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Well-woman Visit

Annual health exams, recommended by the American College of Obstetrics and Gynecology, provide women access to preventive services and an opportunity to discuss strategies to minimize health risks and achieve a healthy lifestyle.

National and state findings

The percentage of U.S. women ages 18-44 with a preventive medical visit in the past year was 73.2% in 2018-2019. Well-woman visits were highest in Rhode Island (81.1%), the District of Columbia (79.6%), New York (79.0%) and Iowa (78.0%); they were lowest in Wyoming (64.7%), Nevada (65.1%) and Idaho (66.5%). The percentage of women with a preventive visit increased 10% from 66.5% in 2016-2017, equaling nearly 3.6 million more women. During this same period, well-woman visits increased significantly in 35 states, led by 35% in Alaska (52.7% to 71.0%) and 26% in Arkansas (60.1% to 75.5%) and Idaho (52.6% to 66.5%).

Subpopulation findings

The percentage of well-woman visits varied by race and ethnicity, educational attainment and income. In 2018-2019, 82.2% of Black women reported a preventive medical visit in the past year, compared with 70.1% of Hispanic women. The percentage of women ages 25-44 reporting a well-visit was highest among college graduates (76.4%) and lowest among those with less than a high school education (66.9%). Also, 77.3% of women ages 25-44 with a household income of $75,000 or more annually reported a preventive medical visit in the past year, significantly higher than women with an income less than $25,000 annually (70.4%). Between 2016-2017 and 2018-2019, well-woman visits increased 12% among multiracial (64.8% to 72.5%) and white (64.4% to 72.1%) women, 11% among Hispanic women (63.2% to 70.1%) and 5% among Black women (78.1% to 82.2%).

Additional related findings

  • In 2019, 12.9% of women ages 19-44 in the U.S. were not covered by private or public health insurance, affecting roughly 7.2 million women. The proportion of uninsured women was 7.3 times higher in Texas (26.3%) than in Massachusetts (3.6%). The District of Columbia (2.5%) had the lowest rate. Since 2018, the uninsured rate has increased nationally (up 2% from 12.6%), with significant increases in California, Colorado, Kentucky and Minnesota.
  • In 2018-2019, 18.8% of U.S. women ages 18-44 reported not seeking needed medical attention due to cost, equaling about 10.7 million women. The percentage of women who avoided care due to cost was 2.9 times higher in Georgia (27.6%) than in Hawaii (9.6%).
  • In 2019, 25.6% of U.S. low-risk births — singleton, headfirst, term births that are the mother’s first — were delivered by cesarean. Despite efforts to reduce low-risk cesarean deliveries, they have only decreased 2% from 26.0% in 2014. Low-risk cesarean deliveries were 1.8 times higher in Mississippi (30.7%) than in Alaska (17.1%). Racial and ethnic disparities in low-risk cesarean deliveries have persisted, with Black mothers (30.0%) experiencing the highest rates in 2019, 1.2 times higher than white (24.7%) and Hispanic (24.8%) mothers.

Well-child Visit

The American Academy of Pediatrics recommends that children receive routine well-child visits to prevent illness, receive routine immunizations, track growth and development, and provide opportunities to discuss parental concerns about child development, behavior, sleep and eating.

National and state findings

The percentage of U.S. children ages 0-17 who received one or more preventive visits in the past 12 months was 80.7% in 2019-2020. Well-child visits were highest in New Hampshire (89.6%), Massachusetts (89.4%) and Maine (89.1%); they were lowest in Nevada (71.7%), Mississippi (74.3%) and Arkansas (74.7%). Well-child visits decreased 2% nationally, from 82.2% in 2016-2017 — a statistically significant change impacting nearly 1.3 million children. They also significantly decreased 8% in Tennessee (85.4% to 78.9%) and 7% in Delaware (87.4% to 80.9%).

Additional related findings

  • In 2019, 5.7% of U.S. children younger than 19 were not covered by private or public health insurance, affecting roughly 4.4 million children. The proportion of children without insurance was 8.5 times higher in Texas (12.7%) than in Massachusetts (1.5%). Since 2018, the uninsured rate among children has increased 10% nationally from 5.2% and significantly increased 31% in Arkansas (4.5% to 5.9%), 18% in Illinois (3.4% to 4.0%), 16% in California (3.1% to 3.6%), and 13% in Texas (11.2% to 12.7%).
  • In 2019-2020, 66.7% of U.S. children ages 0-17 were continuously and adequately insured in the past year. Adequacy is based on whether benefits meet the child’s needs, insurance allows the child to see needed providers and out-of-pocket costs are reasonable. The percentage of children with adequate and continuous health insurance was 1.5 times higher in Hawaii (80.6%) than in Wyoming (54.6%).
  • In 2020, there were 104.6 pediatricians per 100,000 U.S. children ages 0-21. The number of pediatricians varied by state; it was 4.7 times higher in Massachusetts (207.0) than in Idaho (43.8). The District of Columbia had the highest rate at 512.2.
  • In 2019, 54.2% of U.S. adolescents ages 13-17 had received all recommended doses of the HPV vaccine. The HPV vaccination rate was 2.6 times higher in Rhode Island (78.9%) than in Mississippi (30.5%). Between 2018 and 2019, rates increased 6% nationally (from 51.1%) and significantly in one state: 21% in North Dakota (63.6% to 76.9%).

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