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Preventive Clinical Care

Use of many preventive care measures among women and children declined early on in the pandemic. However, flu vaccination among women improved, though large disparities persist by education, income and race/ethnicity.

Women and Children

Cervical Cancer Screening Cervical cancer is preventable and treatable due to the availability of screening tests and vaccines. Screening in the form of routine Pap tests has contributed to significant declines in cervical cancer mortality over the past 40 years.
  • Changes over time. Nationally, the percentage of women ages 21-44 who reported receiving a Pap smear within the past three years significantly decreased 4% from 79.9% to 77.1% between 2018 and 2020. In 2020, nearly 32.2 million women received a recommended cervical cancer screening. Cervical cancer screening significantly decreased in six states, led by 16% in Alaska (80.8% to 67.9%). All age groups and some racial/ethnic, education and income subpopulations experienced significant decreases in cervical cancer screening, led by 8% among women ages 21-24 (62.5% to 57.7%).
  • Disparities. Cervical cancer screening among women was highest in Mississippi (85.2%) and lowest in Alaska (67.9%) in 2020. The prevalence significantly varied by age, race/ethnicity, education and income. It was 1.4 times higher among women ages 25-34 (81.4%) and 35-44 (81.1%) compared with those ages 21-24 (57.7%). It was also 1.4 times higher among Black women (82.2%) compared with Asian women (60.5%).

Children

Preventive Dental Care Early preventive dental visits can preempt many oral health problems. Poor oral health during early childhood can impact health into adolescence and adulthood.
  • Changes over time. Nationally, the percentage of children ages 1-17 whose caregiver reported that they had one or more preventive dental care visits during the past 12 months significantly decreased 6% from 79.6% to 75.1% between 2018-2019 and 2020-2021. The prevalence of preventive dental care visits significantly decreased in seven states, led by 11% in both New Jersey (84.9% to 75.7%) and Ohio (78.4% to 69.6%).
  • Disparities. Preventive dental care among children was highest in Hawaii (84.9%) and lowest in Florida (69.5%) in 2020-2021.
Well-child Visit It is recommended that all children receive routine preventive visits, known as well-child visits. During those visits, children receive important care such as routine immunizations, tracking of growth and development as well as screening for potential issues.
  • Changes over time. Nationally, the percentage of children ages 0-17 whose caregiver reported that they received one or more preventive visits in the past 12 months significantly decreased 7% from 82.2% to 76.7% between 2016-2017 and 2020-2021. The prevalence of well-child visits significantly decreased in 18 states, led by 13% in both California (79.0% to 68.7%) and New Mexico (80.9% to 70.6%). By age group, well-child visits significantly decreased 8% among children ages 3-17 from 80.6% to 74.5%.
  • Disparities. Well-child visits among children were highest in New Hampshire (86.9%) and lowest in Nevada (67.4%) in 2020-2021. The prevalence was significantly higher among children ages 0-2 (88.4%) compared with children ages 3-17 (74.5%).

Women

Graphic representation of flu vaccination information contained on this page. Download the full report PDF from the report Overview page.
Flu Vaccination The flu vaccine helps protect people against seasonal influenza (flu) viruses that may lead to severe complications. While all women are at risk of complications from influenza, pregnant women are at greater risk of severe illness, hospitalization and preterm delivery. Getting the flu vaccine while pregnant also helps protect babies from flu illness in the first several months after birth when they are too young to get vaccinated.
  • Changes over time. Nationally, the percentage of women ages 18-44 who reported receiving a seasonal flu vaccine in the past 12 months significantly increased 26% from 30.8% to 38.9% between 2017-2018 and 2019-2020, with more than 19.9 million women receiving flu vaccinations in 2019-2020. Flu vaccination significantly increased in 41 states and the District of Columbia, led by 51% in both New Hampshire (30.1% to 45.5%) and Oregon (25.8% to 39.0%). Nearly all age, racial/ethnic, education and income subpopulations experienced significant increases in flu vaccination. By group, the largest increases were: 32% among women ages 18-24 (28.3% to 37.4%); 31% among white women (32.2% to 42.1%); and 27% among both college graduates (40.9% to 52.1%) and women with an annual household income of $75,000 or more (40.6% to 51.6%).
  • Disparities. The prevalence of flu vaccination among women was 2.1 times higher in South Dakota (53.3%), the state with the highest value in 2019-2020, compared with Nevada (25.9%), the state with the lowest value. The prevalence varied the most by education, and also significantly varied by income, race/ethnicity, age and metropolitan status.
Graphic representation of flu vaccination information contained on this page. Download the full report PDF from the report Overview page.
‡ Education and income subpopulations are among women ages 25-44.

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