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
Cervical Cancer Screening
Cervical cancer incidence and mortality have declined significantly in the past 40 years, largely due to increased screening that can detect cervical precancer before it turns cancerous. Still, nearly 8 million women aged 21 to 65 have not been screened in the past five years. About 12,000 US women are diagnosed with cervical cancer and about 4,000 die from it each year. All women are at risk, but it occurs most often in women aged 30 and older. Most cases occur in women who have not received proper screening. Estimates suggest that 93% of cervical cancer cases could be prevented through screening and human papillomavirus vaccination.
Percentage of women aged 18 to 44 who received a Pap smear within the past three years
Dedicated Health Care Provider
Having a dedicated health care provider (HCP) may improve the timeliness and quality of care, lower the costs of care, and improve overall health status. A usual HCP is associated with receiving recommended screening and prevention services, as well as improvements in chronic care management for asthma, hypertension, and diabetes. Without a dedicated HCP, emergency department visits are more likely for non-urgent or avoidable problems. Women face numerous cost-related obstacles to obtaining a dedicated HCP, in addition to logistical barriers such as transportation, time off of work, and child care. Hispanic women, uninsured women, and young women report lower rates of having a dedicated HCP.
Percentage of women aged 18 to 44 who report having a personal doctor or health care provider
Periodontal disease and dental caries are common in women of reproductive age, particularly among racial and ethnic minority groups and women with low incomes. Maternal oral health can impact birth outcomes and infant oral health. Maternal periodontal disease has been associated with preterm birth, preeclampsia, and low birthweight. Oral health problems are preventable through routine visits to the dentist and good oral hygiene. Cost and dental insurance are primary predictors of access to and utilization of oral care, and poor oral health status. Fear, low oral health literacy, and limited access to and availability of dental services are other reasons adults forgo routine dental visits.
Percentage of women aged 18 to 44 who self-report having visited a dental health professional within the past year
Annual influenza (flu) vaccination is recommended for everyone 6 months and older, and is the most effective protection against influenza viruses. All women are at risk of flu-related complications such as bacterial pneumonia, bronchitis, sinus and ear infections, and exacerbation of underlying pulmonary conditions. Pregnant women have increased morbidity and mortality from flu infection, including increased risk of premature labor and delivery. Lower vaccination coverage is associated with lack of health insurance, lower education, unemployment, poverty, and fewer provider visits in the past year. Negative attitudes and misperceptions about vaccination remain major reasons for not receiving vaccination. Influenza vaccination is highly cost-effective, particularly among pregnant women.
Percentage of women aged 18 to 44 who received the flu vaccine in the past year
Annual health exams promote prevention practices, recognize risk factors, identify medical problems, and establish a strong provider-patient relationship. Annual assessments should include screening, evaluation, counseling, and immunizations based on age and risk. Significant social disparities exist in receipt of women’s health services (ie, gynecological exam, sexually transmitted infections testing and counseling, contraceptive and pregnancy-related care) and general preventive health services (ie, cholesterol check, blood pressure check, flu vaccine). Poor and unemployed women and those with lower educational attainment are the most adversely affected. Lack of health insurance is a significant barrier to accessing health services for women, with uninsured women consistently having lower utilization than those with full coverage.