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Executive SummaryIntroductionExplore the Health of Women, Children and InfantsFindingsThe Health of Women and Children between StatesThe Health of Women and Children within StatesHealthy Communities for ChildrenClinical Preventive Services for ChildrenRacial Disparities in Measures of MortalityVariations in SmokingMeasures of Women's HealthBehaviors | Measures of Women’s HealthCommunity & Environment | Measures of Women’s HealthPolicy | Measures of Women’s HealthClinical Care | Measures of Women’s HealthOutcomes | Measures of Women’s HealthMeasures of Infants' HealthBehaviors | Measures of Infants’ HealthCommunity & Environment | Measures of Infants’ HealthPolicy | Measures of Infants’ HealthClinical Care | Measures of Infants’ HealthOutcomes | Measures of Infants’ HealthMeasures of Children's HealthBehaviors | Measures of Children’s HealthCommunity & Environment | Measures of Children’s HealthPolicy | Measures of Children’s HealthClinical Care | Measures of Children’s HealthOutcomes | Measures of Children’s HealthState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaUnited StatesAppendixData Sources and Measures of Women’s HealthData Sources and Measures of Infants’ HealthData Sources and Measures of Children’s HealthMethodologyModel DevelopmentAmerica’s Health Rankings® Health of Women and Children Steering GroupThe Team

Behaviors

Drug Dependence or Abuse

Percentage of children aged 12 to 17 who were dependent on or abused illicit drugs or alcohol in the past year
Substance Abuse and Mental Health Services Administration (SAMHSA), National Survey on Drug Use and Health, 2013-2014

High School Graduation

Percentage of high school students who graduate within four years of starting ninth grade with a regular high school diploma (ACGR definition)
United States Department of Education, National Center for Education Statistics, 2013-2014

Overweight or Obese

Percentage of children aged 10 to 17 who are overweight or obese for their age based upon body mass index
Data Resource Center for Child & Adolescent Health (DRC), National Survey of Children’s Health, 2011-2012

Tobacco Use

Percentage of children aged 12 to 17 who used a tobacco product in the past month
SAMHSA, National Survey on Drug Use and Health, 2013-2014

Community & Environment

Adverse Childhood Experiences

Percentage of children aged 0 to 17 who experienced two or more of the following: Socioeconomic hardship, divorce/parental separation, lived with someone who had an alcohol or drug problem, victim or witness of neighborhood violence, lived with someone who was mentally ill or suicidal, domestic violence witness, parent served time in jail, treated or judged unfairly due to race/ethnicity, death of parent
DRC, National Survey of Children’s Health, 2011-2012

Neighborhood Amenities

Percentage of children aged 0 to 17 with access to parks or playgrounds, recreation or community centers, libraries or book mobiles, and sidewalks or walking paths
DRC, National Survey of Children’s Health, 2011-2012

Protective Home Environment (Ages 0-5)

Percentage of children aged 0 to 17 with access to parks or playgrounds, recreation or community centers, libraries or book mobiles, and sidewalks or walking paths
DRC, National Survey of Children’s Health, 2011-2012

Protective Home Environment (Ages 6-17)

Percentage of children aged 6 to 17 who have four or more family meals per week, no television in their bedroom and watch two hours of television or less per day, parents have met all or most of their friends, usually or always do required homework, and experience no household tobacco smoke exposure
DRC, National Survey of Children’s Health, 2011-2012

Supportive Neighborhoods

Percentage of children aged 0 to 17 whose parents report their child is “usually” or “always” safe in their community or neighborhood and they “stongly agree” or “somewhat agree” with at least three of the following: In my neighborhood people help each other out, we watch out for each other’s children, there are people I can count on in this neighborhood, there are trusted adults nearby to help my child if they got hurt or scared while playing outside
DRC, National Survey of Children’s Health, 2011-2012

Policy

Adequate Health Insurance

Percentage of insured children aged 0 to 17 whose parents report their health plan has reasonable out-of-pocket costs, offers benefits or covered services that meet their child’s needs, and allows them to see needed health care providers
DRC, National Survey of Children’s Health, 2011-2012

Children with Health Insurance

Percentage of children aged 0 to 17 with health insurance of any type
DRC, National Survey of Children’s Health, 2011-2012

Homeless Family Households

Number of families sleeping outside, in an emergency shelter, or in a transitional housing program per 10,000 family households
National Alliance to End Homelessness, The State of Homelessness in America 2016, 2015

Water Fluoridation

Percentage of population served by community water systems who receive fluoridated water
Percentage of insured children aged 0 to 17 whose parents report their health plan has reasonable out-of-pocket costs, offers benefits or covered services that meet their child’s needs, and allows them to see needed health care providers

Clinical Care

Adolescent Well-Visit

Percentage of children aged 12 to 17 who had a well-visit in the past 12 months
DRC, National Survey of Children’s Health, 2011-2012

Developmental Screening

Percentage of children aged 10 months to 5 years whose parents report that they received a standardized developmental screening during a well-child visit
DRC, National Survey of Children’s Health, 2011-2012

Immunizations — Adolescents

Combined average z score of the percentage of children aged 13 to 17 years who received ≥ 1 dose of Tdap since age 10 years, ≥ 1 dose of meningococcal conjugate vaccine, and ≥ 3 doses of HPV vaccine (females and males)
CDC, National Immunization Survey, 2014

Immunizations — Adolescents: HPV Female

Percentage of females aged 13 to 17 years who received ≥3 doses of human papillomavirus (HPV) vaccine, either quadrivalent or bivalent
CDC, National Immunization Survey, 2014

Immunizations — Adolescents: HPV Male

Percentage of males aged 13 to 17 years who received ≥3 doses of human papillomavirus (HPV) vaccine, either quadrivalent or bivalent
CDC, National Immunization Survey, 2014

Immunizations — Adolescents: MCV4

Percentage of adolescents aged 13 to 17 years who received ≥1 dose of meningococcal conjugate vaccine (MenACWY) or meningococcal — unknown type vaccine
CDC, National Immunization Survey, 2014

Immunizations — Adolescents: Tdap

Percentage of adolescents aged 13 to 17 years who received ≥1 dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) since age 10 years
CDC, National Immunization Survey, 2014

Immunizations — Children

Percentage of children aged 19 to 35 months who received recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella, and PCV vaccines
CDC, National Immunization Survey, 2014

Medical Home for Special Care Child

Percentage of children aged 0 to 17 with special health care needs that meet medical home criteria (have a personal doctor or nurse, usual source of care, family-centered care, and receive referrals and effective care coordination when needed)
DRC, National Survey of Children with Special Health Care Needs, 2009-2010

Outcomes

Child Mortality

Number of deaths per 100,000 children aged 1 to 18 years
CDC, National Vital Statistics System, 2012-2014

Missed School Days

Percentage of children aged 6 to 17 who missed 11 or more days in the past school year (homeschooled children excluded)
DRC, National Survey of Children’s Health, 2011-2012

Teen Births

Number of births per 1,000 females aged 15 to 19 years
CDC, National Vital Statistics System, 2014

Teen Suicide

Number of deaths by suicide per 100,000 adolescents aged 15 to 19 years
CDC, National Vital Statistics System, 2012-2014

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