Close
Executive BriefIntroductionNational HighlightsFindingsHealth OutcomesSocial and Economic FactorsClinical CareBehaviorsState RankingsAppendixMeasures Table – WomenMeasures Table – ChildrenData Source DescriptionsMethodologyState Summaries
US Summary
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 SummaryAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingThe United Health Foundation is proud to release the America’s Health Rankings® 2023 Health of Women and Children Report, which continues to provide a comprehensive look at the health of these populations.
This report highlights the rising rates of mortality among women of reproductive age and children across the nation and on a state-by-state basis, as well as the stark disparities that exist by geography and race/ethnicity.
Monitoring the health and well-being of women of reproductive age and children is a fundamental aspect of public health. Ensuring the health of these two groups by preventing disease, improving access to care, encouraging healthy behaviors and promoting equity by addressing the social determinants of health can have a significant impact on the overall well-being of individuals, families and communities. According to the U.S. Census Bureau, in 2021 there were 58.7 million women of reproductive age (18-44) and 73.6 million children in the United States, representing roughly 40% of the total population. These populations have continued to grow and diversify in the past several years; however, many of the challenges affecting their health and well-being have remained consistent, and new challenges have emerged.
For the second consecutive year, the mortality rate among both women and children continued to increase, reaching new highs in America’s Health Rankings history. This report highlights the rising rates of maternal mortality and drug deaths among women and introduces two new community and family safety measures that are on the rise: injury deaths among both women and children. Within these measures of mortality, stark disparities exist by geography and race/ethnicity.
Despite negative trends in mortality, the percentage of women who reported their own health was very good or excellent improved, reaching the highest level recorded by America’s Health Rankings.
The data also highlight several changes that occurred during the COVID-19 pandemic. In some cases, long-term improvements like the reduction in teen births continued; however, other measures shifted. For example, there was an encouraging decrease in the prevalence of electronic vapor product use among high schoolers, while there was a discouraging drop in the percentage of 3- and 4-year-olds enrolled in early childhood education.
The 2023 Health of Women and Children Report finds that:
- Mortality rates, including maternal mortality, continued to increase among women of reproductive age and children, while the infant mortality rate declined. All mortality measures had wide disparities by race/ethnicity and geography.
- Women’s mental and behavioral health challenges continued to grow, with increases in the drug death rate and prevalences of frequent mental distress and depression, all with disparities by age, race/ethnicity and geography.
- Despite troubling trends in women’s mortality measures and mental health, the percentage of women who reported their own health was very good or excellent improved, along with the percentage who reported frequent physical distress. However, severe maternal morbidity and the percentage of infants born with a low birth weight significantly worsened.
- Injury deaths, an indicator of community and family safety, have been increasing among women of reproductive age and children.
- During the COVID-19 pandemic, early childhood education enrollment declined substantially between 2019 and 2021.
- Many measures of individuals’ access to care improved while the number of women’s health providers declined.
- Among women of reproductive age, fruit and vegetable intake decreased and the percentage of physically inactive women declined.
- The long-term successes in reducing smoking and teen birth rates have continued.
We encourage policymakers, advocates, community leaders and individuals to use these findings to help target and tailor public health interventions that address these concerning trends and their upstream causes.
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 population health and health care. To achieve this, America’s Health Rankings continues to collaborate with an advisory group to determine the selection of a comprehensive set of measures. The 2023 Health of Women and Children Report is based on:
- 122 measures. These include 83 ranking and 39 additional measures (not included in overall rank). Five new measures are introduced this year including high school completion, injury deaths among women, injury deaths among children, housing cost burden in households with children and maternity care desert. For a full list of measures, definitions and source details, see the Measures Table.
- Five categories of health. These include health outcomes and four other categories that are determinants of health: social and economic factors, physical environment, behaviors and clinical care.
- 34 data sources. Data are from many sources, including CDC’s Behavioral Risk Factor Surveillance System and Pregnancy Risk Assessment Monitoring System, the March of Dimes and the U.S. Census Bureau’s American Community Survey.
The America’s Health Rankings Health of Women and Children Report aims 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, reflecting the impact of social determinants of health.
- Providing a benchmark for states. Each year the report presents strengths, challenges and highlights for every state using data dating back to the first Health of Women and Children Report. Public health advocates can monitor health trends over time and compare their state with other states or the nation. State summaries containing data on all 83 ranking measures are available on the website as a separate download.
- Highlighting disparities. The report shows differences in health between states and among population groups at state and national levels, with groupings based on race/ethnicity, gender, age, educational attainment, income level and metropolitan status. These analyses often reveal differences among groups that national or state aggregate data may mask.
- Stimulating action. The report aims 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 it as a reference when assigning goals for health improvement plans.
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.” The model was developed under the guidance of the America’s Health Rankings’ Advisory Council and committees, with insights from other rankings and health models, namely County Health Rankings & Roadmaps and Healthy People. The model serves as a framework across all America’s Health Rankings reports for identifying and quantifying health drivers and outcomes that impact state and national population health.
