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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
Women of reproductive age (women) and children represent an important segment of American society, composing more than 40% of the total US population, or approximately 131 million individuals. [1] They also represent a substantial proportion of health care spending, including more than $111 billion on pregnancy and newborn care, $276 billion on children’s health care, and $304 billion on women’s health care.[2],[3] Despite this, the United States continually ranks poorly among developed nations on many standard measures of women’s and children’s health, including maternal and infant mortality. [4],[5] Furthermore, disparities in the quality and amount of clinical care received by women and children, as well as in subsequent health outcomes, exist in the United States by race, income, education, and other sociodemographic characteristics. [6] Clinical care services, however, represent only a small portion of the many factors that affect health and well-being. Promoting the health of women and children requires taking a holistic view of the clinical care services they receive, the policies that influence their health, the home environment and community in which they live, and their health behaviors.
Health develops over a lifetime, with health status diminishing or improving based, in part, on exposures to risk and protective factors. Individuals who experience poor health in childhood are more likely to experience poor health in adulthood, as well as lower educational attainment and lower social status. [7] Markers of prenatal and childhood health are also significant predictors of health and economic status in adulthood. [8] The health of America’s women, infants, and children today will impact the future well-being of the United States for generations to come.
America’s Health Rankings® Health of Women and Children Report includes 64 measures of health and well-being, all selected by a steering group of experts in the field of maternal and child health. Comprehensive rankings were calculated based on 60 measures of women’s, infants’, and children’s health, as well as rankings for each of the three populations and each individual measure. Data were incorporated from 18 different sources to create a wide-ranging snapshot of health. Where available, additional sociodemographic data were analyzed to gain a clearer picture of health disparities within each population. Because the language and methods utilized by each data source differ, the language used in this report reflects those differences. More information regarding report methodology can be found in the Methodology section.
Promoting the health of women and children requires taking a holistic view of the clinical care services they receive, the policies that influence their health, the home environment and community in which they live, and their health behaviors.



Purpose and Objectives

America’s Health Rankings has a history of creating widespread awareness of where states stand on important public health measures. Comprehensive data are necessary to assess the current health of women, infants, and children within the United States. To meet this need, the United Health Foundation examined the health of these populations in the America’s Health Rankings Health of Women and Children Report. The report has three primary objectives:
  1. Be a catalyst for a thorough, balanced, and data-driven discussion of women’s, infants’, and children’s health by providing a comprehensive, single source of information across these populations;
  2. Focus attention on the indicators that have the most potential to improve health and drive positive change; and
  3. Create a baseline of overall women’s, infants’, and children’s health to provide a benchmark for states to gauge their relative performance.
The America’s Health Rankings Health of Women and Children Report shines a light on the strengths and challenges faced by the nation and offers a roadmap for community leaders, public health officials, policymakers, and the media to improve the health of women and children within their states. The report builds on United Health Foundation’s work to support better health and encourages others to join in building healthier communities.
1. US Census Bureau. Annual estimates of the resident population for selected age groups by sex for the United States, states, counties, and Puerto Rico Commonwealth and Municipioso: April 1, 2010-July 1, 2015, 2015 population estimates. http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=PEP_2015_PEPAGESEX&prodType=table. Accessed July 15, 2016.
2. Healthcare Cost and Utilization Project (HCUP). 2013; http://hcupnet.ahrq.gov/. Accessed August 5, 2016
3. Centers for Medicare and Medicaid Services. Healthcare expenditures by age and gender. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Age-and-Gender.html. Accessed August 18, 2016.
4. World Health Organization, UNICEF, UNFPA, World Bank Group, United Nations Population Division. Trends in maternal mortality: 1990 to 2015. 2015. http://apps.who.int/iris/bitstream/10665/44423/1/9789241500265_eng.pdf. Accessed July 15, 2016.
5. National Center for Health Statistics. Health, United States, 2015. Hyattsville, MD; 2016. http://www.cdc.gov/nchs/data/hus/hus15.pdf. Accessed August 5, 2016.
6. Agency for Healthcare Research and Quality; 2015 National healthcare quality and disparities report and 5th anniversary update on the national quality strategy. http://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/nhqdr15/2015nhqdr.pdf. Accessed July 15, 2016.
7. Case A, Fertig A, Paxson C. The lasting impact of childhood health and circumstance. Journal of Health Economics. 2005;24:365-389.
8. Kotch JB. Maternal and Child Health: Programs, Problems, and Policy in Public Health. 2nd ed. Sudbury, MA: Jones & Bartlett Publishers Inc.; 2005.

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