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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

Alcohol During Pregnancy

Prenatal exposure to alcohol increases the risk of miscarriage, stillbirth, and fetal alcohol spectrum disorders (FASDs). FASDs last a lifetime and manifest as physical birth defects, long-term impairments to cognitive function—both intellectual and behavioral—and other problems with organ function. FASDs are the most common preventable cause of intellectual disability in the United States and are completely preventable by avoiding alcohol during pregnancy. There is no known safe amount of alcohol or time to consume alcohol while pregnant. The US Surgeon General recommends pregnant women and sexually active women who do not use effective contraception abstain from drinking alcohol.

Percentage of pregnant women aged 18 to 44 who self-report having at least one alcoholic beverage in the past 30 days

Data source: Behavioral Risk Factor Surveillance System, 2011-2014 For details: www.americashealthrankings.org/ALL/alcohol_pregnant



Breastfed

Breastfeeding provides infants with nutrition and immunologic protection, and decreases risk of infant mortality, childhood obesity, asthma, gastroenteritis, types 1 and 2 diabetes, sudden infant death syndrome, and childhood leukemia. Breastfeeding mothers are at decreased risk of type 2 diabetes, and breast and ovarian cancers. Exclusive breastfeeding is recommended for the first six months of a baby’s life. An estimated 74% of babies are ever breastfed and 18.8% of infants are breastfed exclusively for six months. Current suboptimal breastfeeding rates cost the US economy $8.7 billion per year.

Percentage of infants exclusively breastfed for six months

Data source: CDC, Breastfeeding Report Card, 2014 For details: www.americashealthrankings.org/ALL/Breastfed



Sleep Position

An infant’s sleeping arrangement is the primary risk factor for sudden unexpected infant death (SUID). In the United States, SUID claims about 3,500 infants each year, and a prone (face-down) sleep position significantly increases the risk of SUID relative to a supine (face-up) position. The American Academy of Pediatrics recommends that infants be placed on their back for sleep until 12 months of age. Additional safe sleep recommendations include placing the infant to sleep on a firm sleep surface without soft objects, loose bedding, or other similar items and sharing a room with parents but not a bed.

Percentage of women with a recent birth who report their infants are usually placed on their backs to sleep

Data source: Pregnancy Risk Assessment Monitoring System, 2012; Maternal and Infant Health Assessment, 2012 For details: www.americashealthrankings.org/ALL/sleep_position



Smoking During Pregnancy

The harmful effects of smoking extend beyond the smoker. Smoking during pregnancy increases the risk of preterm birth, low birthweight, miscarriage, and sudden infant death syndrome. Children exposed to secondhand smoke are at greater risk for respiratory infections and chronic respiratory conditions such as asthma. Pregnancy may serve as a major motivator to help women quit—an estimated 46% quit. Infants born to mothers who quit smoking during the first trimester are of comparable weight and height to those of non-smoking women. The majority of women who quit smoking during pregnancy relapse postpartum in spite of the harmful effects to children due to secondhand smoke exposure.

Percentage of pregnant women aged 18 to 44 who are self-reported smokers (smoked at least 100 cigarettes in their lifetime and currently smoke)

Data source: Behavioral Risk Factor Surveillance System, 2011-2014 For details: www.americashealthrankings.org/ALL/smoking_pregnant_brfss




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