Findings Health Outcomes | 2024 Health Of Women And Children Report

Executive Brief Introduction National SnapshotFindingsHealth Outcomes Social and Economic Factors Clinical Care Behaviors State RankingsAppendixMeasures Table – Women Measures Table – Children Data Source Descriptions MethodologyState Summaries
US Summary
2024 Health of Women and Children Report 2024 Health of Women and Children Report – Executive Brief 2024 Health of Women and Children Report – State Summaries 2024 Health of Women and Children Report – Concentrated Disadvantage County-Level Maps 2024 Health of Women and Children Report – Measures Table 2024 Health of Women and Children Report – Infographics 2024 Health of Women and Children Report – Report Data (All States)
Several measures of behavioral and physical health among women worsened, like depression and severe maternal morbidity. Mortality among children also worsened. However, several other measures of children’s health improved, including teen suicide and the prevalence of youth who are overweight or have obesity.
Health Outcomes | Mortality
Overall mortality improved among women of reproductive age.
In contrast, rates of maternal mortality and mortality among children worsened. 
Mortality Among Women 
Women in the United States have a higher rate of preventable deaths than women living in other high-income countries. In 2022, the 10 leading causes of death for women ages 20-44 were unintentional injuries (led by poisoning and motor vehicle accidents), cancer, heart disease, suicide, chronic liver disease/cirrhosis, homicide, COVID-19, diabetes, cerebrovascular diseases and deaths associated with pregnancy and childbirth. The number of COVID-19 deaths among women ages 20-44 dropped from approximately 8,700 to 2,300 between 2021 and 2022, shifting the disease from the second to the seventh most common cause of death.
Changes over time. Nationally, mortality among women — the number of deaths per 100,000 females ages 20-44 — decreased 12%, from 136.4 to 120.0 between 2021 and 2022, after increasing 16% between 2020 and 2021. In 2022, about 66,000 women of reproductive age died in the U.S., a decrease of 8,400 deaths compared with 2021. Rates decreased 26% among Hawaiian/Pacific Islander (240.9 to 178.0 deaths per 100,000 women ages 20-44), 17% among Hispanic (97.3 to 81.0), 14% among Black (222.7 to 192.3), 12% among American Indian/Alaska Native (423.4 to 370.5) and 10% among white (138.8 to 124.8) women.
The mortality rate decreased in 20 states, led by: 23% in Alabama (212.3 to 163.1 deaths per 100,000 women ages 20-44), 22% in Mississippi (244.4 to 189.9) and 21% in Florida (159.4 to 125.4).
Disparities. The mortality rate significantly varied by race/ethnicity and geography in 2022. The rate was: 
9.4 times higher among American Indian/Alaska Native (370.5 deaths per 100,000 women ages 20-44) than Asian (39.6) women. The disparity between these two groups was wider in 2022 than in 2019 (7.7).
2.9 times higher in West Virginia (224.8) than Hawaii (78.7).

Related Measure: Maternal Mortality
Nationally, maternal mortality — the number of deaths related to or aggravated by pregnancy (excluding accidental or incidental causes) occurring within 42 days of the end of a pregnancy per 100,000 live births — increased 34%, from 17.3 to 23.2 between 2014-2018 and 2018-2022. The rate exceeds the Healthy People 2030 national target of 15.7 deaths per 100,000. Approximately 4,300 maternal deaths occurred in 2018-2022, about 900 more deaths than in 2014-2018. 
Disparities. The maternal mortality rate significantly varied by race/ethnicity, geography, age and educational attainment in 2018-2022. The rate was: 
4.4 times higher among American Indian/Alaska Native (58.0 deaths per 100,000 live births) than multiracial (13.1) women.
3.9 times higher in Tennessee (41.1) than California (10.5).
3.4 times higher among women age 35 and older (48.1) than those ages 20-24 (14.0).
3.0 times higher among women who graduated from high school (36.2) than college graduates (12.2).
Note: The 2014-2018 and 2018-2022 comparison contains an overlapping data year (2018); thus, the comparison is mainly between the non-overlapping years (2014-2017 and 2019-2022). The values for American Indian/Alaska Native, Black and Hawaiian/Pacific Islander women may not differ significantly based on overlapping 95% confidence intervals. The same is true for multiracial, Asian and Hispanic women; women younger than 20, women ages 20-24 and women ages 25-29; and women with less than a high school education and high school graduates.

Mortality Among Children 
In 2020-2022, the leading causes of death among children ages 1-19 in the U.S. were accidents (unintentional injuries), homicide, suicide, cancer and congenital abnormalities. Many of these types of deaths are often preventable. The leading causes of injury death (both intentional and unintentional) among children in 2020-2022 were firearms, followed by motor vehicle traffic accidents and poisoning. The U.S. is the only nation among its economic peers where firearms are the leading cause of child mortality. 
Changes over time. Nationally, child mortality — the number of deaths per 100,000 children ages 1-19 — increased 14%, from 25.4 to 29.0 between 2017-2019 and 2020-2022. This increase is larger than the increase featured in the 2023 Health of Women and Children Report and exceeds the Healthy People 2030 target of 18.4 deaths per 100,000 population. About 68,000 children died in the U.S. during 2020-2022, an increase of 8,000 deaths since 2017-2019. Rates increased among all age and gender groups. By group, the largest increases between 2017-2019 and 2020-2022 were:
20% among children ages 15-19 (49.8 to 59.9 deaths per 100,000 children), 7% among children ages 5-14 (13.4 to 14.4) and 6% among children ages 1-4 (23.8 to 25.2).
16% among boys (32.3 to 37.5) and 12% among girls (18.1 to 20.2).
During the same period, the child mortality rate increased in 22 states. The largest increases were: 37% in Montana (33.4 to 45.7 deaths per 100,000 children ages 1-19), 29% in Louisiana (36.8 to 47.3) and 25% in North Carolina (26.7 to 33.4).
Disparities. The child mortality rate significantly varied by race/ethnicity, age and geography in 2020-2022. The rate was: 
4.3 times higher among American Indian/Alaska Native (60.7 deaths per 100,000 children ages 1-19) compared with Asian (14.0) children.
4.2 times higher among children ages 15-19 (59.9) than those ages 5-14 (14.4).
3.1 times higher in Mississippi (49.4) than Massachusetts (15.8).
Note: The values for American Indian/Alaska Native and Black children may not differ significantly based on overlapping 95% confidence intervals.​

Health Outcomes | Behavioral Health
Many behavioral health measures worsened for women. Among children, diagnoses of mental health conditions increased and teen suicide rates improved.
Drug Deaths Among Women 
Heavy drug use and overdoses are costly to society, burdening individuals, families, the health care system and the economy. The opioid epidemic has contributed to a decline in overall life expectancy in the U.S. Though this measure includes deaths from all drug deaths, opioids — fentanyl in particular — are the most significant contributor. More than 76% of drug deaths in 2022 involved an opioid. 
Changes over time. Nationally, the drug death rate — death due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 females ages 20-44 — increased 38%, from 20.7 to 28.6 between 2017-2019 and 2020-2022. This increase exceeded the 27% increase featured in last year’s report. The rate is higher than the Healthy People 2030 target of 20.7 deaths per 100,000 population. In 2020-2022, nearly 46,900 women of reproductive age died in the U.S. from a drug overdose, an increase of 13,500 deaths since 2017-2019. The drug death rate increased in 35 states and the District of Columbia. The largest increases were: 113% in Mississippi (12.6 to 26.9 deaths per 100,000 women ages 20-44), 111% in North Dakota (12.3 to 26.0) and 101% in Oregon (11.0 to 22.1).
Disparities. The drug death rate significantly varied by race/ethnicity, geography and age in 2020-2022; all disparities were wider than they were in 2019-2021. The rate was:
19.1 times higher among American Indian/Alaska Native (68.6 deaths per 100,000 women ages 20-44) compared with Asian women (3.6).
10.2 times higher in West Virginia (91.2) than Hawaii (8.9).
2.4 times higher among women ages 35-44 (35.5) than those ages 20-24 (15.0).


Frequent Mental Distress Among Women 
Chronic stressors like housing insecurity, food insecurity and insufficient sleep are associated with frequent mental distress, a self-reported measure representing the population experiencing persistent and severe mental health issues. In severe cases, poor mental health can lead to suicide, one of the leading causes of death in the U.S. 
Changes over time. Nationally, the percentage of women ages 18-44 who reported their mental health was not good 14 or more days in the past 30 days increased 18%, from 19.4% to 22.9% between 2019-2020 and 2021-2022, larger than the 16% increase featured in last year’s report. The prevalence increased across all income and age groups and some educational attainment groups, as well as among women living in both metropolitan and non-metropolitan areas during this time frame. By group, the largest increases were:
38% among women with an annual household income of $50,000-$74,999 (16.7% to 23.1%), 26% among women with incomes of $75,000 or more (12.0% to 15.1%), 20% among women with incomes of $25,000-$49,999 (20.3% to 24.4%) and 17% among women with incomes less than $25,000 (24.8% to 28.9%).
20% among women ages 18-24 (24.5% to 29.4%), 19% among women ages 25-34 (19.1% to 22.8%) and 17% among women ages 35-44 (16.0% to 18.7%).
21% among women who graduated from college (13.5% to 16.3%) and women with some post-high school education (20.8% to 25.1%), and 19% among women who graduated from high school (19.1% to 22.7%).​ 
17% among women living in non-metropolitan areas (21.9% to 25.6%) and 15% among women living in metropolitan areas (19.6% to 22.6%).
During this time frame, the prevalence of frequent mental distress increased in 20 states. The largest increases were: 46% in Alaska (15.8% to 23.0%), 43% in Wisconsin (18.5% to 26.4%) and 37% in Idaho (19.3% to 26.5%). 
Disparities. Frequent mental distress significantly varied by disability, sexual orientation, race/ethnicity, income, geography, age and educational attainment in 2021-2022. The prevalence was:
4.4 times higher among women with independent living difficulty (65.6%) than those without a disability (14.8%).
2.2 times higher among LGBQ+ (43.0%) than straight (19.3%) women.
2.2 times higher among multiracial (33.2%) compared with Asian (15.1%) women.
1.9 times higher among women with an annual household income less than $25,000 (28.9%) than those with incomes of $75,000 or more (15.1%).
1.8 times higher in Tennessee (30.5%) than Hawaii (16.6%).
1.6 times higher among women ages 18-24 (29.4%) than those ages 35-44 (18.7%).
1.5 times higher among women with some post-high school education (25.1%) than college graduates (16.3%).
Note: The values for women with independent living difficulty and those who have difficulty with self-care may not differ significantly based on overlapping 95% confidence intervals. The same is true for multiracial and American Indian/Alaska Native women; as well as Asian, Hispanic and Hawaiian/Pacific Islander women.

Depression Among Women 
Depression is a serious mood disorder that is more common among women than men. The symptoms of depression — such as hopelessness, fatigue and loss of interest in activities — can interfere with daily life.
Changes over time. Nationally, the percentage of women ages 18-44 who reported being told by a health professional that they had a depressive disorder — including depression, major depression, minor depression or dysthymia — increased 11%, from 26.1% to 29.1% between 2019-2020 and 2021-2022, higher than the 8% increase featured in the 2023 report. In 2021-2022, depression affected nearly 17.1 million women ages 18-44 in the U.S., 2.2 million more than in 2019-2020. The prevalence increased among the following population groups between 2019-2020 and 2021-2022:
20% among women with an annual household income of $50,000-$74,999 (26.2% to 31.4%) and 14% among both women with incomes of $75,000 or more (21.1% to 24.1%) and women with incomes of $25,000-$49,999 (27.7% to 31.5%).
16% among women ages 18-24 (28.5% to 33.1%), 12% among women ages 25-34 (26.8% to 29.9%) and 8% among women ages 35-44 (23.9% to 25.8%).
15% among women with some post-high school education (30.2% to 34.6%) and 13% among college graduates (20.9% to 23.7%).
11% among women living in metropolitan areas (25.6% to 28.3%) and 10% among women living in non-metropolitan areas (32.0% to 35.1%).
During this time, the prevalence of depression increased in 16 states. The largest increases were: 32% in New Mexico (21.9% to 28.8%), 28% in Colorado (25.2% to 32.3%)​ and 26% in Wyoming (29.9% to 37.7%).
Disparities. The prevalence of depression varied significantly by disability, race/ethnicity, geography, sexual orientation, educational attainment, income, age, veteran status and metropolitan status in 2021-2022. The prevalence was:
3.7 times higher among women with independent living difficulty (74.1%) than those without a disability (20.3%).
2.6 times higher among multiracial (42.1%) than Asian (16.0%) women.
2.4 times higher in Maine (41.0%) than Hawaii (17.2%).
2.1 times higher among LGBQ+ (55.9%) than straight (26.3%) women.
1.5 times higher among women with some post-high school education (34.6%) than those with less than a high school education (22.8%).
1.4 times higher among women with an annual household income less than $25,000 (33.5%) than those with incomes of $75,000 or more (24.1%).
1.3 times higher among women ages 18-24 (33.1%) than those ages 35-44 (25.8%).
1.3 times higher among women who have served in the U.S. armed forces (37.8%) than those who have not served (29.0%).
1.2 times higher among women living in non-metropolitan (35.1%) than metropolitan (28.3%) areas.
Note: The values for multiracial and white women as well as Asian and Hawaiian/Pacific Islander women may not differ significantly based on overlapping 95% confidence intervals. The same is true for women with less than a high school education and college graduates; as well as for women with incomes less than $25,000, incomes of $25,000-$49,999 and incomes of $50,000-$74,999. 

Mental Health Conditions Among Children 
Early diagnosis of mental health conditions among children is vital to provide adequate care and support and reduce problems at home, in school and in forming friendships. Common mental health conditions among children include anxiety, depression and attention-deficit/hyperactivity disorder (ADHD).
Changes over time. Nationally, the percentage of children ages 3-17 told by a health care provider they currently have ADHD, depression or anxiety problems, or told by a doctor or educator they have behavior or conduct problems, increased 12%, from 17.7% to 19.9% between 2020-2021 and 2022-2023. In 2022-2023, around 12.1 million children had a diagnosis, about 1.4 million more children than in 2020-2021. ADHD increased 12% (9.4% to 10.5%) and anxiety increased 18% (9.1% to 10.7%).​ The prevalence of depression (4.4%) and behavior problems (7.5%) did not significantly change in this period. It is possible that the rise in diagnosed mental health conditions reflects an increase in diagnoses rather than the underlying conditions.
During this period, the prevalence of mental health conditions increased among the following populations:
16% among girls (15.7% to 18.2%) and 10% among boys (19.6% to 21.5%).​
15% among white children (19.9% to 22.9%).​
14% among children with a caregiver who graduated from college (16.9% to 19.3%).
Between 2020-2021 and 2022-2023, mental health conditions among children increased 47% in Minnesota (15.8% to 23.2%), 39% in Missouri (16.3% to 22.7%) and 33% in Utah (17.9% to 23.8%). 
Disparities. Mental health conditions among children significantly varied by race/ethnicity, geography, caregiver educational attainment and gender in 2022-2023. The prevalence was:
3.8 times higher among American Indian/Alaska Native (24.9%) than Hawaiian/Pacific Islander (6.6%) children.
2.1 times higher in Maine (28.9%) than Hawaii (14.0%).
1.6 times higher among children who have a caregiver with some post-high school education (22.8%) than those whose caregivers have less than a high school education (14.2%).
1.2 times higher among boys (21.5%) than girls (18.2%).
Note: The values for American Indian/Alaska Native, white, multiracial and Black children may not differ significantly based on overlapping 95% confidence intervals. The same is true for Asian and Hawaiian/Pacific Islander children; and children who have a caregiver with some post-high school education and those with a caregiver who graduated from high school.

Related Measure: Mental Health Treatment
The surgeon general has issued an advisory on the state of mental health among youth in the U.S. In 2022-2023, 82.5% of children ages 12-17 (nearly 4.5 million) received needed mental health treatment or counseling. The percentage of children receiving treatment ranged from 95.9% in Iowa to 69.0% in Florida, and has not significantly changed in recent years.  

Teen Suicide 
In 2022, suicide was the second-leading cause of death for children ages 10-14 in the U.S. 
Changes over time. Nationally, the teen suicide rate decreased 6%, from 11.2 to 10.5 deaths per 100,000 adolescents ages 15-19 between 2017-2019 and 2020-2022. However, the rate remains significantly higher than in 2014-2016 (8.9), when it started to increase. In 2020-2022, about 7,000 teens died of suicide in the U.S., 380 fewer deaths than in 2017-2019. Between 2017-2019 and 2020-2022, the rate among teenage boys decreased 8% (17.0 to 15.6 deaths per 100,000 adolescents ages 15-19) but is still 11% higher than in 2014-2016 (14.0). 
Teen suicide decreased 24% in Ohio (12.6 to 9.6) during the same period. 
Disparities. The teen suicide rate significantly varied by geography, race/ethnicity and gender in 2020-2022. The rate was:
7.1 times higher in Montana (36.3 deaths per 100,000 adolescents ages 15-19) than New York (5.1). South Dakota (33.7) and Alaska (30.2) also had high rates, and New Jersey (5.3) and Connecticut (5.8) also had low rates.
4.7 times higher among American Indian/Alaska Native (37.2) than Hispanic (7.9) teens.
3.1 times higher among teenage boys (15.6) than teenage girls (5.1).
Note: ​The values for Hispanic, multiracial and Asian adolescents may not differ significantly based on overlapping 95% confidence intervals.

Health Outcomes | Physical Health
Among women, rates of severe maternal morbidity, asthma and obesity worsened. However, the prevalence of youth who are overweight or have obesity improved. Among newborns, congenital syphilis increased, but neonatal abstinence syndrome decreased. 
Severe Maternal Morbidity 
Severe maternal morbidity includes serious and potentially life-threatening events and outcomes, such as eclampsia or hysterectomy. It is estimated that for every pregnancy-related death, 20-30 people experience unexpected outcomes of pregnancy, labor or delivery that lead to short- or long-term health consequences.
Changes over time. Nationally, severe maternal morbidity — the number of significant life-threatening maternal complications during delivery per 10,000 delivery hospitalizations — increased 14%, from 88.3 to 100.3 complications between 2020 and 2021. In 2021, about 33,600 women in the U.S. experienced severe maternal morbidity, about 4,000 more than in 2020. Between 2020 and 2021, severe maternal morbidity increased among the following populations:
35% among American Indian/Alaska Native (99.6 to 134.7 complications per 10,000 delivery hospitalizations), 19% among white (69.9 to 83.4), 16% among Asian/Pacific Islander (98.4 to 114.1), 13% among Black (139.0 to 156.8) and 7% among Hispanic (94.6 to 100.9) women.
17% among women living in the second-least wealthy ZIP code quartile (85.9 to 100.4), 14% among women living in the wealthiest ZIP code quartile (79.8 to 90.6), 13% among women living in the least wealthy ZIP code quartile (100.6 to 113.5) and 12% among women living in the second-wealthiest ZIP code quartile (84.5 to 94.8).
15% among women ages 20-24 (72.3 to 83.2) and women ages 30-34 (84.8 to 97.8), and 12% among women ages 25-29 (75.7 to 85.0) and women age 35 and older (127.9 to 142.7). 
The severe maternal morbidity rate increased in 14 states. The largest increases were: 41% in Oregon (63.9 to 89.9 complications per 10,000 delivery hospitalizations), 35% in Mississippi (69.9 to 94.2), and 32% in both Washington (77.9 to 102.8) and South Carolina (75.3 to 99.3).
Disparities. Severe maternal morbidity was:
2.2 times higher in Alaska (131.1) than Nebraska (60.1).
1.9 times higher among Black (156.8) than white (83.4) women.
1.7 times higher among women age 35 and older (142.7) than those ages 20-24 (83.2).
1.3 times higher among women living in the least-wealthy ZIP code quartile (113.5) than those in the wealthiest income ZIP code quartile (90.6).
Note: The values for women ages 20-24 and ages 25-29 may not differ significantly based on overlapping 95% confidence intervals. The same is true for women living in the wealthiest and second-least wealthy ZIP code quartiles.

Asthma Among Women 
Asthma is a chronic disease that affects the lungs and can cause wheezing, breathing difficulty and coughing. Risk factors for asthma include: having allergies, frequent respiratory infections or a family history of asthma, as well as exposure to common triggers such as tobacco smoke, air pollution, dust and mold.
Changes over time. Nationally, the prevalence of asthma — the percentage of women ages 18-44 who reported ever being told by a health professional that they currently have asthma — increased 9%, from 11.7% to 12.7% between 2019-2020 and 2021-2022. In 2021-2022, about 7.4 million women reported having asthma, an increase of 743,800 women compared with 2019-2020. The prevalence increased among the following population groups:
20% among women with an annual household income of $25,000-$49,999 (11.6% to 13.9%).
16% among women who graduated high school (11.6% to 13.5%) and 11% among college graduates (9.6% to 10.7%).​
10% among women ages 35-44 (11.5% to 12.7%).
One state had a significant increase. Asthma prevalence increased 41% in Georgia (10.0% to 14.1%).
Disparities. The prevalence of asthma among women significantly varied by disability, race/ethnicity, geography, sexual orientation, income and educational attainment. The prevalence was:
3.6 times higher among women who have difficulty with self-care (35.7%) than women without a disability (9.8%).
3.1 times higher among multiracial (17.0%) compared with Asian (5.5%) women.
2.1 times higher in Maine (19.3%) than South Dakota (9.3%).
1.5 times higher among LGBQ+ (18.5%) than straight (12.2%) women.
1.5 times higher among women with an annual household income less than $25,000 (16.0%) than those with incomes of $75,000 or more (10.7%).
1.3 times higher among women with some post-high school education (14.4%) than college graduates (10.7%).
Note: The values for women who have difficulty with self-care and those who have difficulty with mobility may not differ significantly based on overlapping 95% confidence intervals. The same is true for multiracial, American Indian/Alaska Native, Black, white and Hawaiian/Pacific Islander women; women with incomes less than $25,000 and those with incomes of $25,000-$49,999; women with incomes of $75,000 or more and those with incomes of $50,000-$74,999; women with some post-high school education and high school graduates; women who graduated from college and those with less than a high school education; and women ages 25-34 and those ages 35-44.​

Obesity Among Women 
Obesity is a complex health condition with biological, economic, environmental, individual and societal causes. Contributing factors to obesity include social and physical environment, genetics, prenatal and early life influences and behaviors such as poor diet and physical inactivity. Adults with obesity are at an increased risk of developing serious health conditions, including hypertension, Type 2 diabetes, heart disease and stroke, sleep apnea and breathing problems, some cancers and mental illnesses like depression and anxiety.
Changes over time. Nationally, the prevalence of obesity — the percentage of women ages 18-44 who have a body mass index (BMI) of 30.0 or higher based on reported height and weight — increased 8%, from 30.4% to 32.7% between 2019-2020 and 2021-2022. In 2021-2022, about 16 million American women had obesity, an increase of nearly 1.3 million women compared with 2019-2020. The prevalence increased among some income, educational attainment and age groups, as well as among women living in metropolitan areas:
13% among women with an annual household income of $25,000-$49,999 (39.0% to 43.9%) and women with incomes of $75,000 or more (25.0% to 28.2%). 
12% among women who graduated from college (23.7% to 26.5%) and 11% among women with some post-high school education (37.7% to 41.8%).
10% among women ages 35-44 (35.6% to 39.0%).
8% among women living in metropolitan areas (29.5% to 31.8%).
The prevalence of obesity increased in six states. The largest increases were: 37% in Alaska (25.5% to 34.9%), 34% in Nevada (25.8% to 34.6%) and 21% in Maine (28.0% to 33.8%).
Disparities. The prevalence of obesity among women significantly varied by race/ethnicity, geography, age group, disability status, educational attainment, income, veteran status, metropolitan status and sexual orientation in 2021-2022. The prevalence was:
4.0 times higher among Black (47.9%) compared with Asian (12.1%) women.
1.8 times higher in Mississippi (42.0%) than Colorado (23.1%).
1.8 times higher among women ages 35-44 (39.0%) than those ages 18-24 (22.1%).
1.8 times higher among women who have difficulty with mobility (53.8%) than those without a disability (30.6%).
1.7 times higher among women with less than a high school education (45.4%) than college graduates (26.5%). 
1.7 times higher among women with an annual household income less than $25,000 (46.7%) than those with incomes of $75,000 or more (28.2%).
1.3 times higher among women who have not served in the U.S. armed forces (33.0%) than those who have served (26.1%).
1.2 times higher among women living in non-metropolitan (39.1%) than metropolitan (31.8%) areas.
1.1 times higher among LGBQ+ (37.3%) than straight (34.0%) women.
Note: The values for Black and American Indian/Alaska Native women may not differ significantly based on overlapping 95% confidence intervals. The same is true for women who have difficulty with mobility and those who have difficulty with self-care; women with less than a high school education, high school graduates and those with some post-high school education; and women with incomes less than $25,000 and those with incomes of $25,000-$49,999.

Overweight or Obesity Among Youth 
According to the National Center for Health Statistics, the prevalence of childhood obesity has more than tripled since the 1970s. BMI-for-age percentiles are used to define healthy weight, overweight and obesity in children ages 2-19. The healthy weight range is the 5th to less than the 85th percentile; overweight is the 85th to less than the 95th percentile; and obesity is the 95th percentile or higher. It should be noted that weight stigma, also known as weight-based discrimination or weight bias, can lead to negative impacts such as mood and anxiety disorders and health care avoidance.
Changes over time. Nationally, the percentage of children ages 10-17 who have overweight or obesity for their age based on reported height and weight decreased 6.0% from 33.2% to 31.1% between 2020-2021 and 2022-2023. In 2022-2023, approximately 10.2 million American youth had obesity or were overweight, 428,000 fewer than in 2020-2021. The prevalence of youth who were overweight or had obesity decreased 34% in South Dakota (37.2% to 24.4%) between 2020-2021 and 2022-2023.
Disparities. The prevalence of youth who were overweight or had obesity significantly varied by race/ethnicity, geography, caregiver educational attainment and gender in 2022-2023. The prevalence was:
2.3 times higher among Hawaiian/Pacific Islander (50.0%) compared with Asian (21.6%) youth.
1.9 times higher in Mississippi (42.0%) than New Hampshire (21.6%).
1.8 times higher among youth with a caregiver who graduated from high school (41.0%) than those with a caregiver who graduated from college (23.1%).
1.2 times higher among boys (33.8%) than girls (28.2%).
Note:​ The values for Hawaiian/Pacific Islander, Hispanic, Black, American Indian/Alaska Native and multiracial youth may not differ significantly based on overlapping 95% confidence intervals. The same is true for youth with a caregiver who graduated from high school, youth with a caregiver who has some post-high school education and youth with caregivers whose educational attainment is less than high school. ​

Congenital Syphilis 
Complications from congenital syphilis during pregnancy include miscarriage, preterm birth and stillbirth. It may cause neonatal death, anemia or meningitis. The number of congenital syphilis cases in the U.S. has increased in recent years, with more than 10 times as many babies born with syphilis in 2022 as in 2012.
Changes over time. Nationally, congenital syphilis — the number of new cases per 100,000 live births — increased 31%, from 78.5 to 102.5 between 2021 and 2022. In 2022, about 3,800 cases were reported in the U.S., an increase of nearly 900 cases since 2021. Between 2018 and 2022, congenital syphilis cases increased 194%, from 34.9 to 102.5 cases per 100,000 live births. 
Twenty-five states and the District of Columbia had increases greater than or equal to the national change. The largest increases were: 302% in Delaware (9.5 to 38.2 cases per 100,000 live births), 249% in Utah (4.3 to 15.0) and 177% in Pennsylvania (10.6 to 29.4). 
Disparities. The congenital syphilis rate varied by geography in 2022. Among states with cases, the rate was 23.7 times higher in New Mexico (355.3) than Utah (15.0). Idaho, Vermont and Wyoming had no reported cases. 

Neonatal Abstinence Syndrome 
Neonatal abstinence syndrome is a drug withdrawal syndrome occurring in newborns. It is most commonly caused by fetal exposure to maternal opioid use, and is also associated with benzodiazepine, barbiturate and alcohol use. Between 55% and 94% of infants exposed to opioids during gestation experience withdrawal symptoms. Opioid use during pregnancy has increased in the U.S. in the last 20 years, with corresponding increases in neonatal abstinence syndrome.
Changes over time. Nationally, neonatal abstinence syndrome — the number of birth hospitalizations with a diagnosis code of withdrawal symptoms due to prenatal exposure to illicit drugs per 1,000 birth hospitalizations — decreased 5%, from 6.2 to 5.9 between 2020 and 2021. In 2021, there were about 19,600 neonatal abstinence syndrome hospitalizations in the U.S., a decrease of almost 1,000 hospitalizations from 2020. Hospitalization rates decreased among the following population groups: 
9% among white infants (9.2 to 8.4 hospitalizations per 1,000 birth hospitalizations).
9% among infants living in the second-wealthiest ZIP code quartile (5.4 to 4.9).
6% among infants living in large metropolitan areas with at least one million residents (4.8 to 4.5) and 5% among infants living in small to medium metropolitan areas with less than one million residents (7.4 to 7.0). 
The rate increased 17% in Arizona (10.3 to 12.1 hospitalizations per 1,000 birth hospitalizations) and decreased in six states, led by: 31% in Delaware (20.9 to 14.4), 23% in Connecticut (8.8 to 6.8) and 19% in New Jersey (5.7 to 4.6). 
Disparities. The prevalence of neonatal abstinence syndrome hospitalizations significantly varied by race/ethnicity and geography in 2021. The prevalence was:
24.7 times higher among American Indian/Alaska Native (17.3 per 1,000 birth hospitalizations) compared with Asian/Pacific Islander (0.7) infants. 
22.6 times higher in West Virginia (38.4) than Nebraska (1.7).