A new report from the Colorado Center on Law and Policy suggests “housing, food programs, and health care for impoverished and minority Coloradans” is the reason for medical declines among the state’s residents.

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They describe this as the “lottery of life” — referring to where you’re born, where you attend school, where you live and play, and other factors determined primarily by income. Those with more money are healthier; those with less are not.

When parents are working two or three jobs and are infrequently home, evening meals may be fast-food selections, rather than nutritious home-cooked meals. In those situations, no one’s around to supervise kids and stop their unhealthy behaviors, such as sitting in front of the television, smoking, using drugs, consuming junk food, and more.

Not mentioned are two factors not unique to Colorado: illegal immigration and legalized marijuana.

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Colorado’s illegal immigrant population is about 3.4 percent of the total state population of 5.3 million, per the U.S. Census Bureau. The Pew Research Center describes Colorado as a “relatively new” immigrant destination.

Who are these immigrants? In Colorado, the vast majority are from Mexico. Health measures, on average, are lower in Mexico than the U.S., including life expectancy and infant mortality.

The illegal immigration process is arduous. There are long journeys, border crossings, detention camps, all with other immigrants, many from Central America or elsewhere. There’s exposure to infectious diseases such as tuberculosis. All these people are heading to new homes — in Colorado, in this case.

The effects of both illegal immigration and marijuana on health in the state of Colorado were not factored into the report.

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This is a much different population of immigrants than, say, from Australia or Sweden, where legal immigrants are generally healthier and screened for communicable diseases as part of the entry process.

Colorado legalized recreational marijuana in 2012. The number of emergency room visits, particularly for children, has risen due to the inadvertent ingestion of edible marijuana. Driving while impaired is another problem, though that’s difficult to quantify due to limited means of testing.

The long-terms effects of legal marijuana are unknown. Cigarette smoking causes well-documented problems. But at one time, smoking was quite acceptable in general society. Remember advertising showing that four out of five doctors “recommended” a certain brand of cigarette?

The effects of both illegal immigration and marijuana on the health of people in the state of Colorado were not factored into the recent report and should be researched and addressed when drawing conclusions.

Related: For a Long, Healthy Life, Medicine Isn’t the Answer

Perhaps this state health trend is part of a larger overall trend for the nation. The National Center for Health Statistics released a report this week showing U.S. life expectancy has unexpectedly declined since 2014.

Chronic diseases and obesity are the main culprits. Not mentioned is Obamacare, with its increased costs and decreased access to quality health care. A government monopoly on the health care system may satisfy the politicians and bureaucrats — but it doesn’t seem to be making patients healthier.

As for Colorado, it’s not the rugged, pristine state it once was. Immigration, both legal and illegal, is changing the population. Hiking and biking in the mountains has given way to getting high. As in all states, health care costs more and is harder to find.

The Rocky Mountain high health ratings may be coming down to earth.

Brian C Joondeph, M.D., MPS, is a Denver-based physician and writer.