The United Health Foundation's America's Health Ranking is an annual report that focuses on behaviors, environment and community, public and health policy, clinical care and outcomes to provide a score that gives us a picture of the overall health of the nation. Several measures are used to determine overall health ranking. In 2013, Tennessee was ranked 42nd, up from 39th in 2012. Dr. Randy Wykoff says this is due to a change in the metrics used to calculate this year's rankings. What it suggests is that if the same metrics had been used in 2012 and 2013, Tennessee would also have been 42nd in 2012. Therefore, Tennessee only looks worse on paper, rather than being actually worse in terms of overall health. Overall health scores are based on determinants as well as outcomes. Behavioral determinants include: smoking, excessive alcohol consumption, drug-related deaths, obesity, physical inactivity, and high school graduation rate. Community and environmental determinants include: violent crime, occupational deaths, infectious diseases, children living in poverty, and air pollution. Determinants of public and health policies include: lack of health insurance, public health financing and the number of adolescents and children vaccinated. Determinants of clinical care include: accessibility to early prenatal care, availability of primary care physicians and dentists, and avoidable hospitalizations. Finally, several different results are used to determine the overall score. These include: development of diabetes, days of poor mental and physical health, health disparity, infant mortality, cardiovascular disease, cancer deaths, and premature deaths. These measures are weighted according to three criteria. These criteria are: 1) W...... middle of paper ......ears, obesity data from 2012 and 2013 cannot be compared with data from previous years due to the difference in the measurements used to calculate the data. And third, given that heart disease has historically been the leading cause of death in the United States, I believe this is the third major health problem that Tennessee, along with most other states, will experience. that we will face over the next decade. There was a large increase in the percentage of people diagnosed with heart disease in Tennessee between 2012 and 2013, from 5% to 7.2%, and although heart disease data from before 2012 cannot be compared At current data, there was still a large increase between 2012 and 2013. In summary, I believe that an increasing number of children living in poverty, obesity and heart disease are the three main health problems facing the Tennessee will face over the next decade..