National Snapshot

Executive BriefForewordIntroductionNational SnapshotFindingsHealth OutcomesSocial and Economic FactorsPhysical EnvironmentClinical CareSpotlight: Rural CommunitiesBehaviorsState RankingsInternational ComparisonAppendixMeasures TableData Source DescriptionsMethodologyReferencesState Summaries

US Summary

2025 Annual Report 2025 Annual Report – Executive Brief 2025 Annual Report – State Summaries 2025 Annual Report – Economic Hardship Index County-Level Maps 2025 Annual Report – Measures Table 2025 Annual Report – Infographics 2025 Annual Report – Report Data (All States)

Health Outcomes

Drug deaths^a decreased 3% from 32.4 to 31.4 deaths per 100,000 population between 2022 and 2023.
Premature death^a decreased 8% from 8,522 to 7,862 years lost before age 75 per 100,000 population between 2022 and 2023.
Multiple chronic conditions^b increased 6% from 10.7% to 11.3% of adults between 2023 and 2024.

Social and Economic Factors

Firearm deaths^a decreased 3% from 14.5 to 14.0 deaths per 100,000 population between 2022 and 2023.
Homicide^a decreased 13% from 7.7 to 6.7 deaths per 100,000 population between 2020-2021 and 2022-2023.
Unemployment^c increased 7% from 4.3% to 4.6% of the civilian workforce between 2023 and 2024.
Volunteerism^d increased 22% from 23.2% to 28.3% of the population age 16 and older between 2021 and 2023.

Physical Environment

Air pollution^e increased 13% from 7.8 to 8.8 micrograms of fine particles per cubic meter between 2019-2021 and 2022-2024.
Drinking water violations^f decreased 11% from 2.8 to 2.5 average violations per community water system between 2023 and 2024.
Renewable energy^g increased 6% from 20.6% to 21.9% of total electricity generated between 2023 and 2024.
Homelessness^h increased 16% from 19.4 to 22.6 people per 10,000 population between 2023 and 2024.

Clinical Care

Avoided care due to cost^b increased 8% from 10.6% to 11.5% of adults between 2023 and 2024.
Mental health providersⁱ increased 5% from 344.9 to 362.6 providers per 100,000 population between September 2024 and September 2025.
Uninsured^c increased 4% from 7.9% to 8.2% of the population between 2023 and 2024.
Cancer screenings^b increased 15% from 56.0% to 64.5% of adults between 2022 and 2024.
Breast cancer screening^b increased 3% from 72.1% to 74.5% of women ages 40-74 between 2022 and 2024.
Colorectal cancer screening^b increased 15% from 61.8% to 71.1% of adults ages 45-75 between 2022 and 2024.
Flu vaccination^b decreased 4% from 42.9% to 41.3% of adults between 2023 and 2024.

Behaviors

Physical inactivity^b decreased 10% from 24.2% to 21.8% of adults between 2023 and 2024.
E-cigarette use^b increased 4% from 7.7% to 8.0% of adults between 2023 and 2024.
Smoking^b decreased 4% from 12.1% to 11.6% of adults between 2023 and 2024.

a Source: U.S. HHS, Multiple Cause of Death Files via CDC WONDER.

b Source: U.S. HHS, CDC, Behavioral Risk Factor Surveillance System. 

c Source: U.S. Census Bureau, American Community Survey, 1-Year Dataset.

d Source: U.S. Census Bureau, Current Population Survey, Volunteering and Civic Life Supplement.

e Source: U.S. EPA.

f Source: U.S. EPA, Safe Drinking Water Information System via ECHO.

g Source: U.S. EIA, State Energy Data System.

h Source: U.S. HUD, Annual Homelessness Assessment Reports to Congress.

i Source: U.S. HHS, CMS, National Plan and Provider Enumeration System.

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