A broad new study of the impacts of disease in all 50 states finds that Minnesotans live longer and healthier lives than residents of nearly any other state. However, the report finds big disparities among the states and an overall national performance that lags behind other, less developed countries that spend less on health-related costs per person.

The Institute for Health Metrics and Evaluation at the University of Washington coordinated the study, which is published in the April 10 issue of the Journal of the American Medical Association. The new study ranks Minnesota fourth overall in life expectancy behind Hawaii, California and Connecticut.

When the study compares the 50 states' life expectancy by gender, it finds Minnesota men lead the nation with a life expectancy of 78.7 years while Minnesota women rank fourth at 82.9 years. Notably, Minnesota residents overall lead the nation in healthy life expectancy (defined as years of life spent in full health) at 70.3 years.

Minnesota Health Commissioner Jan Malcolm said the new study reinforces Minnesota's reputation as a healthy state, but it also shows how much work still must be done to improve Minnesotans' health. In particular, she noted that the study provides further evidence that the burden of chronic disease is a serious and growing threat to individual and community health as well as the nation's economy. "Minnesota has a lot to be proud of and a lot to work on when it comes to public health," Commissioner Malcolm said in a statement.

Smoking was the top risk factor causing death and disability in Minnesota, according to the study. Other factors in the top five included obesity, high fasting plasma glucose, high blood pressure and alcohol use.

Low back pain was atop the list of health issues causing Minnesotans to live with years of disability, followed by depression. Study authors also cited dramatic increases in Minnesotans' disease burden due to diabetes and opioid use between 1990 and 2016.