Even before COVID-19 flipped the world on its head, health measures for women and children were stagnating or declining in relation to physical and mental well-being. Women of reproductive age and children make up roughly 40% of the US population, and as a result, the well-being and economic strength of communities across the country depend on the health of these populations.
That’s why the findings of the 2021 Health of Women and Children Report , published by America’s Health Rankings, are worrying. The report, which examined 118 measures of health using 35 data sources, found progress in some areas but a number of “concerning negative trends” in many others.
For example, the report identified stagnation or regression in measures that include maternal mortality and mental health conditions like anxiety. Other measures, like the teenage birth rate and rates of smoking, have improved on a national scale, but a closer inspection reveals that both of these measures are plagued by wide racial and geographic disparities.
Here are four measures of physical health and well-being in women and children that warrant attention, according to the report.
Teen birth rate
First, the good news: Between 2013 and 2019, the teen birth rate dropped by 37% nationally, from 26.4 to 16.7 per 1,000 females aged 15 to 19 years. This means there are now 172,000 fewer teen births occurring. Every state (and the District of Columbia) experienced a teen birth rate decrease of at least 25% between 2013 and 2019.
Here’s the bad news: This improvement was not experienced among communities equally. The report notes, for example, that the teen birth rate remains 4.5 times higher in Arkansas (where the rate already sits above the national average at 30 births per 1,000 females aged 15 to 19 years) than in New Hampshire, a state that is bringing the average down with its rate of 6.6 births per 1,000 females aged 15 to 19 years.
Racial disparities also remain prevalent. The teen birth rate is 7.6 times higher in American Indian/Alaska Native communities (28.2 births) than in Asian/Pacific Islander populations (3.7 births).
Similarly, the report found racial and geographic disparities in the rates of low-birthweight infants and low-risk cesarean sections. In 2019, the rate of low birth weight was roughly 8.3%, which has remained stagnant since 2017. This stagnation reflects the lack of progress in addressing racial disparities, the authors noted. This is clear when you consider that the rate of low birthweight among Black mothers (14.7%) is 2.1 times higher than it is for White mothers (7.1%).
Morbidity and mortality
From 2018 to 2019, maternal mortality increased by 16% nationally, from 17.4 to 20.1 deaths per 100,000 live births. Not only do maternal mortality rates remain high nationwide, but they have also shot up drastically in certain states. For example, there was a 70% increase in Florida (from 15.8 to 26.8 per 100,000 live births); a 23% increase in Georgia (from 27.7 to 34.0); and a 16% increase in Indiana (from 24.5 to 28.4). Authors note that the United States still has the highest maternal mortality rate of any developed country, and it is the only industrialized nation with a rising rate.
As with many of these measures, there are large racial and geographic disparities in the maternal mortality rate. Once again, the report found that Black mothers face the greatest challenge when it comes to this measure, with a maternal mortality rate that is 3.3 times higher than for Hispanic mothers and 2.4 times higher than for White mothers.
Mental and behavioral health
Even before the pandemic began, behavioral health challenges were increasing for both women and children. According to the report, the rates of drug deaths among women are increasing, as are rates of experiencing “frequent mental distress.” Likewise, children are facing increased rates of teen suicide and anxiety.
From 2014 to 2019, drug deaths among women increased by 24% across the nation. By 2019, the rate was sitting at 20.7 deaths per 100,000 females aged 20 to 44 years, which represents about 33,000 deaths due to drugs.
Drug deaths among women increased in 23 states, and they rose the most in the District of Columbia, which saw a 170% increase (from 4.3 to 11.6 per 100,000 females aged 20 to 44). While Black women saw the largest increase in drug deaths (a 55% spike, from 9.8 to 15.2), the drug death rate among White women remains the highest of any female demographic at 28.9 deaths per 100,000 women aged 20 to 44 years.
Since 2014, the teen suicide rate has increased nationwide by 26%, reaching 11.2 deaths per 100,000 adolescents ages 15 to 19 years from 2017 to 2019. While Black adolescents experienced the greatest increase (38%), all demographics saw an increase in teen suicide rates. Again, large disparities remain—the rate is 4.7 times higher among American Indian/Alaska Native adolescents (36.1 per 100,000) than it is among Black adolescents (7.7).
The prevalence of tobacco smoking has decreased across the United States by roughly 18% among women aged 18 to 44 years since 2013, and by 29% among pregnant women since 2014. However, approximately 7.7 million American women still smoke, and disparities are prevalent. For example, according to the report, the rate of cigarette smoking among women is 4.5 times higher in West Virginia (29.7%) than it is in Utah (6.6%).
Finances and education play a role—women who earn less than $25,000 per year are 3.3 times more likely to smoke than women who earn more than $75,000. Those who graduated from college are 4.1 times less likely to smoke than those who only have a high school education.