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IntroductionKey FindingsNational InsightsOverviewAccess to Health CareImmunizationsChronic Disease PreventionInequity InsightsAccess to Health Care: Dedicated Health Care ProviderImmunizations: Pneumococcal VaccinationChronic Disease Prevention: Colorectal Cancer ScreeningState Insights: OverallState Insights: Access to Health CareState Insights: ImmunizationsState Insights: Chronic Disease PreventionAppendix 1Appendix 2Footnotes
Prevention performance varies greatly by state, with Massachusetts, Rhode Island, New Hampshire, Connecticut, and Vermont exhibiting the strongest performance across the three categories of prevention. Texas, Arkansas, Nevada, Alaska, and Mississippi have the greatest opportunities for improvements.
Table 5: Highest Scoring States by Prevention Measure 
TOP 5 STATES
Massachusetts
Rhode Island
New Hampshire
Connecticut
Vermont
BOTTOM 5 STATES
Texas
Arkansas
Nevada
Alaska
Mississippi
Figure 18: Overall Prevention, Access to Health Care, Immunizations, and Chronic Disease Prevention Scores by State 
Figure 18 breaks down each state’s prevention performance by the three categories within the prevention model: access to health care (blue), immunizations (orange), and chronic disease prevention (gray). It also provides an overall prevention score (black dots) that shows each state’s performance relative to the national average. The overall prevention score was calculated by averaging the scores of each category.
Several key state-level insights can be drawn from this visual representation, including:
- Most states are either above or below the national average across all three prevention categories, reflecting the inter-relatedness of access to healthcare, immunizations, and chronic disease prevention activities.
- Massachusetts scores the highest when all three categories are combined.
- Mississippi has the most room for improvement when all three categories are combined.
- Michigan and New Jersey vary across prevention categories, as performance in access to health care and chronic disease prevention is above the national average, while performance in immunizations falls below the national average.
Table 6: Thematic of Prevention Measure by State
The thematic table (Table 6) shows how states are performing across all prevention measures presented in this report. A dark blue rectangle indicates a state is in the upper quartile (1 to 12), a light blue the upper middle quartile (13 to 25), a light gray the lower middle quartile (26 to 38) and a dark gray the lowest quartile (39 to 50).
The table shows how states in the upper tier tend to do well on all measures and how states in the lower tier tend to underperform compared with the national average on almost all prevention measures. It also highlights where states are most challenged. Connecticut, which is in the upper tier, is in the second quartile for pneumococcal vaccination coverage. Nevada, which falls in the lowest tier, shines on Tdap immunization coverage for adolescents.