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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

Diabetes

Diabetes is a leading cause of death among women of reproductive age and contributes to heart disease and stroke. It is critical to properly manage diabetes prior to conception and during pregnancy to reduce risk of adverse outcomes for both the baby and mother. Pregnant women with diabetes are at increased risk for preeclampsia, depression, preterm delivery, cesarean section, and congenital anomaly in the baby. Diabetes-related complications in pregnancy may be prevented through healthy dietary practices, regular physical activity, weight loss, and medication modifications. Costs of diagnosed and undiagnosed diabetes and prediabetes exceeded $322 billion in 2012.

Percentage of women aged 18 to 44 who have been told by a doctor that they have diabetes (excludes prediabetes and gestational diabetes)

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



Drug Deaths

More drug overdose deaths occurred in 2014 than any other year on record. Of 47,055 deaths, 60% involved an opioid, and 50% of the opioid deaths involved a prescription. Among women, the drug death rate is highest in the following age groups: 45 to 54 years, 35 to 44 years, and 25 to 34 years, respectively; and the drug death rate is more than two times greater among non-Hispanic whites than non-Hispanic blacks. Infants born to drug-abusing mothers are at risk of low birthweight, preterm delivery, poor intrauterine growth, and neonatal abstinence syndrome. Drug abuse contributes to other issues including teenage pregnancy, HIV/AIDS, sexually transmitted infections, violent crimes, and suicide. The estimated cost of illicit drug use is $193 billion.

Number of deaths due to drug injury of any intent (unintentional, suicide, homicide, or undetermined) per 100,000 females aged 15 to 44

Data source: National Vital Statistics System, 2012-2014 For details: www.americashealthrankings.org/ALL/drug_deaths_women_mch



Maternal Mortality

Among developed countries, the United States has the highest maternal mortality rate (MMR). Between 1987 and 2011, the US MMR more than doubled from 7.2 to 17.8 deaths per 100,000 live births. The top three causes—of the more than 1,300 pregnancy-related US deaths in 2011–2012—were non-cardiovascular diseases (such as cancer, respiratory, or neurological conditions), cardiovascular diseases, and infection or sepsis. Significant disparities exist in MMR by race with black women at highest risk of pregnancy-related death. Women who lack health insurance are three to four times more likely to die of pregnancy-related complications than their insured counterparts.

Number of deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 births

Data source: National Vital Statistics System, 2010-2014 For details: www.americashealthrankings.org/ALL/maternal_mortality



Postpartum Depression

One in ten women experience frequent postpartum depressive symptoms, including lasting sad, anxious, or empty mood, feelings of hopelessness, pessimism, or anger, crying more often than usual, feeling guilty about not being a good mother, feeling disconnected from her baby, worrying that she will hurt the baby, and withdrawing from loved ones. Risk factors for postpartum depression (PPD) include young maternal age, partner-related stress or physical abuse, traumatic or financial stress, tobacco use during pregnancy, and delivery of a low birthweight infant. PPD may affect the early development phases of the mother-infant relationship and contribute to short- and long-term adverse child outcomes.

Percentage of women with a recent live birth who report experiencing postpartum depression (depressive symptoms)

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



Unintended Pregnancy

About 45% of the 6.1 million US pregnancies were unintended in 2011. Low-income women, women aged 18 to 24, cohabitating women, and racial minority women experience the highest rates of unintended pregnancy. Births resulting from unintended or closely spaced pregnancies are associated with adverse health outcomes for mother and baby, including delayed prenatal care, preterm birth, and negative physical and mental impacts for children. Two-thirds of unplanned births were paid for by public insurance programs, mainly Medicaid, and total public expenditures on unintended pregnancies nationwide were estimated at $21 billion in 2010.

Percentage of all pregnancies that were unintended

Data source: Guttmacher Institute, 2010 For details: www.americashealthrankings.org/ALL/unintended_pregnancy




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