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Executive HighlightsIntroductionKey FindingsSocial and Economic FactorsPhysical EnvironmentClinical CareBehaviorsHealth OutcomesInternational ComparisonState Summaries
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US SummaryAppendixMeasures TableData Source DescriptionsThe Team
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS SummaryAppendixMeasures TableData Source DescriptionsThe TeamThe number of mental health providers increased, but fewer people had health insurance.
Mental health providers
Definition: Number of psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, advanced practice nurses specializing in mental health care as well as providers treating alcohol and other drug abuse per 100,000 population.
Mental health providers offer essential care to adults and children who have a mental or behavioral disorder by offering services such as assessment, diagnosis, treatment, medication and therapeutic interventions according to the National Alliance on Mental Illness. The National Institutes of Mental Health reported that 17.9% of Americans experienced some form of mental illness (not including substance abuse disorders) in 2016, but only 43.1% of adults with any mental illness and 64.8% with a serious mental illness reported receiving treatment in the past year.
Findings
Mental health providers increased 9% between 2019 and 2020 (247.4 to 268.6 per 100,000 population) and 23% since 2017 (from 218.0) (Figure 20). This year there are 72,066 more mental health providers than in 2019. The number of mental health providers increased in every state. The largest gains were in Alaska (429.9 to 523.8 per 100,000 population; +662 providers), Oregon (522.3 to 571.0; +2,192 providers) and Washington (373.3 to 413.8; +3,382 providers).
Disparities
The number of mental health providers is highest in Massachusetts (666.4 providers per 100,000 population), Oregon (571.0) and Alaska (523.8). The supply is lowest in Alabama (112.7 providers per 100,000 population), Texas (123.7) and West Virginia (140.5).
Uninsured
Definition: Percentage of population not covered by private or public health insurance.
Health insurance is critical in helping people receive the preventive and medical care they need to achieve and maintain good health. Compared with insured adults, uninsured adults have more health disadvantages, including worse health outcomes and higher rates of mortality and premature death. The uninsured also have inadequate access to quality care and preventive services, leading to expensive medical bills due to undiagnosed or untreated chronic conditions and more emergency room visits.
Between 2010 and 2016, the uninsured rate decreased 45% from 15.5% to 8.6%. Between 2016 and 2019, the percentage of the population that is uninsured increased 7% nationally from 8.6% to 9.2% (Figure 21), leaving 2.3 million more people uninsured. Between 2018 and 2019, the uninsured rate increased significantly in 10 states (Figure 22), led by Kentucky (5.6% to 6.4%). The rate decreased in one state, Virginia (8.8% to 7.9%).
Disparities
In 2019, the uninsured rate was lowest in Massachusetts (3.0%), Rhode Island (4.1%) and Hawaii (4.2%). The rate was highest in Texas (18.4%), Oklahoma (14.3%) and Georgia (13.4%).
Recent improvements in key vaccination rates.
Flu vaccination
Definition: Percentage of adults who reported receiving a seasonal flu vaccine in the past 12 months.
A flu vaccine is the best protection against seasonal influenza viruses, which can pose a serious threat to health, according to the CDC. Each year in the United States, millions of people get the flu, and thousands of people die from it. The vaccine can prevent people from coming down with the flu and can help lessen the degree to which people are sick if they do get it.
Findings
Between 2018 and 2019, flu vaccination coverage increased 25% nationally from 35.0% to 43.7% of adults (Figure 23). However, this remains far below Healthy People 2030's national target to have 70% of the population vaccinated. During this time frame, vaccination coverage increased:
- 41% among ages 18-44 (23.3% to 32.8%), 27% among ages 45-64 (33.9% to 42.9%) and 18% among ages 65 and older (53.9% to 63.7%).
- 36% among adults who identify their race as other (27.4% to 37.4%), 35% among multiracial adults (28.9% to 38.9%), 34% among Hispanic (25.2% to 33.7%), 32% among Black (27.7% to 36.7%), 29% among American Indian/Alaska Native (28.6% to 36.8%), 28% among white (36.3% to 46.6%) and 13% among Asian (38.6% to 43.5%) adults.
- 28% among adults ages 25 and older who are high school graduates (30.5% to 38.9%) and those with some college (33.6% to 42.9%), 27% among those who are college graduates (42.2% to 53.5%) and 18% among those with less than a high school education (30.4% to 35.9%).
Disparities
Flu vaccination coverage varies across states and by age, gender, education, income as well as race and ethnicity. The largest differences in flu vaccination coverage was by age, geography and education (Figure 25). Flu vaccination coverage was highest in Massachusetts (50.5%), Rhode Island (50.4%) and Connecticut (49.7%), and lowest in Nevada (32.5%), Georgia (36.2%) and Wyoming (36.5%). In 2019, flu vaccination coverage was higher among (Figure 26):
- Adults ages 65 and older than younger adults; the prevalence is higher among adults ages 45-64 than those ages 18-44.
- Adults ages 25 and older who are college graduates compared with adults with lower educational levels. Adults with less than a high school education had the lowest prevalence; prevalence increased with each increase in education level.
- White adults compared with all other race and ethnicity groups. Hispanic adults had the lowest prevalence, lower than Black, multiracial, Asian and white adults.
- Adults ages 25 and older with a household income of $75,000 or more compared with adults with lower household incomes; prevalence increased with each increase in income level.
HPV vaccination
Definition: Percentage of adolescents ages 13-17 who have received all recommended doses of the human papillomavirus (HPV) vaccine.
The HPV vaccine is the first vaccine ever developed to prevent cancer. Every year, an estimated 19,000 cases of HPV-associated cancer among females and 13,100 cases of HPV-associated cancer among males could be prevented through vaccination. HPV infections can cause different types of cancer as well as genital warts. Most cases of cervical cancer; cancers of the anus, throat, vagina and vulva; and cases of genital warts are associated with HPV infections.
Findings
Between 2018 and 2019, HPV vaccination coverage among teens increased 6% nationally from 51.1% to 54.2% (Figure 27), slowly progressing toward the Healthy People 2030 target of 80% among teens ages 13-15. Notably, the HPV vaccination rate was also up 8% among white teens (51.6%), who had lower rates than Hispanic (58.1%) and American Indian/Alaska Native (57.5%) teens. HPV vaccination coverage among teens increased significantly in North Dakota from 63.6% to 76.9%.
Disparities
HPV vaccination coverage varies across states and by gender and race and ethnicity (Figure 28). In 2019, HPV vaccination coverage was highest in Rhode Island (78.9%), North Dakota (76.9%) and Massachusetts (74.3%), and lowest in Mississippi (30.5%), Indiana (41.2%) and Wyoming (41.5%). HPV vaccination coverage was higher among female than male teens (Figure 29). Hispanic teens had the highest coverage, followed by American Indian/Alaska Native, Black and Asian teens. White teens had the lowest coverage.
Preventable hospitalizations
Preventable hospitalizations declined in the past year.
Definition: Discharges following hospitalization* per 100,000 Medicare enrollees ages 18 years or older continuously enrolled in Medicare fee-for-service Part A.
* for diabetes with short- or long-term complications, uncontrolled diabetes without complications, diabetes with lower-extremity amputation, chronic obstructive pulmonary disease, angina without a procedure, asthma, hypertension, heart failure, dehydration, bacterial pneumonia or urinary tract infection.
Some hospital admissions related to chronic conditions or acute illnesses can be prevented through adequate management and treatment in outpatient settings. The number of preventable hospitalizations reflects overuse of the hospital as a primary source of care and the efficiency and quality of primary care for outpatient services. Preventable hospitalizations place financial burdens on patients, insurance providers and hospitals. In 2006, $30.8 billion in hospital costs were attributed to preventable hospitalizations.
Findings
Between 2017 and 2018, preventable hospitalizations decreased 5% nationally from 4,475 to 4,237 hospitalizations per 100,000 Medicare enrollees (Figure 30). The largest declines occurred in South Dakota (4,733 to 4,087 hospitalizations per 100,000 Medicare enrollees), North Dakota (4,702 to 4,128), Michigan (5,253 to 4,820), Rhode Island (4,375 to 3,964) and Florida (5,182 to 4,779).
Disparities
Preventable hospitalizations vary across states and by race and ethnicity. In 2018, preventable hospitalizations were highest in Minnesota (5,721 discharges per 100,000 Medicare enrollees), Mississippi (5,628) and West Virginia (5,593), and lowest in Hawaii (1,971), Utah (2,287) and Idaho (2,390). This same year, preventable hospitalizations were highest among Black Medicare enrollees, followed by American Indian/Alaska Native, white and Hispanic Medicare enrollees as well as Medicare enrollees, who identify their race as other. Asian/Pacific Islander Medicare enrollees had the lowest rate of preventable hospitalizations (Figure 31).
