Wisconsin Versus Minnesota: A Border Battle for the Healthiest State

Measuring and ranking the health of counties helps raise awareness of health disparities based on where people live. Recently, there has been increasing interest in comparing the health of counties across state lines, to potentially measure the impact of local and state-level policies.

The counties in Minnesota (n = 87) and Wisconsin (n = 72) were combined into a single 2-state region, and all 159 counties were ranked according to the County Health Rankings methods, with summary ranks for health outcomes and health factors. Multivariable regression analysis was then used to examine the potential impact of state-based programs and policies on health outcomes.

Minnesota was healthier overall than Wisconsin, with lower rates of premature death and better quality of life. Minnesota also performed better than Wisconsin for all 9 health behavior measures, 4 of 7 clinical care measures, 7 of 8 social and economic factors, and 3 of 5 physical environment measures. Furthermore, counties in Wisconsin were more likely to have lower (worse) ranks than counties in Minnesota for both health outcomes and health factors, as well as for the subcategories that make up these summary ranks. Regression analysis showed that Minnesota’s better health status was explained primarily by healthier behaviors and more desirable social and economic factors.

Minnesota’s better health outcomes are largely explained by better social, economic, and behavioral factors. These findings suggest a need for examination of policies and strategies that may be influencing the observed differences across these 2 states.