So how's your health? And have you earned any good degrees lately?

American adults just aren't as healthy as they could be, a recent study by the Robert Wood Johnson Foundation Commission for a Healthier America found. Between 2005 and 2007, a little more than 45 percent of adults ages 25 to 74 reported being in less than very good health. And education levels seems to be a factor.

The study, Reaching America's Health Potential Among Adults: A State-by-State Look at Adult Health, found that the greatest indicator of health was education level. Nationally and on a state-by-state basis, people with higher levels of education were more likely to be healthy. Adults with a high school education were more likely to be unhealthy than college graduates. Adults who had not graduated from high school were more than three times more likely to be unhealthy than college graduates. The disparity between education level and health varied from state to state. Delaware was the best (only nine percent difference between overall adult health and overall health of adult college graduates) and California (with a nearly 20 percent difference) was the worst.

In addition to education, the other important indicators of adult health are household income level and race or ethnicity. While adults take primary responsibility for their own health, factors such as income, education level, and racial discrimination can combine to create significant environmental barriers and make it more difficult for adults to practice healthy habits. It is, for example, far more difficult to quit smoking if you are surrounded by advertising for cigarettes, and it is more difficult to get the recommended amount of physical activity if there aren't any recreational centers or safe places to walk in your neighborhood. This phenomenon is visible right here in DC, where noticeable health disparities in life expectancy exist between metro stops.

As the RWJF report demonstrates, people with knowledge and resources -- what we get through education -- can more easily access adequate care for themselves and their children, including heathy food, exercise, and regular doctor visits. The report also finds that Americans could, and should, be a lot healthier overall. When even those who have the resources to be healthier are missing the mark, it's time to take a step back and look at what's gone wrong. For health care reform to be successful, we need to change the way we think about our own health—not just fixing the problems in the system itself, but also creating a larger culture of prevention and wellness that will make all of us happier, healthier, and wealthier in the future.