Appendix Measures Table | 2023 Annual Report

Executive Brief Introduction National HighlightsFindingsHealth Outcomes Social and Economic Factors Physical Environment Clinical Care State Rankings International ComparisonAppendixMeasures Table Data Source Descriptions MethodologyState Summaries
US Summary
2023 Annual Report – Executive Brief 2023 Annual Report 2023 Annual Report – State Summaries 2023 Annual Report – Economic Hardship Index County-Level Maps 2023 Annual Report – Measures Table 2023 Annual Report – Infographics 2023 Annual Report – Report Data (All States)
SOCIAL AND ECONOMIC FACTORS
Community and Family Safety
Firearm Deaths*
Number of deaths due to firearm injury of any intent (unintentional, suicide, homicide or undetermined) per 100,000 population.
CDC WONDER, Multiple Cause of Death Files, 2021
Homicide
Number of deaths due to injuries inflicted by another person with intent to injure or kill per 100,000 population.
CDC WONDER, Multiple Cause of Death Files, 2020-2021
Occupational Fatalities
Number of fatal occupational injuries in construction, manufacturing, trade, transportation and utility industries as well as professional and business services per 100,000 workers.
U.S. Bureau of Labor Statistics, Census of Fatal Occupational Injuries, 2019-2021
Public Health Funding
State dollars dedicated to public health per person (including federal grants directed to states from the CDC and HRSA).
CDC, HRSA and Trust for America's Health, 2021-2022
Economic Resources
Economic Hardship Index
Index of state economic conditions based on crowded housing, dependency, education, income, poverty and unemployment; normalized values are 1 to 100, with a higher value indicating worse economic conditions.
U.S. Census Bureau, American Community Survey, 2022
Crowded Housing*
Percentage of occupied housing units with more than one person per room.
U.S. Census Bureau, American Community Survey, 2022
Dependency (Ages <18 or >64)*
Percentage of the population ages 0-17 or 65 and older.
U.S. Census Bureau, American Community Survey, 2022
Less Than High School Education*
Percentage of population ages 25 and older without a high school diploma. 
U.S. Census Bureau, American Community Survey, 2022
Per Capita Income*
Per capita income in the past 12 months, in inflation-adjusted dollars to data year. 
U.S. Census Bureau, American Community Survey, 2022
Poverty*
Percentage of households living below the federal poverty level. 
U.S. Census Bureau, American Community Survey, 2022
Unemployment*
Percentage of civilian workforce ages 16-64 that is unemployed. 
U.S. Census Bureau, American Community Survey, 2022
Food Insecurity
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 Series, 2019-2021
Homeownership*
Percentage of housing units owned by the occupant. 
U.S. Census Bureau, American Community Survey, 2022
Homeownership Racial Disparity*
Difference between the homeownership rates of the white population and the racial/ethnic population with the lowest rate (varies by state). 
U.S. Census Bureau, American Community Survey, 2022
Income Inequality
Ratio of median household income at the 80th percentile to median household income at the 20th percentile. 
U.S. Census Bureau, American Community Survey, 2022
Education
Fourth Grade Reading Proficiency†
Percentage of fourth grade public school students who scored proficient or above on the National Assessment of Educational Progress in reading comprehension. 
U.S. Department of Education, National Center for Education Statistics, National Assessment of Educational Progress, 2022 
High School Completion
Percentage of adults ages 25 and older with at least a high school diploma or equivalent. 
U.S. Census Bureau, American Community Survey, 2022
High School Graduation*
Percentage of high school students graduating with a regular high school diploma within four years of starting ninth grade. 
U.S. Department of Education, National Center for EducationStatistics, Common Core of Data, 2019-2020 School Year
Social Support and Engagement
Adverse Childhood Experiences^†
Percentage of children ages 0-17 who have ever experienced two or more of the following: parental divorce or separation; living with someone who had an alcohol or drug problem; neighborhood violence victim or witness; living with someone who was mentally ill, suicidal or severely depressed; domestic violence witness; parent served jail time; being treated or judged unfairly due to race/ethnicity; or death of a parent. 
U.S. HHS, HRSA, MCHB, NationalSurvey of Children’s Health, 2020-2021
High-Speed Internet
Percentage of households with a broadband internet subscription and a computer, smartphone or tablet. 
U.S. Census Bureau, American Community Survey, 2022
Residential Segregation - Black/White
Index of dissimilarity, with higher values indicating greater segregation between Black and non-Hispanic white households, ranging from zero (complete integration) to 100 (complete segregation). 
U.S. Census Bureau, American Community Survey, 2017-2021
Volunteerism
Percentage of population ages 16 and older that reported volunteering in the past 12 months. 
U.S. Census Bureau, Current Population Survey, Volunteering and Civic Life Supplement, 2021
Voter Participation^
Average of the percentage of U.S. citizens ages 18 and older who voted in the last presidential and the last midterm national elections. 
U.S. Census Bureau, Current Population Survey, Voting and Registration Supplement, 2020/2022
PHYSICAL ENVIRONMENT
Air and Water Quality
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, 2020-2022
Drinking Water Violations
Average number of health-based drinking water violations per community water system in a state. 
U.S. Environmental Protection Agency, Enforcement and Compliance History Online, Safe Drinking Water Information System, 2022
Non-Smoking Regulation*
Percentage of population covered by 100% smoke-free laws for restaurants, bars and non-hospitality workplaces. 
American Nonsmokers' Rights Foundation, 2023
Water Fluoridation
Percentage of population served by community water systems that have fluoridated water. 
CDC, Water Fluoridation Reporting System, 2020
Climate and Health
Climate 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, 2022
Climate Risks*
Percentage of the population living in disadvantaged census tracts (at or above the 90th percentile) based on any of the following risks: agricultural value losses, building value losses, or fatalities and injuries due to 14 types of natural hazards; or projected flood or wildfire risk. 
Council on Environmental Quality, Climate and Economic Justice Screening Tool Index, 2022
Renewable Energy*
Percentage of electricity generated from renewable sources (biomass, geothermal, hydroelectric, solar and wind). 
U.S. Energy Information Administration, State Energy Data System, 2022
Transportation Energy Use*
Amount of energy in trillion British thermal units (BTUs) consumed by the transportation of people and goods per 100,000 population. 
U.S. Energy Information Administration, State Energy Data System, 2021
Housing and Transportation
Drive Alone to Work*
Percentage of workers ages 16 and older who drive alone to work. 
U.S. Census Bureau, American Community Survey, 2022
Housing Cost Burden*
Percentage of households with housing costs more than 30% of household income. 
U.S. Census Bureau, American Community Survey PUMS, 2021
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, 2022
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 Housingand Urban Development, Comprehensive Housing Affordability Strategy, 2016-2020
Transportation Health Risks*
Percentage of the population living in disadvantaged census tracts (at or above the 90th percentile) based on any of the following risks: diesel particulate matter exposure, transportation barriers, or traffic proximity and volume. 
Council on Environmental Quality, Climate and Economic Justice Screening Tool Index, 2022
CLINICAL CARE
Access to Care
Avoided Care Due to Cost
Percentage of adults 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, 2022
Providers
Dental Care Providers
Number of general dentists and advanced practice dental therapists per 100,000 population. 
U.S. HHS, Centers for Medicare &Medicaid Services, National Plan and Provider Enumeration System, September 2023
Mental Health Providers
Number of psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists and advanced practice nurses specializing in mental health care per 100,000 population. 
U.S. HHS, Centers for Medicare &Medicaid Services, National Plan and Provider Enumeration System, September 2023
Primary Care Providers
Number of active primary care providers (including general practice, family practice, obstetrics and gynecology, pediatrics, geriatrics, internal medicine, physician assistants and nurse practitioners) per 100,000 population.
 U.S. HHS, Centers for Medicare &Medicaid Services, National Plan and Provider Enumeration System, September 2023
Uninsured
Percentage of population not covered by private or public health insurance. 
U.S. Census Bureau, American Community Survey, 2022
Preventive Clinical Services
Cancer Screenings*
Percentage of women ages 40-74 who reported receiving a mammogram in the past two years and percentage of adults ages 45-75 who reported receiving colorectal cancer screening within the recommended time period. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Breast Cancer Screening*
Percentage of women ages 40-74 who reported receiving a mammogram in the past two years. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Colorectal Cancer Screening
Percentage of adults ages 45-75 who reported receiving one or more of the recommended colorectal cancer screening tests within the recommended time interval (blood stool test within the past year; sigmoidoscopy within the past five years; colonoscopy within the past 10 years; stool DNA test within the past three years; virtual colonoscopy within the past five years or sigmoidoscopy within the past 10 years and blood stool test in the past year). 
CDC, Behavioral Risk Factor Surveillance System, 2022
Dental Visit
Percentage of adults who reported visiting a dentist or dental clinic within the past year. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Immunizations
Childhood Immunizations†
Percentage of children who received by age 24 months all recommended doses of the combined seven-vaccine series: diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine; measles, mumps and rubella (MMR) vaccine; poliovirus vaccine; Haemophilus influenzae type b (Hib) vaccine; hepatitis B (HepB) vaccine; varicella vaccine; and pneumococcal conjugate vaccine (PCV). 
CDC, National Immunization Survey-Child, 2017-2018 Birth Cohort
Flu Vaccination
Percentage of adults who reported receiving a seasonal flu vaccine in the past 12 months. 
CDC, Behavioral Risk Factor Surveillance System, 2022
HPV Vaccination
Percentage of adolescents ages 13-17 who received all recommended doses of the human papillomavirus (HPV) vaccine. 
CDC, National Immunization Survey-Teen, 2022
Quality of Care
Dedicated Health Care Provider
Percentage of adults who reported having a personal doctor or health care provider. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Preventable Hospitalizations
Discharges following hospitalization for ambulatory care sensitive conditions (PQI 90) per 100,000 Medicare beneficiaries ages 18 and older enrolled in the fee-for-service program. 
U.S. HHS, Centers for Medicare & Medicaid Services, Office of Minority Health, Mapping Medicare Disparities Tool, 2021
BEHAVIORS
Nutrition and Physical Activity
Exercise†
Percentage of adults who met the federal physical activity guidelines (150 minutes of moderate or 75 minutes of vigorous aerobic activity and two days of muscle strengthening per week) in the past 30 days. 
CDC, Behavioral Risk Factor Surveillance System, 2019
Fruit and Vegetable Consumption†
Percentage of adults who reported consuming two or more fruits and three or more vegetables daily. 
CDC, Behavioral Risk Factor Surveillance System, 2021
Physical Inactivity
Percentage of adults who reported doing no physical activity or exercise other than their regular job in the past 30 days. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Sexual Health
Chlamydia
Number of new cases of chlamydia per 100,000 population. 
CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Atlas, 2021
High-Risk HIV Behaviors
Percentage of adults who reported having done any of the following in the past year: injected any drug other than those prescribed for you; been treated for a sexually transmitted disease; or given or received money or drugs in exchange for sex. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Teen Births
Births per 1,000 females ages 15-19. 
CDC WONDER, Natality Public Use Files, 2021
Sleep Health
Insufficient Sleep
Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Smoking and Tobacco Use
E-Cigarette Use*
Percentage of adults who reported using e-cigarettes or other electronic vaping products at least once in their lifetime and now use daily or some days. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Smoking
Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days. 
CDC, Behavioral Risk Factor Surveillance System, 2022
HEALTH OUTCOMES
Behavioral Health
Drug Deaths*
Number of deaths due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 population.
CDC WONDER, Multiple Cause of Death Files, 2021
Excessive Drinking
Percentage of adults who reported binge drinking (four or more [females] or five or more [males] drinks on one occasion in the past 30 days) or heavy drinking (eight or more [females] or 15 or more [males] drinks per week). 
CDC, Behavioral Risk Factor Surveillance System, 2022
Frequent Mental Distress
Percentage of adults who reported their mental health was not good 14 or more days in the past 30 days. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Non-Medical Drug Use^
Percentage of adults who reported using prescription drugs non-medically (including pain relievers, stimulants and sedatives) or illicit drugs (excluding cannabis) in the last 12 months.
Denver Health and Hospital Authority, RADARS® System Survey of Non-Medical Use of Prescription Drugs Program, 2023
Suicide*
Number of deaths due to intentional self-harm per 100,000 population. 
CDC WONDER, Multiple Cause of Death Files, 2021
Mortality
Premature Death
Years of potential life lost before age 75 per 100,000 population. 
CDC WONDER, Multiple Cause of Death Files, 2021
Premature Death Racial Disparity†
Ratio of the premature death rate of the racial/ethnic group with the highest rate (varies by state) to the non-Hispanic white rate.
CDC WONDER, Multiple Cause of Death Files, 2018-2020
Physical Health
Frequent Physical Distress
Percentage of adults who reported their physical health was not good 14 or more days in the past 30 days. 
CDC, Behavioral Risk Factor Surveillance System, 2022
High Health Status*
Percentage of adults who reported their health was very good or excellent. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Low Birth Weight
Percentage of infants weighing less than 2,500 grams (5 pounds, 8 ounces) at birth. 
CDC WONDER, Natality Public Use Files, 2021
Low Birth Weight Racial Disparity
Ratio of the low birth weight rate of the racial/ethnic group with the highest rate (varies by state) to the non-Hispanic white rate. 
CDC WONDER, Natality Public Use Files, 2019-2021
Multiple Chronic Conditions
Percentage of adults who had three or more of the following chronic health conditions: arthritis, asthma, chronic kidney disease, chronic obstructive pulmonary disease, cardiovascular disease (heart disease, heart attack or stroke), cancer (excluding non-melanoma skin cancer), depression or diabetes. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Arthritis*
Percentage of adults who reported ever being told by a health professional that they had some form of arthritis. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Asthma*
Percentage of adults who reported ever being told by a health professional that they currently have asthma. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Cancer*
Percentage of adults who reported ever being told by a health professional that they had any form of cancer other than non-melanoma skin cancer. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Cardiovascular Diseases*
Percentage of adults who reported ever 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, 2022
Chronic Kidney Disease*
Percentage of adults who reported ever being told by a health professional that they have kidney disease (excluding kidney stones, bladder infection or incontinence). 
CDC, Behavioral Risk Factor Surveillance System, 2022
Chronic Obstructive Pulmonary Disease*
Percentage of adults who reported ever being told by a health professional that they have chronic obstructive pulmonary disease, emphysema or chronic bronchitis. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Depression*
Percentage of adults who reported ever being told by a health professional that they have a depressive disorder, including depression, major depression, minor depression or dysthymia. 
CDC, Behavioral Risk Factor Surveillance System, 2022
Diabetes*
Percentage of adults who reported ever being told by a health professional that they have diabetes (excluding prediabetes and gestational diabetes). 
CDC, Behavioral Risk Factor Surveillance System, 2022
Risk Factors
High Blood Pressure*†
Percentage of adults who reported being told by a health professional that they had high blood pressure. 
CDC, Behavioral Risk Factor Surveillance System, 2021
High Cholesterol*†
Percentage of adults who reported having their cholesterol checked and being told by a health professional that it was high. 
CDC, Behavioral Risk Factor Surveillance System, 2021
Obesity
Percentage of adults with a body mass index of 30.0 or higher based on reported height and weight. 
CDC, Behavioral Risk Factor Surveillance System, 2022
DEMOGRAPHICS
Total Population*
Number of estimated residents. 
CDC WONDER, Single-Race Population Estimates, 2022
Population - Children Ages <18*
Percentage of population younger than age 18. 
CDC WONDER, Single-Race Population Estimates, 2022
Population - Adults Ages 18-64*
Percentage of population ages 18-64. 
CDC WONDER, Single-Race Population Estimates, 2022
Population - Adults Ages 65+*
Percentage of population ages 65 and older. 
CDC WONDER, Single-Race Population Estimates, 2022
Rural Population*
Percentage of a state’s total population estimated to live in a rural area.
U.S. Census Bureau, American Community Survey, 2021

* Additional measure, not included in the calculation of overall model category or topic summation measures.
† Data in this edition were repeated from the last edition of the Annual Report.
^ Data for each of the components are available in the Explore Data section.
Acronyms
AIDS Acquired immunodeficiency syndrome
CDC Centers for Disease Control and Prevention
HHS United States Department of Health and Human Services
HIV Human immunodeficiency virus
HRSA Health Resources and Services Administration
MCHB Maternal and Child Health Bureau
PUMS Public Use Microdata Sample
STD Sexually transmitted disease
TB Tuberculosis
WONDER Wide-ranging Online Data for Epidemiologic Research
Measures Table

SOCIAL AND ECONOMIC FACTORS

Community and Family Safety

Economic Resources

Education

Social Support and Engagement

PHYSICAL ENVIRONMENT

Air and Water Quality

Climate and Health

Housing and Transportation

CLINICAL CARE

Access to Care

Providers

Preventive Clinical Services

Immunizations

Quality of Care

BEHAVIORS

Nutrition and Physical Activity

Sexual Health

Sleep Health

Smoking and Tobacco Use

HEALTH OUTCOMES

Behavioral Health

Mortality

Physical Health

Risk Factors

DEMOGRAPHICS

Reports

Explore Data

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