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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

Chlamydia

Chlamydia is the most commonly reported sexually transmitted infection with more than 1 million infections among females of all ages in 2014. Case reports underestimate the true burden as many infections are asymptomatic, undiagnosed, untreated, or under reported. Incidence is highest among those aged 15 to 24 and the case rate among females is twice the case rate for males, likely due to more screening in females. If untreated, chlamydia can cause pelvic inflammatory disease, which can lead to chronic pelvic pain, infertility, and increased risk of preterm birth and ectopic pregnancy. The estimated lifetime direct medical cost of chlamydia is $516.7 million.

Number of new cases of chlamydia per 100,000 females aged 15 to 44

Data source: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Atlas, 2014 For details: www.americashealthrankings.org/ALL/Chlamydia_women



Excessive Drinking

More than half of nonpregnant women aged 18 to 44 consume any alcohol and 18.2% report binge drinking. Though light-to-moderate drinking is associated with reduced risk of some cardiovascular issues, even low levels of alcohol consumption are tied to increased risk for other cardiovascular issues, as well as breast cancer and liver problems. Heavy drinking is linked to increased risk of hypertension, fractures and injuries, psychiatric problems, and both intimate partner violence and sexual assault. Nearly 3.3 million unintended pregnancies are attributed to alcohol use each year. The estimated social cost of excessive drinking is $249 billion.

Percentage of women aged 18 to 44 who self-report either binge drinking (having 4 or more drinks on one occasion in the past month) or chronic drinking (having 8 or more drinks per week)

Data source: Behavioral Risk Factor Surveillance System, 2013–2014 For details: www.americashealthrankings.org/ALL/ExcessDrink_women



Obesity

Obesity is generally caused by the regular consumption of more calories than the body is able to burn. Additional contributing factors include genes, prenatal influences (mother’s smoking habits, weight gain, and blood sugar levels), early life influences (infant’s rapid weight gain, breastfeeding duration, and sleep duration), unhealthy diets, insufficient sleep, too much television, lack of physical activity, and the social and physical environment. Obesity is associated with reduced fertility, contraception effectiveness, and breastfeeding intent, initiation, and duration. It is also a risk factor for miscarriage, gestational diabetes, preeclampsia, labor induction, cesarean section, and infant death. Excess medical expenditures attributable to being overweight or obese are $147 billion.

Percentage of women aged 18 to 44 who are obese by self-report with a body mass index of 30.0 or higher

Data source: Behavioral Risk Factor Surveillance System, 2013–2014 For details: www.americashealthrankings.org/ALL/Obesity_women



Physical Inactivity

Physical inactivity increases the risk of developing cardiovascular disease, type 2 diabetes, hypertension, obesity, certain cancers, depression, and premature death. It is more common among US women than men, with more than 60% not meeting recommended guidelines and 25% not active at all. Less than a quarter of pregnant women meet physical activity guidelines despite benefits such as improved mood and decreased risk of gestational diabetes. Increasing physical activity, especially from an absence, prevents numerous chronic diseases and aids in their management. Between 2006 and 2011, 11.1% of health care expenditures were associated with physical inactivity, which cost an estimated $117 billion annually.

Percentage of women aged 18 to 44 who self-report doing no physical activity or exercise other than their regular job in the past 30 days

Data source: Behavioral Risk Factor Surveillance System, 2013–2014 For details: www.americashealthrankings.org/ALL/Sedentary_women



Smoking

Smoking—the leading cause of preventable death—is responsible for more than 200,000 deaths of US women annually. Smoking damages nearly every organ and causes respiratory disease, heart disease, stroke, cancer, decreased fertility, early onset menopause, and increased risk of osteoporosis. Women who smoke are more than twice as likely to have a heart attack as nonsmokers. Secondhand smoke exposure leads to respiratory infections in children and heart disease and lung cancer in adults. Individuals who quit smoking before age 40 live around 10 years longer than those who continue. The direct medical expenditures attributed to smoking exceed $170 billion.

Percentage of 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, 2013–2014 For details: www.americashealthrankings.org/ALL/Smoking_women




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