America's Health Rankings, United Health Foundation Logo

Social & Economic Factors

Weighted sum of the z-scores of ranked community and family safety measures for women.
America's Health Rankings composite measure, 2020

Percentage of women with a recent live birth who experienced violence by husband or partner (current or former) in the 12 months before pregnancy.
CDC, Pregnancy Risk Assessment Monitoring System or state equivalent, 2018

Number of murders, rapes, robberies and aggravated assaults per 100,000 population.
U.S. Department of Justice, Federal Bureau of Investigation, 2018

Economic Resources - Women

Weighted sum of the z-scores of ranked economic resources measures for women.
America's Health Rankings composite measure, 2020

Concentrated Disadvantage

Percentage of households located in census tracts whose averaged z-scores of family households below the poverty line, individuals receiving public assistance, female-headed households, unemployed ages 16 and older and population younger than 18 fall within the 75th percentile.
Steven Manson, Jonathan Schroeder, David Van Riper, and Steven Ruggles. IPUMS National Historical Geographic Information System: Version 14.0 [Database]. Minneapolis, MN: IPUMS. 2019. http://doi.org/10.18128/D050.V14.0, 2014–2018

Food Insecurity - Household

Percentage of households unable to provide adequate food for one or more household members due to lack of resources.
U.S. Department of Agriculture, Household Food Security in the United States Report, 2016–2018

Gender Pay Gap*

Women’s median annual earnings as a percentage of men’s median annual earnings for full-time, year-round civilian workers ages 16 and older.
U.S. Census Bureau, American Community Survey, 2018

Poverty - Women

Percentage of females ages 18-44 who live below the poverty level.
U.S. Census Bureau, American Community Survey, 2018

Unemployment - Women

Percentage of the female civilian workforce who are unemployed.
U.S. Department of Labor, Bureau of Labor Statistics, 2018

Education - Women

Weighted sum of the z-scores of ranked education measures for women.
America's Health Rankings composite measure, 2018

College Graduate - Women

Percentage of women ages 25-44 with a college degree.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Social Support and Engagement - Women

Sum of weighted z-scores of ranked social support and engagement measures for women.
America's Health Rankings composite measure, 2020

Residential Segregation

Index of dissimilarity with higher values indicating greater segregation between Black and white state residents, ranging from zero (complete integration) to 100 (complete segregation).
U.S. Census Bureau, American Community Survey, 2014–2018

Voter Participation (Midterm) - Women

Percentage of female U.S. citizens who voted in the last midterm national election.
U.S. Census Bureau, Current Population Survey, Voter Registration, 2018

 Physical Environment

Air and Water Quality - Women and Children

Sum of weighted z-scores of ranked air and water quality measures for women and children.
America's Health Rankings composite measure, 2020

Air Pollution

Average exposure of the general public to particulate matter of 2.5 microns or less measured in micrograms per cubic meter.
U.S. Environmental Protection Agency; U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2018, 2016–2018

Drinking Water Violations

Percentage of population served by community water systems with a serious drinking water violation during the year.
Environmental Protection Agency (EPA) Enforcement and Compliance History Online (ECHO), Safe Drinking Water Information System (SDWIS), 2020

Household Smoke

Percentage of children ages 0-17 who live in households where someone uses cigarettes, cigars or pipe tobacco.
National Survey of Children's Health, U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), 2018–2019

Risk-Screening Environmental Indicator Score*

Estimated human health-related risk from exposure to toxic chemicals based on emission data of over 600 chemicals, with higher scores denoting elevated risk.
Environmental Protection Agency (EPA), Toxic Release Inventory (TRI) National Analysis File, 2018

Water Fluoridation

Percentage of population served by community water systems that receive fluoridated water.
CDC, Water Fluoridation Reporting System, 2016

Climate Change and Energy Policies*

Number of the following state policies in place: legally binding electricity portfolio standards, carbon pricing policies, climate change action plans, and economy-wide greenhouse gas emission targets.
Center for Climate and Energy Solutions, 2020

Transportation Energy Use*

Per capita energy use by the transportation sector.
U.S. Department of Transportation, State Transportation Statistics, 2018

Housing and Transportation - Women and Children

Sum of weighted z-scores of ranked housing and transportation measures for women and children.
America's Health Rankings composite measure, 2020

Drive Alone to Work - Women

Percent of female workers who drive alone to work.
U.S. Census Bureau, American Community Survey, 2018

Housing With Lead Risk

Percentage of housing stock with potential elevated lead risk due to age of housing.
U.S. Census Bureau, American Community Survey, 2018

Severe Housing Problems

Percentage of occupied housing units with at least one of the following problems: lack of complete kitchen facilities, lack of plumbing facilities, overcrowding or severely cost-burdened occupants
U.S. Department of Housing and Urban Development, Comprehensive Housing Affordability Strategy (CHAS), 2012–2016

Clinical Care

Access to Care - Women

Sum of weighted z-scores of ranked access to care measures for women.
America's Health Rankings composite measure, 2020

Adequate Prenatal Care

Percentage of live births in which the mother received prenatal care beginning in the first four months of pregnancy with the appropriate number of visits for the infant's gestational age.
National Center for Health Statistics, natality data, prepared by March of Dimes, Perinatal Data Center. September, 2020, 2018

Avoided Care due to Cost - Women

Percentage of women ages 18-44 who reported a time in the past 12 months when they needed to see a doctor but could not because of cost.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Publicly-Funded Women's Health Services

Percentage of likely need for contraceptive services among women with a family income 250% below the federal poverty level and women younger than 20 met by publicly-funded clinics.
Guttmacher Institute, Contraceptive Needs and Services Report, 2016

Uninsured Women

Percentage of women ages 19-44 not covered by private or public health insurance.
U.S. Census Bureau, American Community Survey, 2018

Women’s Health Providers

Number of obstetricians, gynecologists and midwives per 100,000 females ages 15 and older.
U.S. HHS, Centers for Medicare & Medicaid Services, National Plan and Provider Enumeration System, Sept. 2019; CDC WONDER Single Race Population Estimates 2010-2018, September, 2019

Preventive Clinical Care - Women

Sum of weighted z-scores of ranked preventive clinical services measures for women.
America's Health Rankings composite measure, 2020

Cervical Cancer Screening

Percentage of women ages 21-44 who received a Pap smear within the past three years.
CDC, Behavioral Risk Factor Surveillance System, 2018

Dental Visit - Women

Percentage of women ages 18-44 who reported visiting the dentist or dental clinic within the past year.
CDC, Behavioral Risk Factor Surveillance System, 2018

Flu Vaccination - Women

Percentage of women ages 18-44 who reported receiving a seasonal flu vaccine in the past 12 months.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Postpartum Visit

Percentage of women with a recent live birth who reported receiving a postpartum checkup.
CDC, Pregnancy Risk Assessment Monitoring System or state equivalent, 2018

Well-Woman Visit

Percentage of women ages 18-44 with a preventive medical visit in the past year.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Quality of Care - Women

Sum of weighted z-scores of ranked quality of care measures for women.
America's Health Rankings composite measure, 2020

Dedicated Health Care Provider - Women

Percentage of women ages 18-44 who reported having one or more people they think of as their personal doctor or health care provider.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Low-risk Cesarean Delivery

Percentage of singleton, head first, term (37 or more completed weeks) first births that were cesarean deliveries.
CDC WONDER Online Database, Natality public-use data, 2018

mPINC

Maternity Practices in Infant and Nutrition Care survey score based on seven birth facility policies and practices, with higher scores denoting better maternity care policies and practices.
CDC, mPINC State Reports, 2018

Behaviors

Nutrition & Physical Activity - Women

Weighted sum of the z-scores of ranked nutrition and physical activity measures for women.
America's Health Rankings composite measure, 2020

Exercise - Women

Percentage of women ages 18-44 who met the federal physical activity guidelines in the past 30 days.
CDC, Behavioral Risk Factor Surveillance System, 2017

Fruit and Vegetable Consumption - Women

Percentage of women ages 18-44 who reported consuming two or more fruits and three or more vegetables daily.
CDC, Behavioral Risk Factor Surveillance System, 2017

Physical Inactivity - Women

Percentage of women ages 18-44 who reported doing no physical activity or exercise other than their regular job in the past 30 days.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Sexual Health - Women

Weighted sum of the z-scores of ranked sexual health measures for women.
America's Health Rankings composite measure, 2020

Chlamydia - Women

Number of new cases of chlamydia per 100,000 females ages 15-44.
CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Atlas, 2018

High-risk HIV Behaviors - Women

Percentage of women ages 18-44 who reported any of the following situations in the past year: injected any drug other than those prescribed for you; have been treated for a sexually transmitted disease or STD; or given or received money or drugs in exchange for sex.
 CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Unintended Pregnancy*

Percentage of women with a recent live birth who did not want to become pregnant or wanted to become pregnant later.
CDC, Pregnancy Risk Assessment Monitoring System or state equivalent, 2018

Sleep Health - Women

Weighted sum of the z-scores of ranked sleep health measures for women.
America's Health Rankings composite measure, 2020

Insufficient Sleep - Women

Percentage of women ages 18-44 who reported sleeping, on average, fewer than seven hours in a 24-hour period.
CDC, Behavioral Risk Factor Surveillance System, 2018

Tobacco Use - Women

Weighted sum of the z-scores of ranked tobacco use measures for women.
America's Health Rankings composite measure, 2020

E-cigarette Use - Women*

Percentage of women ages 18-44 who reported using e-cigarettes or other electronic vaping products daily or some days.
CDC, Behavioral Risk Factor Surveillance System, 2018

Smoking - Women

Percentage of women ages 18-44 who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Smoking During Pregnancy

Percentage of mothers who reported smoking cigarettes during pregnancy.
CDC WONDER Online Database, Natality public-use data, 2018

Outcomes

Behavioral Health - Women

Weighted sum of the z-scores of ranked behavioral health measures for women.
America's Health Rankings composite measure, 2020

Excessive Drinking - Women

Percentage of women ages 18-44 who reported binge drinking (four or more drinks on one occasion in the past 30 days) or chronic drinking (eight or more drinks per week).
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Frequent Mental Distress - Women

Percentage of women ages 18-44 who reported their mental health was not good 14 or more days in the past 30 days.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Illicit Drug Use - Women

Percentage of women ages 12 and older who misused prescription psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) or used cocaine (including crack), heroin, hallucinogens, inhalants or methamphetamine in the past year.
National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration (SAMHSA) restricted online data analysis system (RDAS), 2017–2018

Postpartum Depression

Percentage of women with a recent live birth who reported experiencing depressive symptoms.
CDC, Pregnancy Risk Assessment Monitoring System or state equivalent, 2018

Mortality - Women

Weighted sum of the z-scores of ranked mortality measures for women.
America's Health Rankings composite measure, 2020

Drug Deaths - Women*

Number of deaths due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 females ages 20-44.
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, 2016–2018

Maternal Mortality*

Number of deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births.
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, 2018

Mortality Rate - Women

Number of deaths per 100,000 women ages 20-44.
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, 2018

Physical Health - Women

Sum of weighted z-scores of ranked physical health measures for women.
America's Health Rankings composite measure, 2020

Frequent Physical Distress - Women

Percentage of women ages 18-44 who reported their physical health was not good 14 or more days in the past 30 days.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

High Blood Pressure - Women

Percentage of women ages 18-44 who reported being told by a health professional that they have high blood pressure.
CDC, Behavioral Risk Factor Surveillance System, 2017

High Health Status - Women*

Percentage of women ages 18-44 who reported that their health is very good or excellent.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Maternal Morbidity*

Number of births in which the mother experiences admission to the ICU, a ruptured uterus, a transfusion or an unplanned hysterectomy per 1,000 births.
CDC WONDER Online Database, Natality public-use data (expanded), 2016–2018

Multiple Chronic Conditions - Women

Percentage of women ages 18-44 who have three or more of the following chronic health conditions: arthritis, asthma, CKD, COPD, CVD (heart disease, heart attack, or stroke), cancer (excluding skin), depression or diabetes.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Arthritis - Women*

Percentage of women ages 18-44 who reported being told by a health professional that they have some form of arthritis.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Asthma - Women*

Percentage of women ages 18-44 who reported being told by a health professional that they currently have asthma.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Cancer - Women*

Percentage of women ages 18-44 who reported being told by a health professional that they had any form of cancer, (excluding skin cancer).
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Cardiovascular Disease - Women*

Percentage of women ages 18-44 who reported being told by a health professional that they had angina or coronary heart disease; a heart attack or myocardial infarction; or a stroke.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Chronic Kidney Disease - Women*

Percentage of women ages 18-44 who reported being told by a health professional that they have kidney disease.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Depression - Women*

Percentage of women ages 18-44 who reported being told by a health professional they have a depressive disorder.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

COPD - Women*

Percentage of women ages 18-44 who reported being told by a health professional that they have chronic obstructive pulmonary disease (COPD).
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Diabetes - Women*

Percentage of women ages 18-44 who reported being told by a health professional that they have diabetes (excluding prediabetes and gestational diabetes).
CDC, Behavioral Risk Factor Surveillance System, 2017–2018

Obesity - Women

Percentage of women ages 18-44 with a body mass index of 30.0 or higher based on reported height and weight.
CDC, Behavioral Risk Factor Surveillance System, 2017–2018
* Supplemental Measure