Key Trends Provide Insights into America’s Health and Well-Being over 35 Years

by America's Health Rankings, 04/29/2025

America’s Health Rankings offers valuable insights on the nation’s health and each of the 50 states and the District of Columbia. Over 35 years, the platform has adapted its approach to measuring population health to reflect the evolving understanding of the factors contributing to health and well-being.

America’s Health Rankings is committed to providing relevant, data-driven insights at the state and national levels to inform and drive action to build healthier communities — and that includes spotlighting long-term trend data, which provides context about how some of the nation’s most important indicators of health have shifted over the past three decades. We encourage users to explore data at the state level and among population groups.

Premature death has been measured by America’s Health Rankings since its inception and is a key marker of overall health and well-being, according to the Healthy People 2030 framework.

In 2012, the premature death rate reached the lowest value recorded by America’s Health Rankings, the result of a 17% decrease since 1991, from 8,398 to 6,976 years of potential life lost before age 75 per 100,000 population.

However, 2012 marked a turning point. Since then, the trend has reversed, with premature death rising 22% between 2012 and 2022 — reaching a high of 9,478 deaths in 2021 amid the COVID-19 pandemic. While the most recent data show some improvement between 2021 and 2022, the overall rate of premature death (8,522) remains 1% higher than it was in 1991, erasing decades of progress made between 1990 and 2012.

Drug deaths rose sharply across the country between 2007 and 2022, rising 170% from 12.0 to 32.4 deaths per 100,000 population.

The largest national spike occurred between 2019 and 2020, when the rate climbed 30% from 21.5 to 27.9. Encouragingly, the drug death rate remained relatively stable nationally between 2021 and 2022.

The rate of drug deaths increased in 49 states and the District of Columbia between 2007 and 2022. The four largest increases were in the District of Columbia, Delaware, Maine and Vermont.

Chronic conditions and their risk factors, which are linked to serious health outcomes like premature death, carry significant economic costs.

Between 2011 and 2023, the prevalence of diabetes increased from 9.5% to 11.5% of adults. Obesity in adults — a risk factor for many chronic conditions — also increased from 27.8% to 34.3%.

In 2023, both measures had differences by educational attainment. Diabetes prevalence was 2.3 times higher among adults with less than a high school education (21.2%) compared with college graduates (9.2%). Similarly, adults with less than a high school education had a prevalence of obesity 1.4 times higher than those who graduated from college.

Nationally, between 2010 and 2023, the uninsured rate decreased 49%, from 15.5% to 7.9%. It decreased at the same or higher rate in 25 states and the District of Columbia. However, differences remain: The uninsured rate was 6.3 times higher in Texas (16.4%) than Massachusetts (2.6%) and 5.9 times higher among adults with less than a high school education (20.7%) compared with college graduates (3.5%).

Data across the America’s Health Rankings platform indicate that despite nationwide progress to improve some of the socioeconomic, environmental and clinical care factors that influence health and well-being, negative trends in health outcomes remain challenging, including premature death and chronic disease.

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