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Social and Economic Factors

The health of women, infants and children is fundamental to the health of communities, and vice versa. Health behaviors and outcomes are heavily influenced by social and economic factors at state, community, household and individual levels. Social and economic factors continue to challenge the well-being of families in communities across the country. This year’s report finds stark disparities by gender, race/ethnicity, geography and education across key measures of health. To achieve the highest level of health for all people, more work is needed to address and eliminate these disparities.
America’s Health Rankings Health of Women and Children Report finds that:
  • Nearly 14.7 million (20.5 percent) children ages 0-17 have at least two of nine adverse childhood experiences. Table 6 shows the nine components of the adverse childhood experiences measure at the state level. According to the Child and Adolescent Health Measurement Initiative, adverse childhood experiences (ACEs) are stressful or traumatic events that affect children and have a lasting impact on health and well-being. Early experiences have a broad and profound impact on an individual’s development and subsequent emotional, cognitive, social and biological functioning.
  • Nearly a quarter (24.0 percent) of households are in areas of concentrated disadvantage. This means there is a higher percentage of households headed by females (who are more likely to face wage discrimination than males); a higher percentage of children; and a higher percentage of people unemployed, living in poverty and receiving public assistance. Table 7 shows the five components of the concentrated disadvantage measure at the state level. According to the Association of Maternal and Child Health Programs (AMCHP), concentrated disadvantage is a measure of community well-being that helps identify community-level concentrated poverty and economic segregation. Persistent high levels of concentrated disadvantage can harm physical and mental health and is associated with: poor birth outcomes, child maltreatment, lack of access to healthy foods and recreational areas, poor educational outcomes, teen pregnancy and high rates of violent crime.
  • Nearly one in eight households (12.3 percent) in the nation don’t have adequate food due to lack of resources, despite improvements in food insecurity since 2016. Food insecurity has broad effects on health due to the mental and physical stress that it places on the body. In women it is associated with obesity, anxiety, depression, risky sexual behavior, low birthweight and gestational diabetes. In children it is associated with anemia, asthma, anxiety, depression, cognitive and behavioral problems as well as hospitalization.
  • Nearly 6.9 million women ages 19-44 (12.4 percent) are uninsured — ranging dramatically from 3.3 percent in Massachusetts to 25.6 percent in Texas. Health insurance is a critical factor in ensuring women receive needed care to achieve and maintain good health. Moreover, babies born to healthy mothers start off on a promising path to health that has the potential to last a lifetime. According to the Kaiser Family Foundation, the most common reason for being uninsured is cost.

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