Executive BriefIntroductionNational HighlightsFindingsHealth OutcomesSocial and Economic FactorsBehaviorsClinical CareState RankingsNational SummaryState SummariesAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingUS SummaryAppendixMeasures Table – WomenMeasures Table – ChildrenData Source DescriptionsMethodology
2022 Health of Women and Children Report – Executive Brief2022 Health of Women and Children Report2022 Health of Women and Children Report – State Summaries2022 Health of Women and Children Report – Concentrated Disadvantage County-Level Maps2022 Health of Women and Children Report – Measures Table2022 Health of Women and Children Report – Infographics
Community and Family Safety
The firearm death rate among both women and children continued to rise.
Women and Children
- Changes over time. Nationally, the firearm death rate — deaths due to firearm injury of any intent (unintentional, suicide, homicide or undetermined) per 100,000 — among women ages 20-44 significantly increased 9% from 4.7 to 5.1 between 2015-2017 and 2018-2020, and 28% (from 4.0) since 2012-2014. Among children ages 1-19, the rate significantly increased 18% from 4.0 to 4.7 between 2015-2017 and 2018-2020, and 42% (from 3.3) since 2012-2014. In 2018-2020, 8,288 women and 11,070 children died by firearm.
Among women ages 20-44, the firearm death rate (deaths per 100,000) increased 34% in Missouri, from 8.5 to 11.4 since 2015-2017. Among children ages 1-19, the rate increased in 11 states, led by 71% in Mississippi (5.9 to 10.1).
- Disparities. Among women and children, firearm death rates were highest in Alaska (13.8 deaths per 100,000 women ages 20-44 and 11.5 deaths per 100,000 children ages 1-19) and lowest in Massachusetts (0.9 and 1.2, respectively) in 2018-2020. Among children, the rate in the District of Columbia (14.8) was higher than the rate in any state. Rates among both women and children varied significantly by age and race/ethnicity. The rate was 24.5 times higher among children ages 15-19 (14.7) compared with children ages 1-4 (0.6). Firearm deaths were 12.4 times higher among Black children (14.9) compared with Asian children (1.2), 4.7 times higher compared with Hispanic and white children (both 3.2) and nearly twice as high compared with American Indian/Alaska Native children (7.7). The rate was 10.0 times higher among Black women (11.0) compared with Asian women (1.1).
Social Support and Engagement
Adverse childhood experiences impact millions of children. Access to neighborhood amenities worsened.
Adverse Childhood Experiences Adverse childhood experiences (ACEs) are stressful or traumatic events that can impact children’s health and well-being throughout their lifespan. Early experiences have a broad and profound impact on an individual’s development and subsequent emotional, cognitive, social and biological functioning.
- Estimates in 2020-2021. Nationally, 14.0% of children ages 0-17 experienced two or more of nine adverse childhood experiences (ACEs), as reported by a caregiver, equating to 9.9 million children. The prevalence of two or more adverse childhood experiences was 2.5 times higher in New Mexico (24.7%), the state with the highest value, compared with New York (9.8%), the state with the lowest value.
Neighborhood Amenities Neighborhood amenities offer individuals opportunities to socialize, play, exercise and enjoy the neighborhood in which they live. There is evidence that safe neighborhoods with opportunities for and access to community engagement and healthy lifestyle habits contribute positively to physical and mental health.
- Changes over time. Nationally, the percentage of children ages 0-17 whose caregiver reported that they had access to neighborhood amenities significantly decreased 8% from 38.7% to 35.5% between 2018-2019 and 2020-2021. Neighborhood amenities are defined as all of the following: a park or playground; recreation center, community center or boys' and girls' club; library or bookmobile; and sidewalks or walking paths. Access to neighborhood amenities significantly decreased 21% in Arizona (39.6% to 31.3%) and 17% in Washington (42.9% to 35.5%).
The unemployment rate spiked during the COVID pandemic, disproportionately affecting women.
Unemployment A stable and well-paying job makes it possible for people to maintain good health. Unemployment among women decreased between 2017 and 2019 but spiked in 2020 due to the COVID-19 pandemic. The rate among women peaked at 15.4% in April of 2020, higher than the overall unemployment rate of 14.7%. Working women composed the majority of the 4.2 million Americans who left the labor force in 2020, with Hispanic and Black women experiencing a sharper decline in employment. By August 2022, the unemployment rate among women had declined to 3.3%.
- Changes over time. Nationally, the percentage of the female civilian workforce who were unemployed increased 131% nationally from 3.6% to 8.3%, an increase of about 3.5 million women between 2019 and 2020. Unemployment among women significantly increased in 41 states and the District of Columbia, led by 480% in Hawaii (2.0% to 11.6%).
- Estimates in 2016-2020. Nationally, 26.1% of households with children were located in areas of concentrated disadvantage, affecting an estimated 9.8 million people. Households were identified as being in an area of concentrated disadvantage if the averaged z-score was above the 75th percentile for the following factors: percentage of family households below the poverty line; percentage of individuals receiving public assistance; percentage of female-headed households; percentage of unemployed population ages 16 and older; and percentage of population younger than age 18. The most common factor was receiving public assistance (24.4%), and the least common was being unemployed (5.4%).
- Estimates in 2020-2021. Education is connected to employment, socioeconomic status and other factors that influence health. The disparities by race/ethnicity are striking. The percentage of college graduates was lowest among Hispanic (18.2%), American Indian/Alaska Native (20.2%) and Hawaiian/Pacific Islander (25.1%) women ages 25-44 and highest among Asian women (63.2%).