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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

Concentrated Disadvantage

Concentrated disadvantage provides a broad, community-level look at the impact of poverty and its associated conditions. It has complex socioeconomic roots, but is grounded in the idea that economic segregation concentrates poverty. Communities facing concentrated disadvantage are at greater risk of poor birth outcomes, such as infant mortality and low birthweight, delayed verbal development, and maltreatment of children compared to those in less disadvantaged neighborhoods. Adolescents may face higher rates of teen pregnancy and are at increased risk of mental health issues. Concentrated disadvantage impacts overall health and is correlated with higher allostatic load—or wear and tear on the body.

Percentage of households located in census tracts with a high level of concentrated disadvantage, calculated using five census variables (percentage below poverty line, receiving public assistance, female-headed households, unemployed, less than aged 18)

Data source: American Community Survey, 2010-2014 For details: www.americashealthrankings.org/ALL/ concentrated_disadvantage



Food Insecurity

Food insecurity has a large impact on women and children; 19.2% of households with children and 15.3% of women living alone faced food insecurity in 2014. It is associated with obesity, anxiety, depressive symptoms, poor sleep, poor oral health, and lower self-reported health in women. During pregnancy it is associated with some birth defects and complications, such as gestational diabetes and greater increased weight gain. Food insecurity disproportionately affects households living in poverty, with 33.7% of households under 185% of the federal poverty level facing food insecurity at some point. Health care costs attributed to hunger were $130.5 billion in 2010.

Percentage of households unable to provide adequate food for one or more household members due to lack of resources

Data source: Current Population Survey Food Security Supplement, 2012-2014 For details: www.americashealthrankings.org/ALL/food_insecurity_household



Intimate Partner Violence — Lifetime

Intimate partner violence (IPV) includes physical, sexual, and psychological harm caused by actions of a current or former intimate partner. Women are more likely to experience IPV than men with nearly 1 in 3 US women reporting physical IPV in their lifetime. Nearly 3 in 4 women (71.1%) who experienced IPV had their first experience before age 25. Individuals who experience IPV are at increased risk for a variety of health problems including physical conditions, reproductive difficulties, psychological illnesses, social consequences, and negative health behaviors. The annual costs of intimate partner rape, physical assault, and stalking surpass $5.8 billion.

Percentage of women aged 18 and older who experienced sexual violence, physical violence, stalking, psychological aggression, or control of reproductive or sexual health by an intimate partner in their lifetime

Data source: National Intimate Partner and Sexual Violence Survey, 2010 For details: www.americashealthrankings.org/ALL/ipv-lifetime



Intimate Partner Violence — Pregnancy

Estimates of intimate partner violence (IPV) prevalence in pregnancy vary from 1 to 20%. IPV during pregnancy is a risk factor for severe IPV, including IPV-related homicide. Women who experience IPV during pregnancy are at a higher risk for miscarriage, preterm labor, low birthweight infants, vaginal bleeding, kidney infection, urinary tract infection, and severe nausea, vomiting, or dehydration, as well as depression and lack of attachment to the child. They may engage in more negative health behaviors during pregnancy, including alcohol and/or drug use, smoking, and delaying prenatal care. Risk factors include age, education level, and race/ethnicity.

Percentage of women with a recent live birth who experienced violence by husband or partner during most recent pregnancy

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




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