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Executive BriefForewordIntroductionNational HighlightsFindingsHealth OutcomesSocial and Economic FactorsPhysical EnvironmentClinical CareState RankingsInternational ComparisonCOVID-era Disparities SurveyAppendixMeasures TableData Source DescriptionsMethodologyState Summaries
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US Summary
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS SummaryCLINICAL CARE | Access to Care
The nation has improved in access to care measures of uninsured, mental health providers and primary care providers, though large geographic disparities remain.
Uninsured
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 inadequate access to preventive services, worse health outcomes and higher rates of premature death.
Changes over time. Nationally, the percentage of the population not covered by private or public health insurance decreased 7% from 9.2% to 8.6% between 2019 and 2021. The uninsured rate significantly decreased in 15 states, led by 29% in Maine (8.0% to 5.7%) and 19% in both Idaho (10.8% to 8.8%) and New Hampshire (6.3% to 5.1%).
Disparities. The uninsured rate was 7.2 times higher in Texas (18.0%) than in Massachusetts (2.5%), the states with the highest and lowest rates in 2021. The rate significantly varied by education, race/ethnicity and age. It was:
- 6.0 times higher among those with less than a high school education (22.2%) compared with college graduates (3.7%).
- 3.5 times higher among other race (20.1%) compared with white (5.7%) populations. The American Indian/Alaska Native (19.6%) population also had a high rate.*
Providers
Primary care physicians are typically the patient’s first point of contact with the health care system and provide critical preventive care, disease management and referrals to specialists. Having a sufficient supply of primary care physicians in a community has numerous benefits, including lower rates of infants with low birthweight, lower all-cause mortality and longer life spans, reductions in health system costs and reductions in health disparities. Mental health providers offer essential care to people with mental or behavioral disorders through assessments, diagnoses, treatments, medications and therapeutic interventions. Demand for mental health professionals is projected to increase during and after the COVID-19 pandemic.
Changes over time. Nationally, primary care providers† increased 5% from 252.3 to 265.3 providers per 100,000 population between September 2021 and September 2022. During this time, mental health providers‡ increased 7% from 284.3 to 305.0 providers per 100,000 population, and 40% since America’s Health Rankings first included the measure in 2017 (from 218.0). The supply of primary care providers increased by 5% or more in 32 states and the District of Columbia, led by 11% in the district (494.0 to 546.4) and 8% in Louisiana (226.8 to 243.9), Florida (266.9 to 288.6) and Arizona (221.2 to 239.9). The supply of mental health providers increased by 7% or more in 27 states and the District of Columbia, led by 14% in both the district (589.6 to 670.5) and Arizona (154.8 to 176.0) and 12% in Texas (133.0 to 148.6).
Disparities. The supply of primary care providers was 1.9 times higher in Massachusetts (383.1 providers per 100,000 population) than in Nevada (205.1), and the supply of mental health providers was 5.6 times higher in Massachusetts (722.2) than in Alabama (128.8), the states with the highest and lowest rates in September 2022.
CLINICAL CARE | Preventive Clinical Services
COVID-19 vaccination rates varied by race/ethnicity.
COVID-19 Vaccination and Bivalent Booster Dose
COVID-19 vaccinations and boosters can protect both individuals and communities while reducing strain on health care systems. Currently, COVID-19 vaccines are recommended for everyone 6 months of age and older. The vaccine and booster combination continues to decrease risk of hospitalization and death for those who contract COVID-19. National estimate. As of October 27, 2022, 226,933,827 people or 68.4% of the total U.S. population completed a primary COVID-19 vaccination series, defined as having received one dose of a single-dose vaccine or two doses on different days (regardless of time interval) of either an mRNA or a protein-based series. In addition, 7.3% of the population with a completed primary vaccination series had an updated (bivalent) booster dose since September 1, 2022. COVID-19 vaccination rates remain lower among children than adults. A primary series was completed by 3.5% of children younger than age 5, 31.7% of children ages 5-11 and 60.9% of children ages 12-17.
Disparities. The percentage of the population who completed a primary COVID-19 vaccination series was 1.6 times higher in Rhode Island (86.3%) than in Wyoming (52.4%), the states with the highest and lowest rates as of October 27, 2022. The percentage was 1.5 times higher among Asian (63.7%) compared with Black (43.7%) populations. However, data constraints limit our ability to understand the racial/ethnic breakdown of those who have been vaccinated against COVID-19. For 21.5% of the population who completed the primary COVID-19 vaccination series, their race was unknown — emphasizing the need to prioritize collecting demographic, including racial/ethnic, information in public health data. Explore COVID-19 data.
* The values of the two highest groups were not significantly different from each other based on non-overlapping 95% confidence intervals.
† Primary care providers include general practice, family practice, obstetrics and gynecology, pediatrics, geriatrics and internal medicine providers, as well as physician assistants and nurse practitioners.
‡ Mental health providers include psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists and advanced practice nurses specializing in mental health care.