Mississippi and Louisiana residents, according to a recent survey, are the unhealthiest in the nation. And it isn’t just about what was on the Thanksgiving table last week.

United Health Group compiled its annual survey based on factors ranging from risks for heart disease to high school graduation rate.

The statistics the study uses tie economy and education into yet another vicious circle keeping Southern states like Louisiana and Mississippi at the bottom.

Mississippi state epidemiologist Dr. Mary Currier wasn’t surprised by the findings in the United Health Group study.

&uot;They measure things other than health,&uot; she said. &uot;We know that’s where we stand on those issues.&uot;

Where Mississippi stands, according to the United Health Group survey, is at or near the bottom in several factors, not all directly related to health: heart disease, infant mortality, support for public health care and high school graduation.

Currier said economics is one of the biggest factors that keeps Mississippi’s health rating so low.

&uot;Economics is related to health,&uot; Currier said. &uot;If you live in a neighborhood where it’s not safe to walk, or if you can’t afford to go to a health club, you’re more likely to sit around the house. … And, it’s cheaper to buy a fast food hamburger than to cook healthy food.&uot;

Currier said the Mississippi Department of Health tries to stress that health care is not just influenced by a visit to the doctor.

&uot;The chronic disease division of our office is working with communities to facilitate things like walking trails,&uot; she said. &uot;It’s more than just doctor/patient – there has to be community involvement.&uot;

Across the river in Louisiana, Dr. Jimmy Guidry of the Department of Health and Hospitals isn’t surprised by the survey that puts his state second to last in the nation in terms of unhealthy residents.

But Guidry, who said he tries to look at such studies with an optimistic eye toward improvement, said Louisiana and Mississippi are improving – they are just improving at the same rate that other states are.

&uot;In ranking you seem to stay the same,&uot; he said. &uot;We’re not improving any faster than the previous folks. It’s a long-term effort.

&uot;What I try to do is look at those states that improve and see what they’ve done,&uot; Guidry said. &uot;What programs over there are making a difference?&uot;

Among the worst posted statistics for both states:

— Infant mortality. Mississippi is 49th, Louisiana 47th. Surprisingly, though, both states rank much higher in adequacy of prenatal care, a factor often related to infant mortality. Currier said one simple demographic can be attributed to the high rate of infant mortality: the ratio of black to white residents. Nationwide, she said, infant mortality is higher among blacks. And Mississippi has a high black population.

&uot;It’s a surrogate for economics,&uot; she said, pointing out that the statistic does not have to do with race but with, once again, money.

— High school graduation. Mississippi ranks 47th, Louisiana 48th. High school graduation rate figures into a health survey because statistics show people with more education – and therefore, often more money – pay more attention to their health, Currier said.

Guidry said Louisiana is trying to improve its graduation rate and its rate of students attending college by offering tuition incentives and increasing the education budget.

Still, &uot;that’s going to take a long time to turn around,&uot; he said of the graduation rate statistic.

— Risk for heart disease. Mississippi is 48th, and Louisiana ranks 41st.

Currier said the risk traces back to the Southern diet of heavy, fried foods. &uot;It’s a cultural thing,&uot; she said.

But it is also tied to economics, in some ways, since unhealthy foods tend to be cheaper and quicker, and access to good, preventive health care is limited when people lack income.