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North Dakota Value:
Percentage of women ages 18-44 who reported their mental health was not good 14 or more days in the past 30 days
North Dakota Rank:
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Percentage of women ages 18-44 who reported their mental health was not good 14 or more days in the past 30 days
US Value: 21.0%
Top State(s): Hawaii: 15.5%
Bottom State(s): Arkansas: 28.7%
Definition: Percentage of women ages 18-44 who reported their mental health was not good 14 or more days in the past 30 days
Data Source and Years(s): CDC, Behavioral Risk Factor Surveillance System, 2020-2021
Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
A healthy mental state is essential to positive health and well-being. Frequent mental distress aims to capture the population experiencing persistent and likely severe mental health issues, defined by 14 or more days of poor mental health a month. A strong relationship exists between the 14-day period and clinically diagnosed mental disorders, such as depression and anxiety.
Populations suffering from severe mental illness and frequent mental distress have a higher prevalence of risky health behaviors, including smoking, alcohol use, unhealthy diet and lack of physical activity. These health behaviors increase the likelihood of developing chronic diseases like diabetes, cancer and cardiovascular disease. Chronic stressors like housing insecurity, food insecurity and insufficient sleep are also related to frequent mental distress. In severe cases, poor mental health can lead to suicide, one of the leading causes of death in the United States.
Poor mental health can lead to costly treatments and missed economic opportunities. In 2009 the direct costs of mental health disorders among women totaled nearly $85 billion, with over $20 billion spent on depression-related care. Among pregnant women and their children, untreated perinatal mood and anxiety disorders cost the U.S. roughly $14 billion.
According to America’s Health Rankings data, the prevalence of frequent mental distress is higher among:
Although occasional short periods of mental distress and a few poor mental health days may be unavoidable, more prolonged and severe episodes are treatable and potentially preventable through early intervention. School-based programs can improve students’ mental health through direct (e.g., counseling) or indirect interventions (e.g., anti-bullying campaigns). Parity laws that expand and protect insurance coverage for mental health care are associated with lower out-of-pocket costs, lower suicide rates and increased utilization of health care services. Collaborative care models, which connect primary care providers and mental health specialists, are also effective in managing depressive disorders.
Continued monitoring of frequent mental distress trends may help identify unmet social and mental health needs and inform future interventions. The Centers for Disease Control and Prevention has a resources page for mental health, including a mental health services locator.
Healthy People 2030 has several objectives related to mental health, including:
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Massetti, Greta M., Cheryll C. Thomas, Jessica King, Kathleen Ragan, and Natasha Buchanan Lunsford. 2017. “Mental Health Problems and Cancer Risk Factors Among Young Adults.” American Journal of Preventive Medicine 53 (3 Suppl 1): S30–39. https://doi.org/10.1016/j.amepre.2017.04.023.
Robson, Debbie, and Richard Gray. 2007. “Serious Mental Illness and Physical Health Problems: A Discussion Paper.” International Journal of Nursing Studies 44 (3): 457–66. https://doi.org/10.1016/j.ijnurstu.2006.07.013.
Slabaugh, S. Lane, Mona Shah, Matthew Zack, Laura Happe, Tristan Cordier, Eric Havens, Evan Davidson, Michael Miao, Todd Prewitt, and Haomiao Jia. 2016. “Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days.” Population Health Management 20 (1): 13–22. https://doi.org/10.1089/pop.2015.0162.
Wood, Susan F., Avi Dor, Rebekah E. Gee, Alison Harms, Richard Mauery, Sara Rosenbaum, and Ellen Tan. 2009. “Women’s Health and Health Care Reform: The Economic Burden of Disease in Women.” The Jacobs Institute of Women’s Health, George Washington University School of Public Health and Health Services. https://hsrc.himmelfarb.gwu.edu/sphhs_policy_facpubs/271/.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.