Key Findings Economic Resources And Education | 2021 Health Of Women And Children

Executive Brief Introduction National HighlightsKey FindingsEconomic Resources and Education Preventive Clinical Care Health Behaviors Physical Health Behavioral Health MortalityState Summaries

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2021 Health of Women and Children Report – Executive Brief 2021 Health of Women and Children Report 2021 Health of Women and Children Report –State Summaries 2021 Health of Women and Children Report – Infographics 2021 Health of Women and Children Report – Report Data (All States)

Poverty
Poverty is associated with poor health outcomes, including an increased risk of mortality and chronic disease. Chronic stress associated with poverty — including unreliable access to food, health care and stable housing — is difficult on adults and may impair children’s health and development throughout their lifespan.
National and state findings
Before the COVID-19 pandemic, 15.2% of women ages 18-44 and 16.8% of children in U.S. households lived below the federal poverty level, affecting roughly 8.6 million women and 12.0 million children in 2019. Mississippi had the highest poverty rates among both women and children, while New Hampshire had the lowest. 
Between 2018 and 2019, poverty among women and children declined 7% nationally, from 16.3% among women and 18.0% among children. Poverty rates among women declined significantly in eight states, led by 11% in California (15.1% to 13.5%) and Tennessee (19.0% to 16.9%) and 10% in Illinois (15.5% to 13.9%) and Virginia (14.2% to 12.8%). Poverty among children declined significantly in 15 states, led by 33% in New Hampshire (10.6% to 7.1%), 18% in West Virginia (24.5% to 20.1%) and 17% in Oregon (15.7% to 13.1%).

Subpopulation findings
Poverty rates differed by race and ethnicity in 2019 and were 2.3 times higher among American Indian/Alaska Native women than Asian women. Among children, rates were 3.3 times and 3.2 times higher among Black and American Indian/Alaska Native children than Asian children, respectively. Between 2018 and 2019, the poverty rate declined 12% among Asian children (10.4% to 9.2%), 10% among children who identify their race as other (28.3% to 25.4%), 8% among Hispanic children (25.5% to 23.4%) and 6% among Black (32.5% to 30.6%) and non-Hispanic white (10.9% to 10.2%) children.
Additional related findings
Concentrated disadvantage is a measure of community well-being and is calculated using the percentage of family households below the poverty level, individuals receiving public assistance, female-headed households, unemployed ages 16 and older and population younger than 18. In 2015-2019, 25.1% of U.S. households were located in areas with a high level of concentrated disadvantage. This percentage was 11.9 times higher in Mississippi (46.5%) than in Vermont (3.9%). 
The gender pay gap was 81.0%, meaning women’s median annual earnings for full-time work were nearly 20% less than men’s earnings in 2019. Vermont had the lowest gender pay gap at 91.0%, while Wyoming had the highest at 63.4%. 
Finding quality child care at a reasonable price can be challenging for U.S. families. In 2018, the average price for center-based infant care was 12.5% of a married couple’s median income, an increase of 8% from 11.6% in 2014. Among the 48 states with data, California (17.5%) had the highest average price, 2.3 times higher than in Mississippi (7.6%).
Food insecurity
Food insecurity has broad effects on health due to the mental and physical stress it places on the body. Access to sufficient food is critical for proper nutrition and health in children and adults.
National and state findings
In 2017-2019, 11.1% of U.S. households were unable to provide adequate food for one or more household members due to lack of resources. Household food insecurity was highest in Mississippi (15.7%), West Virginia (15.4%) and Louisiana (15.3%); it was lowest in New Hampshire (6.6%), New Jersey (7.7%) and Iowa (7.9%). Between 2014-2016 and 2017-2019, household food insecurity decreased 15% (from 13.0%) nationally, and significantly in five states: 33% in Oregon (14.6% to 9.8%), 31% in New Jersey (11.1% to 7.7%), 29% in Georgia (14.0% to 10.0%), 27% in Nebraska (14.7% to 10.8%) and 16% in California (11.8% to 9.9%). 
Additional related findings
In 2019-2020, 69.8% of children ages 0-17 lived in U.S. households that could always afford to eat good nutritious meals in the past 12 months. Food sufficiency was 1.4 times higher in Massachusetts (80.0%) than in Mississippi (58.0%). 
In 2018, 53.9% of U.S. children ages 1-4 eligible for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) received benefits in an average month, a 9% increase from 49.3% in 2017. WIC coverage was 1.8 times higher in Vermont (75.0%) than in Tennessee (41.1%). 
Fourth Grade Reading Proficiency
Educational attainment is a strong predictor of health; for children to lead healthy lives, it is essential that they are on track to learn and grow throughout their childhood and adolescence. By the time children reach fourth grade, they are expected to be able to read in order to learn other subjects. If children are not proficient in reading by this age, it becomes harder for them to succeed academically.
National and state findings
Before the COVID-19 pandemic, 34.3% of fourth grade public school students scored proficient or above on the National Assessment of Educational Progress reading assessment in 2019. This varied by state and was 1.9 times higher in Massachusetts (45.4%) than in New Mexico (23.7%), a 21.7 percentage point gap.
Subpopulation findings
Reading proficiency varied widely by race and ethnicity. The percentage was highest among Asian/Pacific Islander students and lowest among Black students in 2019. Compared with the national average, white students had a higher reading proficiency while Hispanic and American Indian/Alaska Native students had a lower percentage of students proficient in reading.
Additional related findings 
In 2019, 48.9% of children ages 3-4 were enrolled in nursery school, preschool or kindergarten. The percentage of children enrolled in early childhood education programs was 2.4 times higher in New Jersey (67.8%) than in North Dakota (28.5%). The District of Columbia had the highest enrollment rate at 85.6% of children.