AppendixMeasures Table Data Source Description

Impact of COVID-19

Coronavirus (COVID-19) disease, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), started circulating in December of 2019 and rapidly evolved into a global pandemic.1,2 According to the Centers for Disease Control and Prevention (CDC), the COVID-19 pandemic has claimed more than 1,047,000 lives across the U.S. as of September 14, 2022, and affected countless others.3 The pandemic has also disproportionately affected certain racial and ethnic groups, resulting in higher levels of exposure, more severe illness and higher rates of hospitalizations and deaths.4 In addition, many mitigation strategies have negatively impacted vulnerable populations and worsened long-standing disparities.5

Infectious diseases like COVID-19 affect individuals differently. People who get COVID-19 may experience symptoms including but not limited to fever, cough, sore throat, fatigue and shortness of breath.6 COVID-19 can cause severe illness and lead to life-threatening outcomes and long-term effects.7–9 COVID-19 also poses enormous health, economic and social challenges to the population at large.10

After more than two years of the pandemic, there are more tools available to fight the spread of COVID-19 and prevent hospitalizations and deaths, including vaccinations. Still, some communities and people remain at higher risk.11 Our oldest community members, people with medical conditions, people who are immunocompromised and pregnant women face many challenges staying healthy during the ongoing pandemic.

After an individual has been infected with COVID-19, it is possible for them to experience long-term effects from the infection. Post-COVID conditions, also referred to as long COVID, cover a wide range of symptoms including fatigue, fever, difficulty breathing or shortness of breath, chest pain, cough, heart palpitations, headaches, difficulty concentrating (brain fog), sleep problems, changes in taste and/or smell, depression or anxiety, diarrhea, stomach pain as well as joint or muscle pain.9 These symptoms may start with an initial COVID-19 infection or appear at a later time. Even people who did not experience any symptoms from a COVID-19 infection can develop long COVID.

As the nation continues to face the effects of the COVID-19 public health crisis, the United Health Foundation remains committed to providing data-driven insights that can help build healthier communities across the country.

COVID-19 Data

The COVID-19 Data report contains 17 measures, with data related to COVID-19 deaths, vaccinations, booster doses, long COVID and pandemic-related life disruptions.

Deaths

Among those who develop COVID-19, some severe cases result in death. This report contains the following death measures: 

The provisional COVID-19 death rate among the total population indicates the age-adjusted number of deaths directly attributed to COVID-19 per 100,000 people.
The provisional mortality rate is an estimate of deaths from all causes during the previous 12 months. This rate includes but is not limited to deaths caused by COVID-19. The provisional death rate is important because the COVID-19 pandemic has indirectly increased other causes of death, partially due to strain on the hospital system and people avoiding routine health care during the height of the pandemic.12 Excess deaths have also been attributed to the worsening of existing health care disparities.13

Vaccinations

Vaccinations are safe and effective, and are one of the most important tools for reducing the burden of COVID-19.14 There are currently four vaccines authorized and recommended for use in the United States to protect people from severe COVID-19 infection, hospitalization and death.15 This report includes measures of primary vaccination including the percentage of the total population who have been fully vaccinated; the percentage of adults ages 65 and older who have been fully vaccinated; and the percentage of children younger than age 5, ages 5-11 and ages 12-17 who have been fully vaccinated. Measures of receipt of booster doses for the total population and adults ages 65 and older are also included.

Particular attention has been paid to protecting vulnerable individuals within long-term care settings.16 This report includes four COVID-19 vaccination measures focused on the vaccination of long-term care facility residents and staff, as well as booster doses among residents and staff.

Long COVID

While many people recover well after the initial infection and symptoms, it is possible for individuals to experience long-term effects from COVID-19, also referred to as long COVID.9 Long COVID conditions cover a wide range of symptoms that may last or appear after the initial COVID-19 infection. This report includes the percentage of adults ages 18 and older who tested positive for COVID-19 and reported experiencing symptoms lasting three or more months.

Pandemic Telehealth Visits

Telehealth or telemedicine visits allow patients to receive care from a health care provider without an in-person visit. Using telehealth can limit exposure to illnesses such as COVID-19, reduce travel time, circumvent issues getting child care or time off work, shorten wait times for appointments and improve access to specialists.17 The use of telehealth visits increased during the COVID-19 pandemic.18 This report includes the percentage of children ages 0-17 who used telehealth for health visits because of the coronavirus pandemic.

Childcare Disruptions

Child care allows parents to work and contribute to the economy.19 A study of working parents found that inadequate child care can have serious negative effects on work performance and career opportunities, including forcing parents to reduce work hours, decline additional training and turn down promotions or new positions.20 This report \contains data for the percentage of children ages 0-11 whose caregiver reported that regular daycare or childcare arrangements were closed or unavailable because of the coronavirus pandemic.

Well-child Visit Disruptions

The American Academy of Pediatrics recommends that all infants, toddlers and children receive routine preventive visits, known as well-child visits, throughout their life.21 The American Academy of Pediatrics and others are concerned that delays in routine vaccinations during the pandemic could result in additional outbreaks of vaccine-preventable illnesses.22 Delays in screenings, referrals, and guidance may have additional consequences. This report contains data on the percentage of children ages 0-17 whose caregiver reported missed, skipped or delayed preventive check-ups because of the coronavirus pandemic.

Methodology Updates

The following measures are no longer being updated within this report:

COVID-19 case rate
COVID-19 Medicare claims hospitalizations rate
COVID-19 Medicare cases

COVID-19 death rate, a measure of the cumulative number of COVID-19 deaths per 100,000 population, has been replaced by COVID-19 deaths - provisional.

What is known about COVID-19 continues to evolve. Continuously updated information and data are available from the CDC, including the CDC COVID DataTracker and National Healthcare Safety Network, as well as the National Institutes of Health, state and local public health departments and health care providers.

Explore Health Topics

In addition to COVID-19 data, America’s Health Rankings® presents data on a wide range of health topics for exploration, including health conditions identified as risk factors for severe illness or death from COVID-19 and other related measures. This section of America’s Health Rankings website allows users to plot values for the U.S. and the states with the healthiest and least healthy values for selected measures and use a comparison plot. It also offers a heatmap display that allows users to see associations across measures.

See also:

References

1. World Health Organization. “Naming the Coronavirus Disease (COVID-19) and the Virus That Causes It.” Accessed September 26, 2022. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. 2. World Health Organization. “Listings of WHO’s Response to COVID-19,” January 29, 2021. https://www.who.int/news/item/29-06-2020-covidtimeline. 3. Centers for Disease Control and Prevention. “COVID Data Tracker Weekly Review,” September 23, 2022. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html. 4. Andraska, Elizabeth Ann et al. “Health Care Disparities during the COVID-19 Pandemic.” Seminars in Vascular Surgery 34, no. 3 (September 2021): 82–88. https://doi.org/10.1053/j.semvascsurg.2021.08.002. 5. Centers for Disease Control and Prevention. “Unintended Consequences of COVID-19 Mitigation Strategies: Racial and Ethnic Health Disparities,” December 10, 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/disparities-impact.html. 6. Centers for Disease Control and Prevention. “Symptoms of COVID-19,” August 11, 2022. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. 7. Centers for Disease Control and Prevention. “Factors That Affect Your Risk of Getting Very Sick from COVID-19,” August 11, 2020. https://www.cdc.gov/coronavirus/2019-ncov/your-health/risks-getting-very-sick.html. 8. Centers for Disease Control and Prevention. “Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Professionals,” June 15, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html. 9. Centers for Disease Control and Prevention. “Long COVID or Post-COVID Conditions,” September 1, 2022. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html. 10. Chakraborty, Indranil et al. “COVID-19 Outbreak: Migration, Effects on Society, Global Environment and Prevention.” Science of The Total Environment 728 (August 2020): 138882. https://doi.org/10.1016/j.scitotenv.2020.138882. 11. Centers for Disease Control and Prevention. “Understanding Risk,” August 11, 2020. https://www.cdc.gov/coronavirus/2019-ncov/your-health/understanding-risk.html. 12. French, Geoffrey et al. “Impact of Hospital Strain on Excess Deaths During the COVID-19 Pandemic — United States, July 2020–July 2021.” MMWR. Morbidity and Mortality Weekly Report 70, no. 46 (November 19, 2021): 1613–16. https://doi.org/10.15585/mmwr.mm7046a5. 13. Shiels, Meredith S. et al. “Racial and Ethnic Disparities in Excess Deaths During the COVID-19 Pandemic, March to December 2020.” Annals of Internal Medicine 174, no. 12 (December 2021): 1693–99. https://doi.org/10.7326/M21-2134. 14. Centers for Disease Control and Prevention. “Ensuring COVID-19 Vaccine Safety in the US,” July 19, 2022. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety.html. 15. Centers for Disease Control and Prevention. “Stay Up to Date with COVID-19 Vaccines Including Boosters,” September 8, 2022. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. 16. Centers for Disease Control and Prevention. “COVID-19 Vaccines for Long-Term Care Residents,” August 30, 2022. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/LTCF-residents.html. 17. Telehealth.HHS.gov. “What Is Telehealth?,” September 14, 2022. https://telehealth.hhs.gov/patients/understanding-telehealth/. 18. Brotman, Joshua J. et al. “Providing Outpatient Telehealth Services in the United States.” Chest 159, no. 4 (April 2021): 1548–58. https://doi.org/10.1016/j.chest.2020.11.020. 19. U.S. Chamber of Commerce Foundation. “Piecing Together Solutions: The Importance of Childcare to U.S. Families and Businesses.” U.S. Chamber of Commerce Foundation, Center for Education and Workforce, December 2020. https://www.uschamberfoundation.org/sites/default/files/EarlyEd_Minis_Report6_121420_Final.pdf. 20. Belfield, Clive R. “The Economic Impacts of Insufficient Child Care on Working Families.” ReadyNation/Council for a Strong America, September 2018. https://strongnation.s3.amazonaws.com/documents/522/3c5cdb46-eda2-4723-9e8e-f20511cc9f0f.pdf. 21. HealthyChildren.org. “AAP Schedule of Well-Child Care Visits.” American Academy of Pediatrics, August 18, 2022. https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx. 22. American Academy of Pediatrics. “Guidance on Providing Pediatric Well-Care During COVID-19,” July 19, 2022. http://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/guidance-on-providing-pediatric-well-care-during-covid-19/.

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