For 29 years, America’s Health Rankings® has provided a wide variety of health and health-related information to help policymakers, advocates and individuals understand the health of key populations in a holistic, inclusive manner. This year’s update to the Health of Women and Children Report builds on that commitment, providing insights on women of reproductive age and children, who together compose more than 40 percent of the total U.S. population. Research shows that health develops over a lifetime and markers of prenatal and childhood health are significant predictors of health and economic status in adulthood. United Health Foundation recognizes that the health of America’s women, infants and children today will impact the future well-being of the United States for generations to come.

Summary of Key Findings

Progress

• Encouraging Declines in Tobacco Use: the nation has made encouraging progress in regard to the prevalence of smoking among women and children.
• Progress Made Across Key Markers of Care: this year’s update finds that progress has been made in key measures of clinical care, including an increase in the percentage of women with a dedicated health care provider; a decline in the percentage of uninsured women; and a decline in teen births.

Challenges

• Concerning Increases in Key Mortality Rates: key measures of mortality for both women and children have increased since 2016, including: an increase in the rate of drug deaths among females aged 15-44; and an increase in the nation’s maternal mortality rate per 100,000 live births.
• Notable Differences in Mortality Rates Across States: mortality rates for women and children vary widely across states, highlighting alarming health disparities across state lines.
• Striking inequities in mortality rates across women, infants and children.
• Wide variation across states for the rate of well-visits for women, infants and adolescents.

Concerning Increases in Key Mortality Rates

• The rate of drug deaths increased 20 percent among females aged 15-44.
• The teen suicide rate has increased 6 percent per 100,000 adolescents aged 15-19.
• The nation’s maternal mortality rate increased 4 percent per 100,000 live births, which measures deaths from any cause related to or aggravated by pregnancy and childbirth.

• Drug death rates are higher among women aged 35-44 compared with those aged 15-24 and 25-34.
• The maternal mortality rate among black women is 2.5 times higher than the rate among white women and 4 times higher than the rate among Asian/Pacific Islander and Hispanic women; the rate among white women is about 1.5 times higher than the rate among Asian/Pacific Islander and Hispanic women.
• Teen suicide rates are highest among American Indian & Alaska Native teens, followed by white, Hispanic and black teens.
• Black children face the highest child mortality rate among racial/ethnic groups – more than 2 times higher than the rate for Asian children and 1.5 times higher than the rate for white children.

Notable Differences in Mortality Rates Across States

• For example, West Virginia has the highest drug death rate among women aged 15-44 (at 41.6 deaths per 100,000), while Hawaii has the lowest drug death rate (at 5.5 deaths per 100,000) among this population.
• Even greater differences are found when looking at maternal mortality. Georgia experiences the highest rate (at 46.2 deaths per 100,000), while California experiences the lowest rate (at 4.5 deaths per 100,000).
• Teen suicide is another measure where large differences are reported across states. Rhode Island has the lowest teen suicide rate in the country among adolescents aged 15-19 (at 4.7 deaths per 100,000) which is one-eighth the teen suicide rate in Alaska (at 35.1 deaths per 100,000), the state with the highest rate in the country.
• States face stark differences in child mortality, as South Dakota, the state with the highest child mortality rate, has a rate among children aged 1-18 (at 36.4 deaths per 100,000), has a rate three times higher than Connecticut, the state with the lowest rate (at 12.8 deaths per 100,000).

Encouraging Declines in Tobacco Use

Progress Made Across Key Markers of Care

• Nationally, 90.7 percent of babies aged 0-2 years received well-baby checks, but among states, it varies from a low of 83.0 percent in Texas to an encouraging high of 98.8 percent in Ohio.
• Looking at adolescents, 78.9 percent received a well-visit in the last year, while only two-thirds of Alaska teens aged 12-17 received a well-visit in the past year, compared with nearly 90 percent of teens in Delaware.
• Finally, about two-thirds of women received a well-visit nationally, but notable differences exist regionally. Rates for well-woman visits are generally higher among states east of the Mississippi and lower in Texas, Alaska and mountain states.

Healthiest States for Women, Infants and Children

Populations Fare Differently Within States

• For women, Massachusetts, Vermont and Minnesota rank as the top three states; Texas, Louisiana and Arkansas have the greatest opportunity for improvement.
• For infant health, New Hampshire, California and Oregon are strongest; Mississippi, West Virginia and Alabama face the greatest challenges.
• Children are healthiest in Massachusetts, Connecticut and New Hampshire; Mississippi, Alaska and Oklahoma have the lowest scores for this population group.

Conclusion