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Behaviors

Drug Deaths

Age-adjusted number of deaths due to drug injury of any intent (unintentional, suicide, homicide or undetermined) per 100,000 population (3-year average)
Centers for Disease Control and Prevention (CDC) WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death Files, 2014-2016

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, 2017

High School Graduation

Percentage of high school students who graduate with a regular high school diploma within four years of starting ninth grade (2-year average)
U.S. Department of Education, National Center for Education Statistics, 2015-2016

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, 2017

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, 2017

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, 2017

Community & Environment

Air Pollution

Average exposure of the general public to particulate matter of 2.5 microns (PM2.5) or less in size (3-year average)
U.S. Environmental Protection Agency; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2017, 2015-2017

Children in Poverty

Percentage of children younger than age 18 who live in households below the poverty threshold
U.S. Census Bureau, American Community Survey, 2017

Infectious Disease

Mean z score of the incidence of chlamydia, pertussis and Salmonella per 100,000 population
America's Health Rankings composite measure, 2018
Chlamydia: Number of new cases of chlamydia per 100,000 population
CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Atlas, 2016
Pertussis: Number of new cases of pertussis per 100,000 population
CDC, National Notifiable Infectious Diseases Surveillance System, Annual Tables of Infectious Disease Data, 2016
Salmonella: Number of new cases of Salmonella per 100,000 population
CDC, National Notifiable Infectious Diseases Surveillance System, Annual Tables of Infectious Disease Data, 2016

Occupational Fatalities

Number of fatal occupational injuries in construction, manufacturing, trade, transportation, utilities and professional and business services per 100,000 workers (3-year average)
U.S. Bureau of Labor Statistics, Census of Fatal Occupational Injuries; U.S. Bureau of Economic Analysis, 2014-2016

Violent Crime

Number of offenses of murder, rape, robbery and aggravated assault per 100,000 population
U.S. Department of Justice, Federal Bureau of Investigation, 2017

Policy

Immunizations - Adolescents

Mean z score of the percentage of adolescents aged 13 to 17 who received the recommended doses of Tdap, meningococcal and HPV vaccines
America's Health Rankings composite measure, 2018
HPV Females: Percentage of females aged 13 to 17 who are up to date on all the recommended doses of human papillomavirus (HPV) vaccine
CDC, National Immunization Survey-Teen, 2017
HPV Males: Percentage of males aged 13 to 17 who are up to date on all the recommended doses of human papillomavirus (HPV) vaccine
CDC, National Immunization Survey-Teen, 2017
Meningococcal: Percentage of adolescents aged 13 to 17 who received >=1 dose of meningococcal conjugate (MenACWY) vaccine
CDC, National Immunization Survey-Teen, 2017
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-Teen, 2017

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 vaccination
CDC, National Immunization Survey-Child, 2017

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 (2-year average)
Trust For America’s Health; U.S. Department of Health and Human Services (HHS); U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2017, 2016-2017

Uninsured

Percentage of the population that does not have health insurance privately, through their employer or through the government (2-year average)
U.S. Census Bureau, American Community Survey, 2016-2017

Clinical Care

Dentists

Number of practicing dentists per 100,000 population
American Dental Association, 2017

Low Birthweight

Percentage of infants weighing less than 2,500 grams (5 pounds, 8 ounces) at birth
CDC WONDER Online Database, Natality public-use data, 2016

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, 2017; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2017, 2017

Preventable Hospitalizations*

Number of discharges for ambulatory care-sensitive conditions per 1,000 Medicare enrollees
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
Special data request for information on active state licensed physicians provided by Redi-Data, Inc. Sept 28, 2018; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2017, 2017

Outcomes

Cancer Deaths

Age-adjusted number of deaths due to all causes of cancer per 100,000 population (3-year average)
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death Files, 2014-2016

Cardiovascular Deaths

Age-adjusted number of deaths due to all cardiovascular diseases including heart disease and stroke per 100,000 population (3-year average)
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death Files, 2014-2016

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, 2017

Disparity in Health Status

Difference between the percentage of adults aged 25 and older with at least a high school education compared with those without who reported their health is very good or excellent
CDC, Behavioral Risk Factor Surveillance System, 2017

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, 2017

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, 2017

Infant Mortality

Number of infant deaths (before age 1) per 1,000 live births (2-year average)
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death Files and Natality public-use data, 2015-2016

Premature Death

Number of years of potential life lost before age 75 per 100,000 population
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death Files, 2016
*The data appearing in this edition are the same that appeared in the 2017 edition.