Close
Executive BriefForewordIntroductionNational HighlightsFindingsHealth OutcomesSocial and Economic FactorsPhysical EnvironmentClinical CareState RankingsInternational ComparisonCOVID-era Disparities SurveyAppendixMeasures TableData Source DescriptionsMethodologyState Summaries
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
US Summary
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS SummaryIntroduction
Since 2020, Americans have experienced the devastating impact of living through a public health emergency. Despite having the highest per capita health spending among Organization for Economic Co-operation and Development (OECD) countries, the United States had the largest decrease in life expectancy during the COVID-19 pandemic.
The United Health Foundation, in partnership with the American Public Health Association, is pleased to present the 2022 special edition of the Annual Report. This special edition represents the America’s Health Rankings® platform’s broadest portrait to date of the COVID-19 pandemic’s impact, analyzing more than 80 measures at national and state levels to understand the impact of the pandemic at its height in 2020 and 2021, with focused analyses on health disparities by race and ethnicity. This year, the report is supplemented with COVID-19 vaccination and death data from the Centers for Disease Control and Prevention (CDC); long COVID data from the U.S. Census Bureau; and new data from the COVID-era Disparities Survey, conducted by Morning Consult in October 2022, which collected direct insights from individuals affected by the pandemic.
This special edition highlights profound disparities by race and ethnicity across nearly all areas of health and well-being. Disparities widened for fourth graders’ reading proficiency and several mortality measures, including premature death, drug deaths and firearm deaths. Meanwhile, high-speed internet access increased among nearly all racial/ethnic groups, narrowing the racial gap. Other findings included an increase in the supply of primary care and mental health providers as well as a decrease in uninsured and food insecurity rates. Overall challenges included a decrease in fourth grade reading proficiency as well as increases in premature death, drug deaths, drug use, frequent mental distress, multiple chronic conditions and firearm deaths.
Since the peak of the pandemic, the nation has made improvements overall as millions of Americans were vaccinated and returned to many pre-pandemic activities. The COVID-era Disparities Survey, an online survey of more than 3,800 adults, found that Americans’ experiences during the pandemic varied for different populations, from the loss of close friends and family and mental health impacts to social isolation.
This year’s Annual Report includes overall state rankings once again. Rankings were excluded over the past two years due to the extraordinary and unprecedented health challenges during the pandemic. Community leaders and advocates can use this year’s report to tailor and target public health efforts in their states to address issues caused or exacerbated by the pandemic and, ultimately, build healthier communities.
The America’s Health Rankings Annual Report is the longest-running state-by-state analysis of the nation’s health. First published in 1990, America’s Health Rankings continues to provide an opportunity to track short- and long-term public health successes as well as identify current and emerging challenges at state and national levels.
Objective
America’s Health Rankings aims to inform and drive action to build healthier communities by offering credible, trusted data that can guide efforts to improve health and health care. To achieve this, a comprehensive set of measures are analyzed to assess the health of populations across the nation. The report uses a wealth of reputable data sources to produce a combination of key health-related measures across categories of health determinants and health outcomes, including:
- Eighty-three measures. These include 51 measures used in the scoring of states plus 32 additional measures used to track current and emerging health issues at state and national levels. The Annual Report leverages the most recent data available for each measure.
- Five categories of health. These consist of health outcomes and four categories that are determinants of health: social and economic factors, physical environment, behaviors and clinical care.
- Twenty-nine sources. Data in this report come from many different sources, including the CDC’s Behavioral Risk Factor Surveillance System, the U.S. Department of Agriculture’s Household Food Security in the United States report and the U.S. Census Bureau’s Current Population Survey.
- International comparison. This report features a look at the health of the U.S. compared to other OECD countries in measures of infant mortality, total health spending and life expectancy, the last of which has dropped across the world due to COVID-19.
- Supplemental sources. For this special edition, additional COVID-19 data were drawn from the platform as well as from the COVID-era Disparities Survey collected online by Morning Consult in October 2022. Data were analyzed to better understand the impact of the COVID-19 pandemic on health thus far.
The America’s Health Rankings Annual Report seeks to improve population health by:
- Presenting a holistic view of health. This report goes beyond measures of clinical care and health behaviors by considering social, economic and physical environment measures to reflect the growing understanding of the impact of social determinants on health.
- Providing a benchmark for states. Each year the report presents trends, strengths, challenges and highlights for every state. With the America’s Health Rankings Annual Report’s 33 years of data, public health advocates can monitor health trends over time and compare their state with neighboring states and the nation. Every state has its strengths and challenges. It is important to consider the measures collectively, as each measure does not stand alone but rather influences and is influenced by other measures of health and everyday life.
- Stimulating action. The report is intended to drive change and improve health by promoting data-driven discussions among individuals, community leaders, public health workers, policymakers and the media. States can incorporate the report into their annual review of programs, and many organizations use the report as a reference when assigning goals for health-improvement plans.
- Highlighting disparities. The report shows differences in health between states and among population groups at state and national levels, with groupings based on age, gender, race and ethnicity, educational attainment, income and metropolitan status. These analyses often reveal differences among groups that national or state aggregate data mask.
Model for Measuring America’s Health
America’s Health Rankings is built upon the World Health Organization’s definition of health: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
