking, but found the availability of primary care physicians here limited compared with other areas.

It also noted a high "geographic disparity" regarding access to health services for those in remote rural areas, and cited a low rate of funding for public health as significant health challenges.

Utah's ranking was a pleasant surprise to health officials, who often deal with both the results of poor health choices and a relatively large gap in funding for public health programs.

Utah's spending was $60 per person for public health last year, compared with a national average of $94 per person and $150 per person in Vermont.

Dr. David Sundwall, executive director of the Utah Department of Health, said he was surprised and pleased by the jump in rank.

"It's obviously a continuation of a cultural predisposition to healthy behaviors, and I'm grateful to have people living here who care about their health," he said.

Sundwall was particularly pleased that the boost "comes at a time when the state is increasingly diverse."

"We can't just say anymore that those white Mormons are healthy people," he said. "We have to assume some of these improvements are due both to public health practices and state policies," including a legislative mandate that children in Utah who meet the income guidelines qualify for government-funded health insurance.

Dr. Elizabeth Joy, a family and sports medicine physician at the University of Utah, said she was a bit surprised by Utah's high ranking as well, though "there are a lot of really good things about the lifestyle here that provide us with good health as a state."

Though Utah's rate of obesity continues to increase at about the same rate as the rest of the nation, "we have a lower rate overall and a much lower rate than some parts of the nation, especially in the Southeast," Joy said.

Sundwall said he takes no comfort in the fact that Utahns were fifth best in the nation in the percentage of obese residents, noting 23 percent of Utahns still fall into that category.

"We are not yet getting fat as fast as the rest of the nation is," he said. "However, we are on a quick track of getting there."

Health promotion will continue to be needed, particularly among young people, Joy said. She's hoping to see a bill introduced during the upcoming legislative session that will restrict the vending machine choices available in the state's middle schools.

"Fat kids and fat adolescents become fat adults," she said. "If you're fat as a kid, your risk of obesity as an adult is almost guaranteed. It's a habitual as well as a physiological change that occurs as a result of the environment our bodies are exposed to."

The report praised Utah for its efforts in preventing infant mortality, noting the state's rate has dropped by 45 percent over the 20 years the health rankings report has been published. It also noted the decreasing rate of uninsured residents.

Utah has consistently ranked among the top 10 healthiest states in the 20 years the report has been published.

For more information, see the report at www.americashealthrankings.org or www.unitedhealthfoundation.org.