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Violent Crime

Violent crime causes injuries, mental health issues, disability, death, and long-term stress in children, families, and neighborhoods. Violent crime interferes with healthy lifestyles by discouraging physical activity. Exposure to violence in childhood is associated with increased risk of chronic diseases in adulthood such as heart disease, diabetes, and stroke. There were more than 1.1 million US violent crimes in 2013 and nearly 14,000 homicides. Homicide is the third-leading cause of death among 15 to 34 year olds. Violent crime carries an annual economic burden estimated at $65 billion in lost productivity and $6 billion in direct medical costs.


Data source: Federal Bureau of Investigation, 2013 For details: www.americashealthrankings.org/ALL/Crime


Measure: Violent Crime, 2015 Annual Report
Measure: Violent Crime, 2015 Annual Report

Why does this matter?

Families, neighborhoods and communities are all affected when violent crime occurs. Violent crimes cause physical harm as well as social and emotional distress including injury, disability, premature death, depression, anxiety and post-traumatic stress disorder. Violent crime can lead to less physical activity. When personal safety is threatened, individuals are less likely to choose to walk or bike to their destination, regardless of neighborhood income levels.

Violent crimes place a financial burden on hospitals and health care systems. Costs — including violence preparedness, prevention, as well as security and safety within health care facilities — were estimated at $2.7 billion in 2016. The overall estimated economic burden of violent crime was $65 billion in lost productivity and $6 billion in direct medical costs in 2007. Researchers estimate the following per-offense total costs: $9 million per homicide, $241,000 per rape/sexual assault, $107,000 per aggravated assault and $42,000 per robbery (2008 dollars).

Source:
  • Federal Bureau of Investigation, Uniform Crime Reporting Program, 2013


Occupational Fatalities

Fatalities represent how high-risk jobs and unsafe working conditions impact the population. In 2013, 4,405 deaths occurred on the job. The leading causes were transportation incidents, contact with equipment, falls, and violence that includes homicide and suicide. Hispanic workers are at higher risk of dying from work-related injuries than non-Hispanic workers. Workplace fatalities are almost always preventable. Increased safety precautions and regulatory oversight have helped to decrease the estimated 8.6 million annual occupational injuries that lead to fatalities. The estimated annual direct and indirect cost of these fatalities is $6 billion.


Data source: Census of Fatal Occupational Injuries & US Bureau of Economic Analysis, 2011 to 2014P For details: www.americashealthrankings.org/ALL/WorkFatalities


Measure: Occupational Fatalities, 2015 Annual Report
Measure: Occupational Fatalities, 2015 Annual Report

Why does this matter?

Occupational fatalities, also known as workplace fatalities, represent unsafe working conditions and personal risks faced by workers. In 2019, there were 5,333 fatal workplace injuries — a 2% increase since 2018. Transportation incidents accounted for the majority of fatalities at 39.8%, followed by falls, slips and trips which accounted for 16.5% of fatalities. In 2019, fishing and hunting occupations had the highest rate of fatal workplace fatalities followed by logging occupations and then aircraft flight engineer occupations.

Costs related to workplace injury and death were estimated at $171.0 billion in 2019. Costs include workers' compensation, administrative expenses, wage and productivity losses, medical fees and damages to company property.

Source:
  • U.S. Bureau of Labor Statistics, Census of Fatal Occupational Injuries, 2012-2014


Children in Poverty

Poverty’s effect on health has been documented with higher rates of chronic diseases and shorter life expectancy. Poverty influences a family’s ability to meet children’s basic needs and limits access to health care, healthy foods, educational opportunities, and physical activity choices. Children in poverty are 3 times more likely to have unmet health needs than other children. Children born into poverty are more likely than other children to have low birthweight and die within a month after birth. Programs such as the Supplemental Nutrition Assistance Program (SNAP) and Women, Infants, and Children (WIC) help alleviate some ill effects of poverty.


Data source: Current Population Survey 2015 Annual Social and Economic Supplement, 2014 For details: www.americashealthrankings.org/ALL/ChildPoverty



Measure: Children in Poverty, 2015 Annual Report
Source:
  • U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2014



Air Pollution

Fine particulates in smoke or haze penetrate lung tissue and increase premature death in people with heart disease and lung disease. Large particulates irritate eyes, lungs, and the throat. Air pollution is linked to increased respiratory symptoms, decreased lung function, asthma, chronic bronchitis, irregular heartbeats, and heart attacks. Asthma affects 7.1 million children; its direct medical costs total $50.1 billion annually, while lost productivity adds $6.1 billion. Combustion emissions cause an estimated 200,000 annual premature deaths. The EPA estimates the Clean Air Act prevented 130,000 heart attacks, 1.7 million asthma attacks, and 13 million lost workdays between 1990 and 2010.

Data source: Environmental Protection Agency, 2012 to 2014 For details: www.americashealthrankings.org/ALL/air



Measure: Air Pollution, 2015 Annual Report
Measure: Air Pollution, 2015 Annual Report

Why does this matter?

Air pollution is associated with heart and lung problems and even premature death. Large pollutant particles in the air can cause irritation and discomfort, while small, fine pollutants from sources such as auto exhaust or power plants can penetrate deeply into lung tissue and enter the bloodstream. The environment is also impacted by air pollution, as particles are carried from one area to another. Examples include increasing acidification in lakes and streams and changing nutrient patterns in soil. 

Exposure to fine particle air pollution, including from wildfires, has been linked to problems with respiratory and cardiovascular functions, including:

  • Decreased lung function.
  • Asthma.
  • Irregular heartbeat.
  • Heart attack.
  • Early death in those suffering from heart disease or lung disease. 

Air pollution of fine particulate matter originating from human activity was estimated to be responsible for 107,000 premature deaths in 2011. The same study found the cost to society was an estimated $886 billion. The United States Office of Management and Budget (OMB) reports the costs and benefits of federal regulations. OMB found that regulations issued between 2004 and 2014 to limit air pollution by the Environmental Protection Agency (EPA) generated between $157 billion and $777 billion (in 2010 dollars) in benefits to the U.S. economy, mainly by reducing the health risks of exposure to fine particulate matter.

Source:
  • U.S. Environmental Protection Agency, 2012-2014



Infectious Disease

Historically, public health focused on combating infectious diseases caused by inferior sanitation and poor hygiene. Many public health strides were made through clean water, immunizations, antibiotics, and education. Public health’s focus shifted in the mid-1900s from infectious diseases like cholera and smallpox to chronic diseases like diabetes and cancer. Despite this focus on chronic diseases, infectious diseases still pose a threat and burden on our nation’s health; they can be especially severe in young children and seniors, leading to hospitalizations and even death. The incidence of infectious diseases indicates the toll that largely preventable diseases place on the population.

Data source: Summary of Notifiable Diseases (MMWR), 2013 & NCHHSTP Atlas, 2013 For details: www.americashealthrankings.org/ALL/infectiousdisease


Measure: Infectious Disease, 2015 Annual Report
Measure: Infectious Disease, 2015 Annual Report

Why does this matter?

Beginning in the middle of the 20th century, the field of public health began to shift its focus from infectious diseases like cholera and smallpox to chronic diseases like diabetes and cancer. Innovations in sanitation, hygiene and science helped dramatically improve the health of the U.S. population. Clean water measures, immunizations, antibiotics, education and early intervention are many efforts that decreased the rates of infectious disease. However, largely preventable infectious diseases still pose a threat to our nation’s health. Rates of some infectious diseases, such as chlamydia, continue to rise despite the readily available prevention and treatment options.

Three common diseases, each with different modes of transmission, prevention strategies and treatment options are included in this composite measure:

  • Chlamydia: A sexually transmitted infection (STI), identified through screening at-risk populations and can be treated with antibiotics.
  • Pertussis: Often called whooping cough, pertussis is spread through respiratory droplets and may be prevented through vaccination.
  • Salmonella: Generally foodborne and is prevented through proper food and animal handling practices, such as hand washing.
Source:
  • America's Health Rankings composite measure, 2015

Chlamydia

1.4 million Chlamydia cases were reported in 2012—most for any reportable disease—but the 2013 incidence rate dropped 1.5% (first recorded decrease).


Data source: NCHHSTP Atlas, 2013


Measure: Chlamydia, 2015 Annual Report
Measure: Chlamydia, 2015 Annual Report

Why does this Matter?

Chlamydia is the most commonly reported sexually transmitted infection (STI) in the U.S. and can infect both men and women. Chlamydia is caused by the bacterium Chlamydia trachomatis. More than 1.8 million chlamydia cases were reported in 2019, though many more cases go undiagnosed and unreported.

Chlamydial infections are usually asymptomatic, but can still cause permanent damage to reproductive organs. Untreated chlamydia in men rarely causes life-threatening damage, but can cause painful testicular swelling. Among women, untreated chlamydia can lead to pelvic inflammatory disease, chronic pelvic pain, inability to get pregnant or ectopic pregnancy, a life-threatening condition in which the fertilized egg develops outside the uterus. 

Chlamydia consistently accounts for the majority of medical costs from nonviral STIs. Chlamydia cost the U.S. over $700 million in 2018, due less to its cost per case than to its extremely high incidence rate.

Source:
  • CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Atlas, 2013



Pertussis

CDC estimates that half of infants aged 1 year and younger who develop pertussis are hospitalized.


Data source: Summary of Notifiable Diseases (MMWR), 2013



Measure: Pertussis, 2015 Annual Report
Measure: Pertussis, 2015 Annual Report

Why does this matter?

Pertussis, commonly known as “whooping cough,” is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. Pertussis can be a serious and potentially life-threatening illness, especially among infants, and is spread through the air by spending time with an infected person who is coughing and sneezing. Symptoms typically develop within five to 10 days of exposure but can take up to three weeks. The disease is often mistaken for a cold until the onset of rapid, intense coughing fits, generally one to two weeks into the disease.

In 2017, there were 18,975 reported cases of pertussis, though many cases go undiagnosed and unreported. Reported cases of pertussis reached an all time low of 1,010 reported cases in 1976 and has gradually increased over the past 40 years, in part due to increased surveillance and better diagnostics. From 2004 to 2012 the number of cases was notably high. In 2012 there were 48,277 cases of pertussis reported by states, representing the highest number of pertussis cases reported in the United States since 1955. The rise in new cases may be associated with increased use of student vaccine exemptions in schools, as well as waning effectiveness of the pertussis vaccine over time leaving older children and adults susceptible to pertussis.

Source:
  • CDC, National Notifiable Diseases Surveillance System, 2013





Salmonella

1.2 million US Salmonella infections occur annually; 1 million of them result from food eaten in the United States.

Data source: Summary of Notifiable Diseases (MMWR), 2013


Measure: Salmonella, 2015 Annual Report
Measure: Salmonella, 2015 Annual Report

Why does this matter?

Salmonellosis is a gastrointestinal illness caused by several species of Salmonella bacteria. The bacteria typically live in the intestines of humans and animals and are commonly transmitted through the consumption of food contaminated with animal feces. Salmonella symptoms usually appear 12 to 72 hours after exposure and include diarrhea, fever and abdominal cramps.

According to the Centers for Disease Control and Prevention (CDC), non-typhoidal Salmonella causes an estimated 1.2 million illnesses and 450 deaths in the United States annually, with 1 million of the illnesses resulting from contaminated food. Salmonella is responsible for the most hospitalizations and deaths per year of any germ found in food. Although many cases are mild and are not diagnosed or reported, 27% of diagnosed cases result in hospitalization and 0.4% of diagnosed cases result in death. Around $365 million in medical costs are attributed to Salmonella infections annually.

Source:
  • CDC, National Notifiable Diseases Surveillance System, 2013

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