Foreword

I want to thank you for taking the time to explore this edition of the America’s Health Rankings Health of Women and Children Report. A decade after the report’s first publication, this milestone offers an opportunity to reflect on where sustained efforts are making a difference in the health of these populations that form the cornerstone of our communities — and where challenges remain.

Over the course of my career as a maternal fetal medicine specialist, I have seen how sustained attention can gradually improve the health of women and infants. I am encouraged that more women are receiving preventive care and breastfeeding, while fewer women use tobacco products during pregnancy and fewer babies are born with neonatal abstinence syndrome. The progress documented in this report reflects decades of work by health care providers, public health leaders, community organizations and individuals. Yet, these achievements over the past decade stand in contrast to the fact that maternal morbidity and mortality increased dramatically over the same time period.

This raises an important question: Why hasn’t the progress we’ve made translated into better maternal health outcomes? In reflecting on the data, a few perspectives come to mind.

First, changes in behaviors and socioeconomic conditions that shape women’s health may take years to translate into better outcomes. Improvements in education and poverty rates, for example, can strengthen women’s health over time, but their effects may not immediately appear in measures such as mortality, chronic disease or mental health. The findings reinforce the need to sustain the efforts driving progress, even when their full impact is not yet visible.

Second, women’s health cannot be viewed as a series of isolated moments. Pregnancy, childbirth, menopause and individual diagnoses are important points in a woman's life, but they are part of a much larger story. A woman’s health is shaped throughout their everyday life, with effects that can extend to children, families and communities. Rising rates of obesity, diabetes, depression and frequent mental distress help illustrate why improving maternal outcomes requires attention to women’s health long before pregnancy begins and well after it ends.

Creating healthier communities takes more than any single investment or action — it requires sustained coordination among health care leaders, local community partners and families. The United Health Foundation is helping scale community-led programs that respond to local needs and improve care for women and families across the country. In New Mexico, our partnership with La Clinica de Familia

has served 1,240 patients through expanded prenatal and well-woman care, with 95% of babies born through the program at or above a healthy birth weight. In Wisconsin, we are working with Meta House

to provide specialized care for pregnant, postpartum and parenting women experiencing substance use disorder. Every baby born to a participant who entered residential treatment at least one month before delivery was born substance-free.

Expanding access and supporting women and families will also require us to further build the capacity of the health care workforce and strengthen community-based care. We are optimistic that the Foundation’s 10-year, $100 million commitment

to support current and future health care professionals can help do that, alongside our doula partnerships, which have supported more than 200 new doulas in enrolling in programs, and more than 470 in continuing education or professional development.

The challenges identified in this report are significant, but the progress of the past decade shows that change is possible.