Social and Economic Factors

Concentrated disadvantage measures the percentage of households with children that are located in census tracts for which the averaged z-score of the following factors is above the 75th percentile: family households below the poverty line, female-headed households, individuals receiving public assistance, unemployed population age 16 and older and population younger than 18. It serves as an indicator

of community well-being and projected socioeconomic needs.³⁶ Studies have found that living in areas of higher community socioeconomic disadvantage is associated with lack of access

to healthy foods and recreational areas; environmental hazards

, including lead exposure, poor air quality and substandard housing; and chronic conditions

such as obesity, asthma, depression, anxiety and sexually transmitted infections.^36–38

Changes over time. Concentrated disadvantage increased 10% or more in 12 states and simultaneously decreased 10% or more in seven states between 2015-2019 and 2019-2023. The largest increases were: 54% in North Dakota (4.8% to 7.4%), 43% in Wyoming (5.1% to 7.3%) and 39% in Hawaii (14.7% to 20.4%). The largest decreases were: 40% in Idaho (12.8% to 7.7%), 39% in Utah (10.8% to 6.6%) and 29% in South Dakota (15.0% to 10.6%).

During the same time, several components of concentrated disadvantage decreased. The prevalence of family households below the poverty threshold decreased 8% (9.5% to 8.7%), and the prevalence of female-headed households (12.4% to 12.2%), individuals receiving public assistance (25.2% to 24.7%) and unemployed individuals (5.3% to 5.2%) all decreased 2%.

Differences. During 2019-2023, concentrated disadvantage was 15.0 times higher in New Mexico (46.6%) than in Vermont (3.1%).

Related Measure: Poverty Among Women
Nationally, the percentage of women ages 18-44 living below the poverty level decreased 2%, from 15.2% to 14.9% between 2022 and 2023. In 2023, more than 8.6 million women were living below the poverty level, a decrease of more than 100,000 women compared with 2022. Between 2022 and 2023, poverty among women significantly decreased 13% in Missouri (16.1% to 14.0%). 

Differences. In 2023, the prevalence of poverty among women significantly varied by geography and race/ethnicity. The prevalence was:

Children who live in food-insecure households are at increased risk of adverse health outcomes

such as asthma, depression and forgoing necessary medical care.³⁹ The federal Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

has supported families across the United States for more than 50 years, providing health care referrals, breastfeeding support, nutrition education and additional food to low-income women and children at risk of hunger.⁴⁰

Changes over time. Nationally, the percentage of children ages 0-4 eligible for WIC who received benefits in an average month increased 5%, from 49.9% to 52.2% between 2021 and 2022. During this time, WIC coverage increased 5% or more in 27 states. The largest increases were: 19% in both Delaware (46.8% to 55.6%) and Arkansas (32.1% to 38.3%), 13% in West Virginia (52.1% to 58.8%), and 12% in both New York (52.0% to 58.1%) and New Mexico (33.1% to 37.0%). The prevalence of WIC coverage also decreased 19% in the District of Columbia (56.9% to 46.0%) and 5% in New Hampshire (53.0% to 50.3%).

Differences. The prevalence of WIC coverage was 2.2 times higher in Vermont (72.9%) than in Louisiana (33.5%) in 2022.

Voting is associated with better individual and mental health

, reduced community violence and lower unemployment rates.⁴¹ Women gained the right to vote

a century ago, and since 1980 they have consistently voted at significantly higher

rates than men.^42,43 There is evidence

that women have different policy priorities than men, focusing on issues such as funding for public health.⁴⁴

Changes over time. Nationally, the percentage of female U.S. citizens age 18 and older who voted in the last presidential election decreased 2%, from 68.4% to 66.9% between 2020 and 2024.

During this time, voter participation among women significantly decreased 17% in Arizona (76.5% to 63.3%) and 10% in Texas (66.3% to 59.9%).

Differences. Voter participation among women was 1.4 times higher in Minnesota (79.0%) than in Arkansas (54.6%) in 2024. 

The health of individuals and communities is closely tied

to the environment in which they live.⁴⁵ Neighborhood amenities

, such as recreational facilities, libraries, playgrounds and sidewalks, offer opportunities to socialize, play, exercise and enjoy one’s home.⁴⁶ 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.⁴⁷

Changes over time. Nationally, the percentage of children ages 0-17 with access to neighborhood amenities (including all of the following: a park or playground; a recreation center, community center or boys' and girls' club; a library or bookmobile; and sidewalks or walking paths) increased 6%, from 36.1% to 38.2% between 2021-2022 and 2023-2024. In 2023-2024, 26.5 million children had access to all neighborhood amenities, an increase of 1.4 million children compared with 2021-2022. 

Between 2021-2022 and 2023-2024, the prevalence of neighborhood amenities significantly increased:

During this time frame, neighborhood amenities increased 24% in North Dakota (33.6% to 41.6%) and 22% in Indiana (26.0% to 31.8%).

Differences. The prevalence of neighborhood amenities among children varied significantly by geography, race/ethnicity, caregiver educational attainment and special health care needs status in 2023-2024. The prevalence was:

Reading aloud to children was described as the most important factor in developing literacy by the Commission on Reading’s 1985 landmark report Becoming a Nation of Readers

.⁴⁸ Research has shown

that regularly reading aloud to children stimulates patterns of brain development that strengthen language, literacy and social-emotional skills at a critical age.⁴⁹ Other language-rich experiences that benefit brain development and future school success include talking and singing

to young children.⁵⁰

Changes over time. Nationally, the percentage of children ages 0-5 whose family members read, sang or told stories to them every day during the past week increased 5%, from 57.1% to 59.7% between 2021-2022 and 2023-2024. In 2023-2024, nearly 12.9 million children had someone read, sing or tell stories to them every day, an increase of 157,800 children compared with 2021-2022.

Between 2021-2022 and 2023-2024, the prevalence of reading, singing or storytelling significantly increased 6% among girls (58.4% to 62.0%). During this time frame, reading, singing or storytelling increased 20% in Virginia (57.4% to 68.8%).

Differences. The prevalence of reading, singing or storytelling varied significantly by race/ethnicity, caregiver educational attainment, geography and gender in 2023-2024. The prevalence was:

Evidence

suggests that early childhood education, combined with higher educational attainment, contributes to improved health and promotes health equity.⁵¹ Typically, children who attend early childhood education programs have reduced rates of teen births and teen crime, improved standardized test scores and increased high school graduation rates. 

Changes over time. Nationally, the percentage of children ages 3-4 who were enrolled in nursery school, preschool or kindergarten increased 4% from 46.7% to 48.5% between 2022 and 2023, returning to pre-pandemic levels. This means over 95,100 additional children ages 3 and 4 were enrolled in nursery school, preschool or kindergarten.

The rate of early childhood education enrollment increased in three states between 2022 and 2023: 19% in Arizona (33.7% to 40.0%), 10% in Texas (43.5% to 47.7%) and 7% in California (45.4% to 48.4%). 

Differences. In 2023, early childhood education enrollment among children ages 3-4 was 3.4 times higher in the District of Columbia (90.1%) and 2.4 times higher in Connecticut and New Jersey (both 65.6%) than in North Dakota (26.8%). 

Chronic absenteeism

is defined as missing 10% or more of the school year, whether the absence is excused or unexcused.⁵² Research has found that chronic absenteeism is strongly associated

with falling behind academically, becoming socially disengaged and dropping out of school.⁵³

Nationally, the percentage of public school students who missed 10% or more of their school days in an academic year was 27.8% in 2022-2023, representing approximately 13.4 million students.

Differences. Chronic school absenteeism was 2.8 times higher in the District of Columbia (46.7%) and 2.6 times higher in Oregon (43.8%) than in New Jersey (16.7%) in 2022-2023.

Fourth grade reading proficiency is an important indicator

of adequate educational development.⁵⁴ By the time a child reaches fourth grade, they are expected to be able to read to learn

other academic subjects.⁵⁵ If a child is not proficient in reading by this age, it becomes harder for them to succeed academically. 

Changes over time. Nationally, the percentage of fourth grade public school students who scored proficient or above on the National Assessment of Educational Progress in reading

comprehension decreased 5%, from 32.1% to 30.5% between 2022 and 2024.⁵⁶

Between 2022 and 2024, fourth grade reading proficiency decreased:

During this time frame, fourth grade reading proficiency decreased by the national change (5%) or more in 27 states. The largest decreases were: 18% in Nebraska (34.0% to 28.0%), 16% in Arizona (31.4% to 26.4%) and 15% in Florida (39.0% to 33.0%).

Over the same period, fourth grade reading proficiency increased 5% or more in 10 states and the District of Columbia, led by: 12% in the District of Columbia (26.5% to 29.6%), Nevada (26.9% to 30.0%) and Louisiana (28.3% to 31.8%); and 10% in both West Virginia (22.3% to 24.6%) and Maryland (30.6% to 33.6%).

Differences. In 2024, fourth grade reading proficiency varied by race/ethnicity, geography and gender. The prevalence was: