Clinical Care

Preventive Clinical Care

Women and Children

• Changes over time. Nationally, the percentage of women ages 21-44 who reported receiving a Pap smear within the past three years significantly decreased 4% from 79.9% to 77.1% between 2018 and 2020. In 2020, nearly 32.2 million women received a recommended cervical cancer screening. Cervical cancer screening significantly decreased in six states, led by 16% in Alaska (80.8% to 67.9%). All age groups and some racial/ethnic, education and income subpopulations experienced significant decreases in cervical cancer screening, led by 8% among women ages 21-24 (62.5% to 57.7%).
• Disparities. Cervical cancer screening among women was highest in Mississippi (85.2%) and lowest in Alaska (67.9%) in 2020. The prevalence significantly varied by age, race/ethnicity, education and income. It was 1.4 times higher among women ages 25-34 (81.4%) and 35-44 (81.1%) compared with those ages 21-24 (57.7%). It was also 1.4 times higher among Black women (82.2%) compared with Asian women (60.5%).

Children

• Changes over time. Nationally, the percentage of children ages 1-17 whose caregiver reported that they had one or more preventive dental care visits during the past 12 months significantly decreased 6% from 79.6% to 75.1% between 2018-2019 and 2020-2021. The prevalence of preventive dental care visits significantly decreased in seven states, led by 11% in both New Jersey (84.9% to 75.7%) and Ohio (78.4% to 69.6%).
• Disparities. Preventive dental care among children was highest in Hawaii (84.9%) and lowest in Florida (69.5%) in 2020-2021.

• Changes over time. Nationally, the percentage of children ages 0-17 whose caregiver reported that they received one or more preventive visits in the past 12 months significantly decreased 7% from 82.2% to 76.7% between 2016-2017 and 2020-2021. The prevalence of well-child visits significantly decreased in 18 states, led by 13% in both California (79.0% to 68.7%) and New Mexico (80.9% to 70.6%). By age group, well-child visits significantly decreased 8% among children ages 3-17 from 80.6% to 74.5%.
• Disparities. Well-child visits among children were highest in New Hampshire (86.9%) and lowest in Nevada (67.4%) in 2020-2021. The prevalence was significantly higher among children ages 0-2 (88.4%) compared with children ages 3-17 (74.5%).

Women

• Changes over time. Nationally, the percentage of women ages 18-44 who reported receiving a seasonal flu vaccine in the past 12 months significantly increased 26% from 30.8% to 38.9% between 2017-2018 and 2019-2020, with more than 19.9 million women receiving flu vaccinations in 2019-2020. Flu vaccination significantly increased in 41 states and the District of Columbia, led by 51% in both New Hampshire (30.1% to 45.5%) and Oregon (25.8% to 39.0%). Nearly all age, racial/ethnic, education and income subpopulations experienced significant increases in flu vaccination. By group, the largest increases were: 32% among women ages 18-24 (28.3% to 37.4%); 31% among white women (32.2% to 42.1%); and 27% among both college graduates (40.9% to 52.1%) and women with an annual household income of $75,000 or more (40.6% to 51.6%).‡
• Disparities. The prevalence of flu vaccination among women was 2.1 times higher in South Dakota (53.3%), the state with the highest value in 2019-2020, compared with Nevada (25.9%), the state with the lowest value. The prevalence varied the most by education, and also significantly varied by income, race/ethnicity, age and metropolitan status.