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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 Summaries
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
United 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
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew 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 TeamCervical Cancer Screening
Cervical cancer incidence and mortality have declined significantly in the past 40 years, largely due to increased screening that can detect cervical precancer before it turns cancerous. Still, nearly 8 million women aged 21 to 65 have not been screened in the past five years. About 12,000 US women are diagnosed with cervical cancer and about 4,000 die from it each year. All women are at risk, but it occurs most often in women aged 30 and older. Most cases occur in women who have not received proper screening. Estimates suggest that 93% of cervical cancer cases could be prevented through screening and human papillomavirus vaccination.
Percentage of women aged 18 to 44 who received a Pap smear within the past three years
Data source: Behavioral Risk Factor Surveillance System, 2013–2014 For details: www.americashealthrankings.org/ALL/cervical_cancer_screen_women
Dedicated Health Care Provider
Having a dedicated health care provider (HCP) may improve the timeliness and quality of care, lower the costs of care, and improve overall health status. A usual HCP is associated with receiving recommended screening and prevention services, as well as improvements in chronic care management for asthma, hypertension, and diabetes. Without a dedicated HCP, emergency department visits are more likely for non-urgent or avoidable problems. Women face numerous cost-related obstacles to obtaining a dedicated HCP, in addition to logistical barriers such as transportation, time off of work, and child care. Hispanic women, uninsured women, and young women report lower rates of having a dedicated HCP.
Percentage of women aged 18 to 44 who report having a personal doctor or health care provider
Data source: Behavioral Risk Factor Surveillance System, 2013–2014 For details: www.americashealthrankings.org/ALL/dedicated_HC_provider_women
Dental Visit
Periodontal disease and dental caries are common in women of reproductive age, particularly among racial and ethnic minority groups and women with low incomes. Maternal oral health can impact birth outcomes and infant oral health. Maternal periodontal disease has been associated with preterm birth, preeclampsia, and low birthweight. Oral health problems are preventable through routine visits to the dentist and good oral hygiene. Cost and dental insurance are primary predictors of access to and utilization of oral care, and poor oral health status. Fear, low oral health literacy, and limited access to and availability of dental services are other reasons adults forgo routine dental visits.
Percentage of women aged 18 to 44 who self-report having visited a dental health professional within the past year
Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/dental_visit_women
Flu Vaccine
Annual influenza (flu) vaccination is recommended for everyone 6 months and older, and is the most effective protection against influenza viruses. All women are at risk of flu-related complications such as bacterial pneumonia, bronchitis, sinus and ear infections, and exacerbation of underlying pulmonary conditions. Pregnant women have increased morbidity and mortality from flu infection, including increased risk of premature labor and delivery. Lower vaccination coverage is associated with lack of health insurance, lower education, unemployment, poverty, and fewer provider visits in the past year. Negative attitudes and misperceptions about vaccination remain major reasons for not receiving vaccination. Influenza vaccination is highly cost-effective, particularly among pregnant women.
Percentage of women aged 18 to 44 who received the flu vaccine in the past year
Data source: Behavioral Risk Factor Surveillance System, 2013–2014 For details: www.americashealthrankings.org/ALL/flu_vaccine_women
Well-Woman Visit
Annual health exams promote prevention practices, recognize risk factors, identify medical problems, and establish a strong provider-patient relationship. Annual assessments should include screening, evaluation, counseling, and immunizations based on age and risk. Significant social disparities exist in receipt of women’s health services (ie, gynecological exam, sexually transmitted infections testing and counseling, contraceptive and pregnancy-related care) and general preventive health services (ie, cholesterol check, blood pressure check, flu vaccine). Poor and unemployed women and those with lower educational attainment are the most adversely affected. Lack of health insurance is a significant barrier to accessing health services for women, with uninsured women consistently having lower utilization than those with full coverage.
Percentage of women aged 18 to 44 with a preventive medical visit in the past year
Data source: Behavioral Risk Factor Surveillance System, 2013–2014 For details: www.americashealthrankings.org/ALL/well_women_visit_women