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The 35th America’s Health Rankings® Annual Report, released in partnership with the American Public Health Association (APHA), provides a comprehensive look at health across the nation with a focus on long-term trends and short-term changes.
The Annual Report, first published in 1990, is the longest-running state-by-state analysis of the nation’s health. As a leader in public health data analysis, America’s Health Rankings’ model for measuring health has advanced over 35 years to reflect the evolving understanding of factors that contribute to population health and well-being.
This 35th edition examines long-term trends and short-term changes across 88 measures of health that span five categories of health and includes an analysis of international health data from the Organization for Economic Co-operation and Development (OECD). It features data from diverse populations, identifying areas where population-wide successes have been the result of progress made across all groups, as well as instances where disparities between groups indicate a need for focused attention.
The analysis revealed notable decade-long improvements in clinical care access measures and socioeconomic factors as well as persistent challenges over the past several decades in such health outcomes as diabetes, obesity, drug deaths and depression.
The 2024 Annual Report finds that:
- While the premature death rate improved between 2021 and 2022, the rate is 1% higher than it was in 1991, erasing years of progress made between 1990 and 2012.
- Depression, frequent mental distress and non-medical drug use among adults increased, as well as drug deaths and suicide, presenting continued long-term behavioral health challenges.
- High health status among adults declined over the past decade, while asthma, diabetes and obesity all increased. However, the prevalence of adults with multiple chronic conditions has recently decreased.
- Homicide deaths and occupational fatalities are lower than 35 years ago. However, in recent years, the homicide rate has risen alongside an increase in firearm deaths.
- Public health funding increased during the pandemic but is returning to pre-pandemic levels.
- Food insecurity, poverty and unemployment have decreased over the past decade. However, the pandemic negatively impacted these socioeconomic factors. In recent years, food insecurity has increased, while poverty and unemployment have returned to pre-pandemic levels.
- High school graduation has increased over the past decade. However, geographic and racial/ethnic disparities persist.
- High-speed internet access has increased overall and across all racial/ethnic groups, with the disparity between the highest and lowest groups narrowing.
- Air pollution has recently increased after reaching an all-time 20-year low in 2019-2021.
- Heat and worker health is a new measure in the Annual Report that tracks heat-related illnesses among U.S. workers.
- Over the past decade, severe housing problems have decreased, yet geographic and racial/ethnic disparities persist.
- Uninsured rates are lower than a decade ago, but significant disparities persist.
- Flu vaccination rates have decreased recently but are higher than in 2011.
- The reduction in the teen birth rate is a national success. However, significant disparities by race/ethnicity and geography persist.
This contrast, between worsening outcomes and improvements in certain drivers of health, underscores the complex nature of the health challenges the nation faces and compels stakeholders to think innovatively about how to improve health outcomes for different communities. Looking to the future, America’s Health Rankings encourages health leaders to use these findings to cultivate collaborative solutions that address the persistent challenges and gaps in our nation’s health and well-being, while building on successes.
Objective
America’s Health Rankings aims to inform and drive action to build healthier communities by offering credible, trusted data that can guide efforts to improve population health and health care. To achieve this, America’s Health Rankings collaborates with an advisory committee to determine the selection of a comprehensive set of measures. The 2024 Annual Report is based on:
- Measures: 88. These include 49 measures used to calculate the state rankings and 39 additional (unweighted) measures not used in calculating the state rankings. One of these 39 additional measures, heat and worker health, is new this year. For a full list of measures, definitions and source details, see the Measures Table.
- Categories of health: five. The report analyzes health and well-being comprehensively through measures of Health Outcomes and four categories of health drivers: Social and Economic Factors, Physical Environment, Behaviors, and Clinical Care.
- Data sources: 26. Data are from many sources, including the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, the Council on Environmental Quality’s Climate and Economic Justice Screening Tool Index and the U.S. Census Bureau’s American Community Survey.
- International comparison. This report features a comparison of the U. S. compared with other OECD countries across measures of infant mortality, life expectancy and total health spending.
The America’s Health Rankings Annual Report aims to improve population health by:
- Presenting a holistic view of health. This report goes beyond measures of clinical care and health behaviors by considering social, economic and physical environment measures, reflecting the impact of social drivers of health.
- Providing a benchmark for states. Each year, the report presents strengths, challenges and key findings for every state and the District of Columbia. Public health advocates can monitor health trends over time and compare their state with other states and the nation. State Summaries, containing data on all 49 ranking measures, are available on the website as a separate download.
- Highlighting disparities. The report shows differences in health between states and among demographic groups at state and national levels, with groupings based on race/ethnicity, gender, age, disability status, educational attainment, income level, metropolitan status, sexual orientation and veteran status. These analyses often reveal differences among groups that national or state aggregate data may mask.
- Stimulating action. The report aims to drive change and improve health by promoting data-driven discussions among individuals, community leaders, public health workers, policymakers and the media. States can incorporate the report into their annual review of programs, and many organizations use it as a reference when assigning goals for health improvement plans.
Model For Measuring America’s Health
America’s Health Rankings is built upon the World Health Organization’s definition of health: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The model was developed under the guidance of an advisory council and committees, with insights from other rankings and health models, namely County Health Rankings & Roadmaps and Healthy People 2030. The model serves as a framework across all of America’s Health Rankings reports for identifying and quantifying health drivers and outcomes that impact state and national population health.
Supporting Healthy People 2030: Measuring Health Disparities and Health Equity
Healthy People 2030 is a program led by the Office of Disease Prevention and Health Promotion within the U.S. Department of Health and Human Services (HHS) that sets data-driven national objectives for the nation’s health and well-being over the next decade, with a key focus on addressing the social determinants of health and working toward health equity. For nearly five decades, Healthy People’s national-level objectives have served as valuable benchmarks for advancing health and well-being at the state level. It also provides data to track the nation’s progress toward achieving those goals, as well as tools that help guide individuals, organizations and communities to do so.
As a long-standing champion of public health and the HHS Healthy People 2030 goals, the United Health Foundation is honored to be recognized as a Healthy People 2030 Champion.
Healthy People 2030 Champion badge is a service mark of the U.S. Department of Health and Human Services. Used with permission. Participation by United Health Foundation does not imply endorsement by HHS/ODPHP.