In every state across the country, adults who have not completed college are more likely to be in "less than very good" health, a new report from the Robert Wood Johnson Foundation Commission to Build a Healthier America finds. Moreover, the report found that adults in every state fall far short of the level of good health that should be achievable for all Americans.

According to Reaching America's Health Potential Among Adults: A State-by-State Look at Adult Health (24 pages, PDF), 45 percent of all U.S. adults between the ages of 25 and 74 reported being in less than very good health. The rate varied widely across the states, from a high of 53 percent in Mississippi to a low of 35 percent in Vermont, and also varied depending on level of education. For example, adults who had not graduated from high school were more than two and a half times as likely to be in less than very good health as college graduates, while those who had graduated from high school but did not attend college were nearly twice as likely to be in less than very good health as college graduates.

The largest health gap by education was found in California, where 48 percent of all adults reported that they were in less than very good health, compared with only 28 percent of adults who graduated from college, while the smallest gap was found in Delaware. Although racial and ethnic minorities were more likely to report being in less than very good health, differences in health status by education level were still seen within every racial and ethnic group.

The report also established a national benchmark for adult health, examining the best level of health achieved in any state among college-graduate adults who also have healthy behaviors. That benchmark rate was found in Vermont, where the rate of less than very good health was only 19 percent among college graduates who exercise and do not smoke. Comparing rates in every state against the benchmark revealed that adults at every education level and in every racial and ethnic group are not as healthy as they could be.

"Access to affordable, high-quality medical care is essential, but that alone will not improve the health of all Americans," said commission co-chair Alice M. Rivlin. "What this report tells us is that education has a tremendous impact on how long and how well we live. Policy makers need to focus on schools and education, as well as promoting healthier homes, communities, and workplaces, to improve the health of our nation."