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2025 Annual Report

Measures Table

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Executive BriefForewordIntroductionNational SnapshotFindingsHealth OutcomesSocial and Economic FactorsPhysical EnvironmentClinical CareSpotlight: Rural CommunitiesBehaviorsState RankingsInternational ComparisonAppendixMeasures TableData Source DescriptionsMethodologyReferencesState SummariesUS SummaryAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
2025 Annual Report2025 Annual Report – Executive Brief2025 Annual Report – State Summaries2025 Annual Report – Economic Hardship Index County-Level Maps2025 Annual Report – Measures Table2025 Annual Report – Infographics2025 Annual Report – Report Data (All States)
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Social and Economic Factors

Measure
Description
Source(s)
Data Year(s)
Community and Family Safety
Firearm Deaths*^
Number of deaths due to firearm injury of any intent (unintentional, suicide, homicide or undetermined) per 100,000 population
U.S. HHS, Multiple Cause of Death Files via CDC WONDER
2023
Homicide^
Number of deaths due to injuries inflicted by another person with intent to injure or kill per 100,000 population
U.S. HHS, Multiple Cause of Death Files via CDC WONDER
2022-2023
Occupational Fatalities
Number of fatal occupational injuries in construction, manufacturing, trade, transportation and utility industries as well as professional and business services per 100,000 workers
U.S. DOL, Bureau of Labor Statistics, Census of Fatal Occupational Injuries
2020-2022†
Public Health Funding
State dollars dedicated to public health per person (including federal grants directed to states from the CDC and the Health Resources and Services Administration) 
Trust for America's Health, The Impact of Chronic Underfunding on America's Public Health System Report Series; U.S. HHS, CDC Grant Funding Profiles and HRSA Awarded Grants
2022-2023†
Economic Resources
Economic Hardship Index
Index of state economic conditions based on crowded housing, dependency, education, income, poverty and unemployment; normalized values are 1 to 100, with a higher value indicating worse economic conditions
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Crowded Housing*
Percentage of occupied housing units with more than one person per room
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Dependency (Ages <18 or >64)*
Percentage of the population ages 0-17 or 65 and older
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Less Than High School Education*
Percentage of the population age 25 and older without a high school diploma
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Per Capita Income*
Per capita income in the past 12 months, in inflation-adjusted dollars to data year
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Poverty*
Percentage of households living below the federal poverty level
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Unemployment*
Percentage of the civilian workforce ages 16-64 that is unemployed
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Food Insecurity
Percentage of households unable to provide adequate food for one or more household members due to lack of resources
USDA, Household Food Security in the United States Report Series
2021-2023†
Homeownership*
Percentage of housing units owned by the occupant
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Homeownership Racial Disparity*
Difference between the homeownership rates of the white population and the racial/ethnic population with the lowest rate (varies by state)
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Income Inequality
Ratio of median household income at the 80th percentile to median household income at the 20th percentile
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Education
Fourth Grade Reading Proficiency
Percentage of fourth grade public school students who scored proficient or above on the National Assessment of Educational Progress in reading comprehension
U.S. ED, National Center for Education Statistics, National Assessment of Educational Progress
2024
High School Completion
Percentage of adults age 25 and older with at least a high school diploma or equivalent
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
High School Graduation*
Percentage of high school students graduating with a regular high school diploma within four years of starting ninth grade
U.S. ED, National Center for Education Statistics, EDFacts
2021-2022 School Year†
Social Support and Engagement
Adverse Childhood Experiences^
Percentage of children ages 0-17 who have ever experienced two or more of the following adverse experiences: parental divorce or separation; household with an alcohol or drug problem; household with mental illness; neighborhood violence victim or witness; domestic violence witness; parent served jail time; treated or judged unfairly due to race/ethnicity; treated or judged unfairly due to a health condition or disability; or death of a parent
U.S. HHS, Maternal and Child Health Bureau, National Survey of Children's Health
2023-2024
High-Speed Internet
Percentage of households with a broadband internet subscription and a computer, smartphone or tablet
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Neighborhood Racial/Ethnic Segregation
Index of segregation ranging from zero (all racial/ethnic census groups are distributed equally across all census tracts at the state level) to 100 (all groups reside in separate tracts)
U.S. Census Bureau, American Community Survey, 5-Year Dataset
2019-2023
Residential Segregation - Black/White
Index of segregation between Black and non-Hispanic white households measured by the proportion of a state’s population that would need to move in order to achieve complete integration, ranging from zero (the proportion of each racial/ethnic group in each census tract is the same as their proportion to the population as a whole) to 100 (each tract contains only one racial/ethnic group)
U.S. Census Bureau, American Community Survey, 5-Year Dataset
2019-2023
Volunteerism
Percentage of population age 16 and older who reported volunteering in the past 12 months
U.S. Census Bureau, Current Population Survey, Volunteering and Civic Life Supplement
2023
Voter Participation (Average)
Average of the percentage of U.S. citizens age 18 and older who voted in the last presidential and the last midterm national elections
U.S. Census Bureau, Current Population Survey, Voting and Registration Supplement
2022/2024
Voter Participation (Presidential)*
Percentage of U.S. citizens age 18 and older who voted in the last presidential election
U.S. Census Bureau, Current Population Survey, Voting and Registration Supplement
2024
Voter Participation (Midterm)*
Percentage of U.S. citizens age 18 and older who voted in the last midterm national election
U.S. Census Bureau, Current Population Survey, Voting and Registration Supplement
2022†

Physical Environment

Measure
Description
Source(s)
Data Year(s)
Air and Water Quality
Air Pollution
Average exposure of the general public to particulate matter of 2.5 microns or less, measured in micrograms per cubic meter
U.S. EPA
2022-2024
Drinking Water Violations
Average number of health-based drinking water violations per community water system in a state
U.S. EPA, Safe Drinking Water Information System via ECHO
2024
Smoke-Free Policies*
Percentage of the population covered by 100% smoke-free laws for restaurants, bars and nonhospitality workplaces
American Nonsmokers' Rights Foundation
2025
Water Fluoridation
Percentage of the population served by community water systems that has fluoridated water
U.S. HHS, CDC, Water Fluoridation Reporting System
2022†
Climate and Health
Climate Policies
Number of the four following state policies in place: legally binding electricity portfolio standards; carbon pricing policies; climate change action plans; and economy-wide greenhouse gas emission targets
Center for Climate and Energy Solutions
2024
Climate Risks*
Percentage of the population living in census tracts at or above the 90th percentile for projected flood risk, projected wildfire risk, fatalities and injuries from natural hazards, agricultural value losses from natural hazards, or building value losses from natural hazards
CEQ, Climate and Economic Justice Screening Tool
2022†
Heat and Worker Health*
Rate of nonfatal heat-related illness cases causing days away from work per 10,000 full-time workers
U.S. DOL, Bureau of Labor Statistics, Survey of Occupational Injuries and Illnesses via CDC National Environmental Public Health Tracking Network
2020†
Heat-Coded Emergency Department Visits*
Age-adjusted rate of emergency department visits for heat-related illness per 100,000 population
U.S. HHS, CDC, National Environmental Public Health Tracking Network
2023
Renewable Energy*^
Percentage of electricity generated from renewable sources (wind, solar rays, hydroelectric energy, biomass or geothermal heat)
U.S. EIA, State Energy Data System
2024
Transportation Energy Use*
Amount of energy in trillion British thermal units (BTUs) consumed by the transportation of people and goods per 100,000 population
U.S. EIA, State Energy Data System
2023
Housing and Transit
Drive Alone to Work
Percentage of workers age 16 and older who drive alone to work
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Homelessness*^
Number of people experiencing homelessness per 10,000 population
U.S. HUD, Annual Homelessness Assessment Reports to Congress
2024
Housing Cost Burden*
Percentage of households for which housing costs are 30% or more of household income
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Housing With Lead Risk
Percentage of housing stock with potential elevated lead risk due to age of housing
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Severe Housing Problems
Percentage of occupied housing units with at least one of the following problems: lack of complete kitchen facilities, lack of plumbing facilities, overcrowding, or severely cost-burdened occupants 
U.S. HUD, Comprehensive Housing Affordability Strategy
2017-2021†
Transportation Health Risks*
Percentage of the population living in census tracts at or above the 90th percentile in diesel particulate matter exposure, transportation barriers, or traffic proximity and volume
CEQ, Climate and Economic Justice Screening Tool
2022†

Clinical Care

Measure
Description
Source(s)
Data Year(s)
Access to Care
Avoided Care Due to Cost
Percentage of adults who reported a time in the past 12 months when they needed to see a doctor but could not because of cost
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Providers
Dental Care Providers
Number of general dentists and advanced practice dental therapists per 100,000 population
U.S. HHS, CMS, National Plan and Provider Enumeration System
September 2025
Mental Health Providers
Number of psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists and advanced practice nurses specializing in mental health care per 100,000 population
U.S. HHS, CMS, National Plan and Provider Enumeration System
September 2025
Primary Care Providers
Number of active primary care providers (including general practice, family practice, obstetrics and gynecology, pediatrics, geriatrics and internal medicine physicians, as well as physician assistants and nurse practitioners) per 100,000 population
U.S. HHS, CMS, National Plan and Provider Enumeration System
September 2025
Uninsured
Percentage of the population not covered by private or public health insurance
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2024
Preventive Clinical Services
Cancer Screenings
Percentage of women ages 40-74 who reported receiving a mammogram in the past two years and percentage of adults ages 45-75 who reported receiving colorectal cancer screening within the recommended time period
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Breast Cancer Screening*
Percentage of women ages 40-74 who reported receiving a mammogram in the past two years
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Colorectal Cancer Screening*
Percentage of adults ages 45-75 who reported receiving one or more of the recommended colorectal cancer screening tests within the recommended time interval: blood stool test within the past year; sigmoidoscopy within the past five years; colonoscopy within the past 10 years; stool DNA test within the past three years; virtual colonoscopy within the past five years or sigmoidoscopy within the past 10 years and blood stool test in the past year
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Dental Visit
Percentage of adults who reported visiting a dentist or dental clinic within the past year
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Immunizations
Childhood Immunizations
Percentage of children who received by age 24 months all recommended doses of the combined seven-vaccine series: diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine; measles, mumps and rubella (MMR) vaccine; poliovirus vaccine; Haemophilus influenzae type b (Hib) vaccine; hepatitis B (HepB) vaccine; varicella vaccine; and pneumococcal conjugate vaccine (PCV)
U.S. HHS, CDC, NIS-Child
2020-2021 Birth Cohort†
Flu Vaccination
Percentage of adults who reported receiving a seasonal flu vaccine in the past 12 months
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
HPV Vaccination
Percentage of adolescents ages 13-17 who received all recommended doses of the human papillomavirus (HPV) vaccine
U.S. HHS, CDC, NIS-Teen
2024
Quality of Care
Dedicated Health Care Provider
Percentage of adults who reported having a personal doctor or health care provider
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Preventable Hospitalizations
Discharges following hospitalization for ambulatory care sensitive conditions (PQI 90) per 100,000 Medicare beneficiaries age 18 and older enrolled in the fee-for-service program
U.S. HHS, CMS, Mapping Medicare Disparities Tool
2023

Behaviors

Measure
Description
Source(s)
Data Year(s)
Nutrition and Physical Activity
Exercise
Percentage of adults who met the federal physical activity guidelines (150 minutes of moderate or 75 minutes of vigorous aerobic activity and two days of muscle strengthening per week) in the past 30 days
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2023†
Fruit and Vegetable Consumption
Percentage of adults who reported consuming two or more fruits and three or more vegetables daily
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2021†
Physical Inactivity
Percentage of adults who reported doing no physical activity or exercise other than their regular job in the past 30 days
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Sexual Health
Chlamydia
Number of new cases of chlamydia per 100,000 population
U.S. HHS, CDC, NCHHSTP AtlasPlus
2023
High-Risk HIV Behaviors
Percentage of adults who reported having done any of the following in the past year: injecting any drug other than those prescribed for them; being treated for a sexually transmitted disease; or giving or receiving money or drugs in exchange for sex
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Teen Births
Births per 1,000 females ages 15-19
U.S. HHS, Natality Public Use Files via CDC WONDER
2023
Sleep Health
Insufficient Sleep
Percentage of adults who reported sleeping, on average, less than seven hours in a 24-hour period
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2022†
Smoking and Tobacco Use
E-Cigarette Use
Percentage of adults who reported using e-cigarettes or other electronic vaping products at least once in their lifetime and now use daily or some days
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Smoking
Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024

Health Outcomes

Measure
Description
Source(s)
Data Year(s)
Behavioral Health
Drug Deaths*
Number of deaths due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 population 
U.S. HHS, Multiple Cause of Death Files via CDC WONDER
2023
Excessive Drinking^
Percentage of adults who reported binge drinking (four or more drinks on one occasion in the past 30 days for females or five or more for males) or heavy drinking (eight or more drinks per week for females or 15 or more for males)
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Frequent Mental Distress
Percentage of adults who reported their mental health was not good 14 or more days in the past 30 days
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Non-Medical Drug Use - Past Year
Percentage of adults who reported using prescription drugs non-medically (including pain relievers, stimulants and sedatives) or illicit drugs (excluding cannabis) in the last 12 months
RADARS® System Survey of Non-Medical Use of Prescription Drugs Program
2025
Cannabis Use*
Percentage of adults who reported using cannabis (including THC or both THC and CBD) in the last 12 months 
RADARS® System Survey of Non-Medical Use of Prescription Drugs Program
2025
Illicit Drug Use (Excluding Opioids and Cannabis)*
Percentage of adults who reported using illicit drugs other than opioids and cannabis in the last 12 months
RADARS® System Survey of Non-Medical Use of Prescription Drugs Program
2025
Illicit Opioid Use*
Percentage of adults who reported using illicit opioids in the last 12 months
RADARS® System Survey of Non-Medical Use of Prescription Drugs Program
2025
Non-Medical Prescription Drug Use (Excluding Opioids and Cannabis)*
Percentage of adults who reported using prescription drugs other than opioids and cannabis non-medically in the last 12 months
RADARS® System Survey of Non-Medical Use of Prescription Drugs Program
2025
Non-Medical Prescription Opioid Use*
Percentage of adults who reported using prescription opioids non-medically in the last 12 months
RADARS® System Survey of Non-Medical Use of Prescription Drugs Program
2025
Non-Medical Drug Use - Past Month*
Percentage of adults who reported using prescription drugs non-medically (including pain relievers, stimulants, sedatives) or illicit drugs (excluding cannabis) in the last 30 days
RADARS® System Survey of Non-Medical Use of Prescription Drugs Program
2025
Suicide*
Number of deaths due to intentional self-harm per 100,000 population
U.S. HHS, Multiple Cause of Death Files via CDC WONDER
2023
Mortality
Premature Death
Years of potential life lost before age 75 per 100,000 population 
U.S. HHS, Multiple Cause of Death Files via CDC WONDER
2023
Premature Death Racial Disparity
Ratio of the premature death rate of the racial/ethnic group with the highest rate (varies by state) to the non-Hispanic white rate
U.S. HHS, Multiple Cause of Death Files via CDC WONDER
2021-2023
Physical Health
Frequent Physical Distress
Percentage of adults who reported their physical health was not good 14 or more days in the past 30 days
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
High Health Status*
Percentage of adults who reported their health was very good or excellent
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Low Birth Weight
Percentage of infants weighing less than 2,500 grams (5 pounds, 8 ounces) at birth
U.S. HHS, Natality Public Use Files via CDC WONDER
2023
Low Birth Weight Racial Disparity
Ratio of the low birth weight rate of the racial/ethnic group with the highest rate (varies by state) to the non-Hispanic white rate
U.S. HHS, Natality Public Use Files via CDC WONDER
2021-2023
Multiple Chronic Conditions
Percentage of adults who have three or more of the following chronic health conditions: arthritis, asthma, chronic kidney disease, chronic obstructive pulmonary disease, cardiovascular disease (heart disease, heart attack or stroke), cancer (excluding non-melanoma skin cancer), depression or diabetes
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Arthritis*
Percentage of adults who reported ever being told by a health professional that they had some form of arthritis
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Asthma*
Percentage of adults who reported ever being told by a health professional that they have asthma
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Cancer*
Percentage of adults who reported ever being told by a health professional that they had any form of cancer other than non-melanoma skin cancer
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Cardiovascular Diseases*
Percentage of adults who reported ever being told by a health professional that they had angina or coronary heart disease, a heart attack or myocardial infarction, or a stroke
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Chronic Kidney Disease*
Percentage of adults who reported ever being told by a health professional that they had kidney disease (excluding kidney stones, bladder infection and incontinence)
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Chronic Obstructive Pulmonary Disease*
Percentage of adults who reported ever being told by a health professional that they had chronic obstructive pulmonary disease, emphysema or chronic bronchitis
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Depression*
Percentage of adults who reported ever being told by a health professional that they had a depressive disorder, including depression, major depression, minor depression or dysthymia
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Diabetes*
Percentage of adults who reported ever being told by a health professional that they had diabetes (excluding prediabetes and gestational diabetes)
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024
Risk Factors
High Blood Pressure*
Percentage of adults who reported being told by a health professional that they had high blood pressure
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2023†
High Cholesterol*
Percentage of adults who reported having their cholesterol checked and being told by a health professional that it was high
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2023†
Obesity
Percentage of adults who have a body mass index of 30.0 or higher based on reported height and weight
U.S. HHS, CDC, Behavioral Risk Factor Surveillance System
2024

Demographics

Measure
Description
Source(s)
Data Year(s)
Total Population*
Number of estimated residents
U.S. Census Bureau, Single-Race Population Estimates via CDC WONDER
2024
Population - Age <18*
Percentage of the population that is younger than age 18
U.S. Census Bureau, Single-Race Population Estimates via CDC WONDER
2024
Population - Ages 18-64*
Percentage of the population that is ages 18-64
U.S. Census Bureau, Single-Race Population Estimates via CDC WONDER
2024
Population - Age 65+*
Percentage of the population that is age 65 and older
U.S. Census Bureau, Single-Race Population Estimates via CDC WONDER
2024
Rural Population*^
Percentage of a state's total population estimated to live in a rural area
U.S. Census Bureau, American Community Survey, 1-Year Dataset
2023†
* Unweighted measure, excluded from the Overall and category composite measures.
^ Data for each of the components are available in the Explore Data section.
† Data in this edition were repeated from the last edition.

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