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IntroductionFindingsComparison With Other NationsCore MeasuresBehaviorsCommunity & EnvironmentPolicyClinical CareOutcomesSupplemental MeasuresState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaUS SummaryAppendixDescription of Core MeasuresDescription of Supplemental MeasuresMethodologyModel DevelopmentScientific Advisory CommitteeThe TeamAcknowledgementsConclusion
Lack of Health Insurance
Individuals without health insurance have more difficulty accessing the health care system, are often unable to participate in preventive care programs, and have more unmet health needs than those with health insurance. Unmet health needs may develop into more serious conditions requiring more costly treatments. Lack of health insurance often leads to emergency department visits that can be 10 times more costly than treatment in a clinic. The unmet health needs of the uninsured contribute to a 25% greater risk of mortality compared with those who have health insurance; this accounts for an estimated 18,000 excess deaths annually.
Data source: American Community Survey, 2013 to 2014 For details: www.americashealthrankings.org/ALL/HealthInsurance
Public Health Funding
Public health funding allows states to proactively implement preventive and education programs that improve health. Public health program spending represents only a small fraction of all health care spending, yet its impact can be substantial. Increased spending on public health programs is associated with a decrease in mortality from preventable causes of death. Research shows investing $10 per person per year in community-based programs proven to increase physical activity, improve nutrition, and prevent smoking or other tobacco use could save the country more than $16 billion annually within 5 years. This is a return of $5.60 for every $1 invested.
Data source: Trust For America’s Health, 2013 to 2014 For details: www.americashealthrankings.org/ALL/PH_Spending
Immunizations—Children
Early childhood immunization is a safe and cost-effective means of controlling diseases. Infants receiving recommended immunizations by age 2 are protected from 14 diseases. Routine childhood immunizations save an estimated $10 billion in direct medical costs. Health insurance plans are required to cover immunizations, and for those without insurance, there are programs that provide free vaccines for eligible children. Vaccinations have led to a 95% decrease in vaccine-preventable diseases in the last 50 years. The CDC included vaccines in the 10 greatest public health achievements of the 20th century.
Data source: National Immunization Survey, 2014 For details: www.americashealthrankings.org/ALL/Immunize
Immunizations—Adolescents
As children age, protection from some childhood vaccines begins to diminish, putting school-aged children at risk for diseases like pertussis. A TDaP booster at age 11 or 12 is needed to maintain protection against tetanus, diphtheria, and pertussis. The booster also protects those who come in contact with school-aged children, most importantly infants and the elderly. Additional vaccines protect against new diseases older children may come in contact with as children or as adults. This includes meningococcal conjugate vaccine (MCV4) that protects against meningococcal disease and HPV vaccination that protects against cervical, genital, and oropharyngeal cancers.
Data source: National Immunization Survey, 2014 For details: www.americashealthrankings.org/ALL/Immunize_teens
Immunizations, HPV Female—Adolescents
This vaccine targets the HPV types that most commonly cause cervical cancer and can cause anal, oropharyngeal, vulvar, and penile cancers.
Data source: National Immunization Survey, 2014 For details: www.americashealthrankings.org/ ALL/Immunize_teens
Immunizations, HPV Male—Adolescents
This vaccine targets the HPV types that most commonly cause cervical cancer and can cause anal, oropharyngeal, vulvar, and penile cancers.
Data source: National Immunization Survey, 2014 For details: www.americashealthrankings.org/ALL/Immunize_teens
Immunizations, MCV4—Adolescents
The meningococcal vaccine protects against the most common forms of meningococcal disease and its complications.
Data source: National Immunization Survey, 2014 For details: www.americashealthrankings.org/ALL/Immunize_teens
Immunizations, TDaP—Adolescents
Since US TDaP vaccination began, reported tetanus and diphtheria cases dropped 99%, and reported pertussis cases dropped 80%.
Data source: National Immunization Survey, 2014 For details: www.americashealthrankings.org/ALL/Immunize_teens