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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

Household Smoke

Secondhand smoke exposure is linked to increased incidence of respiratory illness and asthma among children, and the increased rate of asthma continues into adulthood. It is also correlated with increased incidence of ear infections, sudden infant death syndrome, behavioral problems, neurocognitive deficits, and metabolic syndrome in adolescents. Children’s exposure to secondhand smoke has steadily declined since 1999 mirroring the decline in smoking rates. However, in 2012 an estimated 24.2 million children aged 3 to 19 were exposed to enough smoke to have elevated serum cotinine levels in their blood. Secondhand smoke exposure disproportionately impacts children living in poverty, adding to the disadvantages they face in health and development.

Percentage of children aged 0 to 17 who live in households in which someone uses cigarettes, cigars, or pipe tobacco

Data source: National Survey of Children’s Health, 2011–2012 For details:

Infant Child Care Cost

Affordable child care is important for families who may not be able to utilize relatives for care or have employment flexibility to provide care on their own. The average annual cost of infant care varies widely by state from $17,062 in Massachusetts (15.1% of a married couple’s median income) to $4,822 in Mississippi (7.1% of a married couple’s median income). Cost is even more prohibitive for single-parent households, where the average cost is between 24.1% (South Dakota) and 88.1% (Washington, DC) of median income. Low income and rural communities also face shortages of licensed providers despite high demand.

Average cost for center-based infant care as a percentage of married-couple’s median income

Data source: Child Care Aware, Parents and the High Cost of Child Care 2015 Report, 2014 data For details:

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