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IntroductionExecutive SummaryFindingsOverviewState RankingsSuccessesChallengesVariations in Mortality MeasuresVariations in the Number of Health Care Providers Between and Within StatesHealth EquityComparison with Organization for Economic Cooperation and Development NationsCore MeasuresBehaviorsCommunity & EnvironmentPolicyClinical CareOutcomesSupplemental MeasuresBehaviorsCommunity & EnvironmentPolicyClinical CareOutcomesState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS SummaryAppendixData Sources and MeasuresMethodology2017 Model DevelopmentScientific Advisory CommitteeThe TeamConclusion
Behaviors
Drug Deaths
Age-adjusted number of deaths due to drug injury of any intent (unintentional, suicide, homicide or undetermined) per 100,000 population
Centers for Disease Control and Prevention (CDC), National Vital Statistics System, 2013-2015
Excessive Drinking
Percentage of adults who reported either binge drinking (having four or more [women] or five or more [men] drinks on one occasion in the past 30 days) or chronic drinking (having eight or more [women] or 15 or more [men] drinks per week)
CDC, Behavioral Risk Factor Surveillance System, 2016
High School Graduation*
Percentage of high school students who graduate with a regular high school diploma within four years of starting ninth grade (ACGR)
U.S. Department of Education, National Center for Education Statistics, 2014-2015
Obesity
Percentage of adults with a body mass index of 30.0 or higher based on reported height and weight
CDC, Behavioral Risk Factor Surveillance System, 2016
Physical Inactivity
Percentage of adults who reported doing no physical activity or exercise other than their regular job in the past 30 days
CDC, Behavioral Risk Factor Surveillance System, 2016
Smoking
Percentage of adults who are smokers (reported smoking at least 100 cigarettes in their lifetime and currently smoke every or some days)
CDC, Behavioral Risk Factor Surveillance System, 2016
Community & Environment
Air Pollution
Average exposure of the general public to particulate matter of 2.5 microns or less in size (PM2.5)
U.S. Environmental Protection Agency, 2014-2016; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2016, 2014-2016
Children in Poverty
Percentage of children younger than 18 who live in households at or below the poverty threshold
U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2016
Infectious Disease
Mean z score of the incidence of chlamydia, pertussis and Salmonella per 100,000 population
America's Health Rankings composite measure, 2017
Chlamydia:
Number of new cases of chlamydia per 100,000 population
CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Atlas, 2015
Pertussis:
Number of new cases of pertussis per 100,000 population
CDC, Morbidity and Mortality Weekly Report (MMWR), Summary of Notifiable Infectious Diseases and Conditions, 2015
Salmonella:
Number of new cases of Salmonella per 100,000 population
CDC, MMWR, Summary of Notifiable Infectious Diseases and Conditions, 2015
Occupational Fatalities
Number of fatal occupational injuries in construction, manufacturing, trade, transportation, utilities and professional and business services per 100,000 workers
U.S. Bureau of Labor Statistics, Census of Fatal Occupational Injuries 2013-2015; U.S. Bureau of Economic Analysis, 2013-2015
Violent Crime
Number of murders, rapes, robberies and aggravated assaults per 100,000 population
Federal Bureau of Investigation, 2016
Policy
Immunizations-Adolescents
Mean z score of the percentage of adolescents aged 13 to 17 who received >=1 dose of Tdap vaccine since age 10, >=1 dose of meningococcal vaccine and all recommended doses of human papillomavirus vaccine
America's Health Rankings composite measure, 2017
HPV Females:
Percentage of females aged 13 to 17 who are up to date on all recommended doses of human papillomavirus (HPV) vaccine
CDC, National Immunization Survey, 2016
HPV Males:
Percentage of males aged 13 to 17 who are up to date on all recommended doses of human papillomavirus (HPV) vaccine
CDC, National Immunization Survey, 2016
Meningococcal:
Percentage of adolescents aged 13 to 17 who received >=1 dose of meningococcal conjugate vaccine (MenACWY)
CDC, National Immunization Survey, 2016
Tdap:
Percentage of adolescents aged 13 to 17 who received >=1 dose of tetanus, diphtheria and acellular pertussis (Tdap) vaccine since age 10
CDC, National Immunization Survey, 2016
Immunizations-Children
Percentage of children aged 19 to 35 months who received recommended doses of diphtheria, tetanus and acellular pertussis (DTaP), measles, mumps and rubella (MMR), polio, Haemophilus influenzae type b (Hib), hepatitis B, varicella and pneumococcal conjugate vaccines
CDC, National Immunization Survey, 2016
Public Health Funding
State dollars dedicated to public health and federal dollars directed to states by the Centers for Disease Control and Prevention and the Health Resources Services Administration per person
Trust For America’s Health, 2015-2016; U.S. Department of Health & Human Services (HHS), 2015-2016; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2016, 2015-2016
Uninsured
Percentage of the population that does not have health insurance privately, through their employer or through the government
U.S. Census Bureau, American Community Survey, 2015-2016
Clinical Care
Dentists
Number of practicing dentists per 100,000 population
American Dental Association, 2016
Low Birthweight
Percentage of infants weighing less than 2,500 grams (5 pounds, 8 ounces) at birth
CDC, National Vital Statistics System, 2015
Mental Health Providers
Number of psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, providers that treat alcohol and other drug abuse and advanced practice nurses specializing in mental health care per 100,000 population
U.S. HHS, Centers for Medicare & Medicaid Services, National Plan and Provider Enumeration System, 2016; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2016, 2016
Preventable Hospitalizations
Number of discharges for ambulatory care-sensitive conditions per 1,000 Medicare enrollees aged 65 and older
The Dartmouth Atlas of Health Care, 2015
Primary Care Physicians
Number of active primary care physicians (including general practice, family practice, obstetrics and gynecology, pediatrics, geriatrics and internal medicine) per 100,000 population
American Medical Association, Special data request for active state licensed physicians provided by Redi-Data, Inc., Sept 18, 2017; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2016, 2016
Outcomes
Cancer Deaths
Age-adjusted number of deaths due to all causes of cancer per 100,000 population
CDC, National Vital Statistics System, 2013-2015
Cardiovascular Deaths
Age-adjusted number of deaths due to all cardiovascular diseases including heart disease and stroke per 100,000 population
CDC, National Vital Statistics System, 2013-2015
Diabetes
Percentage of adults who reported being told by a health professional that they have diabetes (excludes prediabetes and gestational diabetes)
CDC, Behavioral Risk Factor Surveillance System, 2016
Disparity in Health Status
Difference between the percentage of adults with a high school education compared with those without who reported their health is very good or excellent (adults <25 years excluded)
CDC, Behavioral Risk Factor Surveillance System, 2016
Frequent Mental Distress
Percentage of adults who reported their mental health was not good 14 or more days in the past 30 days
CDC, Behavioral Risk Factor Surveillance System, 2016
Frequent Physical Distress
Percentage of adults who reported their physical health was not good 14 or more days in the past 30 days
CDC, Behavioral Risk Factor Surveillance System, 2016
Infant Mortality
Number of infant deaths (before age 1 year) per 1,000 live births
CDC, National Vital Statistics System, 2014-2015
Premature Death
Number of years of potential life lost before age 75 per 100,000 population
CDC, National Vital Statistics System, 2015
*Data appearing in this edition are the same that appeared in the 2016 edition; an update was not available at the time of this publication.