Clinical Care

Cost is a central barrier

to accessing care for many Americans.⁵⁰ Avoiding or delaying needed health care has been associated with increased preventable hospitalizations

and missed opportunities to prevent

disease and manage

chronic conditions, all of which can lead to worse and more expensive health outcomes.^51–53

Changes over time. Nationally, the 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 increased 8% from 10.6% to 11.5% between 2023 and 2024.

Between 2023 and 2024, the percentage of adults who could not afford care due to cost increased:

During this time frame, the prevalence of avoiding care due to cost increased in eight states. The largest increases were: 30% in Nebraska (8.8% to 11.4%), 29% in Louisiana (11.5% to 14.8%) and 24% in Montana (9.7% to 12.0%).

Differences. The prevalence of avoiding care due to cost varied significantly by income, age, educational attainment, disability status, geography, race/ethnicity, veteran status, sexual orientation and gender in 2024. The prevalence was:

Mental health providers offer essential care

to adults and children with mental or behavioral disorders through assessments, diagnoses, treatments, medications and therapeutic interventions.⁵⁴ A 2024 analysis found that more than 122 million

Americans were living in areas with a shortage of mental health care professionals, and only 26.4% of the population’s mental health care needs were met.⁵⁵

Changes over time. Mental health providers — psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists and advanced practice nurses specializing in mental health care — increased 5% nationally from 344.9 to 362.6 providers per 100,000 population between September 2024 and September 2025, and 57% (from 230.5) since September 2018.

Between September 2024 and September 2025, the rate of mental health providers increased 5% or more in 34 states, led by: 10% in both Nebraska (346.9 to 380.7) and North Dakota (258.3 to 284.2), 9% in Montana (410.3 to 448.9), and 8% in West Virginia (206.2 to 223.2), Virginia (273.1 to 294.6) and Maryland (380.1 to 412.1).

Differences. The number of mental health providers per 100,000 population varied by geography in September 2025 and was 5.0 times higher in Alaska (822.0 providers per 100,000 population) than in Alabama (162.9).​

Health insurance coverage

has been shown to promote positive health outcomes, increase appropriate use of health care services and offer financial protection against high medical expenses.⁵⁶ Nearly two-thirds of uninsured adults ages 18-64 report being uninsured because they cannot afford

coverage.⁵⁷

Changes over time. Nationally, the percentage of the population not covered by private or public health insurance increased 4% from 7.9% to 8.2% between 2023 and 2024. In 2024, nearly 27.5 million people in the U.S. were uninsured, an increase of 1.3 million since 2023. 

Between 2023 and 2024, the uninsured rate significantly increased: 

Between 2023 and 2024, the uninsured population significantly increased in eight states and the District of Columbia. The largest increases were: 67% in the District of Columbia (2.7% to 4.5%), 36% in North Dakota (4.5% to 6.1%), 26% in Kentucky (5.4% to 6.8%) and 21% in Minnesota (4.2% to 5.1%). During the same period, the uninsured rate significantly decreased 8% in California (6.4% to 5.9%).

Differences. The uninsured rate varied significantly by geography, educational attainment, race/ethnicity and age in 2024. The rate was:

Cancer screenings can help detect cancer early

, when treatment is most effective.⁵⁸ Both mammography

and colorectal screening

have been found to be cost-effective methods of reducing

deaths from breast and colorectal cancers, which are among the most common types.^59–61

Changes over time. Nationally, cancer screenings (a combined measure of breast cancer and colorectal cancer screenings) increased 15% from 56.0% to 64.5% between 2022 and 2024. Looking at the two cancer screening components separately, breast cancer screening increased 3% (72.1% to 74.5% of women ages 40-74 who reported receiving a mammogram in the past two years) and colorectal cancer screening increased 15% (61.8% to 71.1% of adults ages 45-75 who reported receiving colorectal cancer screening within the recommended time period). Despite improvements, screening rates remain lower than Healthy People 2030 targets to increase the proportion of females who get screened for breast cancer to 80.3%

and increase the proportion of adults who get screened for colorectal cancer to 72.8%

.^62,63

Between 2022 and 2024, the prevalence of cancer screenings significantly increased:

During the same time, the prevalence of cancer screenings significantly increased in 47 states and the District of Columbia, led by: 28% in New Jersey (52.0% to 66.7%), 26% in Vermont (55.0% to 69.2%), and 24% in both New Hampshire (57.9% to 71.7%) and California (47.3% to 58.5%). 

Differences. Cancer screenings varied significantly by educational attainment, geography, age, race/ethnicity, income, disability status, veteran status, metropolitan status, gender and sexual orientation. The prevalence was:

Note: No data were available for Tennessee in 2024 or for Kentucky and Pennsylvania in 2023. The values for adults ages 18-44 (56.6%) and 45-64 (58.7%) may not differ significantly based on overlapping 95% confidence intervals. The same is true for white (67.7%) and Black (67.4%) adults; as well as Hispanic (52.8%), Asian (53.9%), American Indian/Alaska Native (54.1%), Hawaiian/Pacific Islander (55.1%) and other race (58.3%) adults; adults with incomes of $150,000 or more (70.8%), those with incomes of $100,000 to $149,999 (70.1%) and those with incomes of $75,000 to $99,999 (68.6%); and adults who have difficulty seeing (69.5%), those who have difficulty with cognition (55.9%), those with independent living difficulty (56.4%) and those who have difficulty with self-care (59.6%). Disability groups are not mutually exclusive.

A flu vaccine is the best protection

against seasonal influenza viruses.⁶⁴ Getting vaccinated can reduce

the severity of symptoms, defend against catching the virus and protect those with chronic illnesses.⁶⁴ Hospitalizations for chronic conditions exacerbated by the flu, like diabetes and chronic lung disease, can also be reduced

by vaccination.⁶⁴

Changes over time. Nationally, the percentage of adults who reported receiving a seasonal flu vaccine in the past 12 months decreased 4% from 42.9% to 41.3% between 2023 and 2024. The current rate does not meet the Healthy People 2030 target to increase the proportion of people who get the flu vaccine every year to 70% of the population

.⁶⁵

Between 2023 and 2024, flu vaccinations significantly decreased:

During the same time, the percentage of adults who received flu vaccinations decreased in eight states. The largest decreases were: 12% in Illinois (45.2% to 39.9%), 11% in Florida (37.6% to 33.5%), 8% in Ohio (42.9% to 39.6%) and 7% in Connecticut (50.8% to 47.3%). 

Differences. Flu vaccinations significantly varied by age, educational attainment, geography, race/ethnicity, income, disability status, veteran status, gender and metropolitan status. The prevalence was: