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Executive SummaryIntroductionExplore the Health of Women, Children and InfantsFindingsThe Health of Women and Children between StatesThe Health of Women and Children within StatesHealthy Communities for ChildrenClinical Preventive Services for ChildrenRacial Disparities in Measures of MortalityVariations in SmokingMeasures of Women's HealthBehaviors | Measures of Women’s HealthCommunity & Environment | Measures of Women’s HealthPolicy | Measures of Women’s HealthClinical Care | Measures of Women’s HealthOutcomes | Measures of Women’s HealthMeasures of Infants' HealthBehaviors | Measures of Infants’ HealthCommunity & Environment | Measures of Infants’ HealthPolicy | Measures of Infants’ HealthClinical Care | Measures of Infants’ HealthOutcomes | Measures of Infants’ HealthMeasures of Children's HealthBehaviors | Measures of Children’s HealthCommunity & Environment | Measures of Children’s HealthPolicy | Measures of Children’s HealthClinical Care | Measures of Children’s HealthOutcomes | Measures of Children’s HealthState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaUnited StatesAppendixData Sources and Measures of Women’s HealthData Sources and Measures of Infants’ HealthData Sources and Measures of Children’s HealthMethodologyModel DevelopmentAmerica’s Health Rankings® Health of Women and Children Steering GroupThe Team

Child Mortality

US infant and child mortality has declined consistently for decades, while mortality rates among adolescents and young adults (aged 15 to 24 years) have declined only modestly. Yet, the United States has the 6th highest overall youth mortality rate of any industrialized country. Accidents are the leading cause of death among all youth aged 1 to 19. The three most common types of accidents in this age group are motor vehicle traffic (54% of unintentional injury deaths), drowning (13%), and poisoning (10%). Other common causes of child mortality are congenital malformations, homicide, suicides, and cancer.

Number of deaths per 100,000 children aged 1 to 18 years

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Data source: National Vital Statistics System, 2012–2014 For details: www.americashealthrankings.org/ ALL/child_mortality



Missed School Days

Children’s health and education are inextricably linked with long-lasting implications throughout the lifespan. School attendance is a key component of academic performance and missed school days have consistently been associated with worse academic outcomes. Chronic absenteeism and the resulting lower academic performance contribute to the widening achievement gap in US schools. Educational disparities and health disparities tend to affect the same low income and racial minority subgroups. Community, family, and child health factors such as asthma, overweight or obesity, poor oral health, hunger, and depression can cause missed school days. Students who miss more school are more likely to engage in risky behaviors such as tobacco, alcohol, and illegal drug use.

Percentage of children aged 6 to 17 who missed 11 or more days in the past school year (homeschooled children excluded)

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Data source: National Survey of Children’s Health, 2011–2012 For details: www.americashealthrankings.org/ ALL/missed_school



Teen Births

There are substantial health, social, and economic costs associated with teen pregnancy and childrearing. Teen mothers are significantly more likely to drop out of high school and face unemployment; their children are more likely to have worse educational, behavioral, and health outcomes than children born to older parents. Fortunately, the teen birth rate has declined 61% since 1991 and hit a US historic low in 2014 at 24.2 births per 1,000 females aged 15 to 19. Despite these declines, the teen birth rates for Hispanics and non-Hispanic blacks are more than two times higher than the rate for non-Hispanic whites.

Number of births per 1,000 females aged 15 to 19 years

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Data source: National Vital Statistics System, 2014 For details: www.americashealthrankings.org/ALL/ TeenBirth_MCH



Teen Suicide

Suicide is the second leading cause of death among adolescents aged 15 to 19. Suicide rates among males are higher than among females, but females have a higher attempt rate than males. Far more adolescents have suicidal thoughts or attempt suicide and survive than those who die by suicide. Firearms are the most common method of death by suicide in youth. Risk factors for suicide in adolescents include psychiatric disorder, psychiatric comorbidity, family history of depression or suicide, loss of a parent to death or divorce, physical and/or sexual abuse, and lack of a support network and feelings of social isolation.

Number of deaths by suicide per 100,000 adolescents aged 15 to 19 years

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Data source: National Vital Statistics System, 2012–2014 For details: www.americashealthrankings.org/ALL/ teen_suicide