In a pair of reports released this week, the Center on Society and Health and the Urban Institute provide detailed information on how states differ on measures of birth, child, and adolescent health outcomes, and how those outcomes are connected to dozens of potential drivers of health. For example, rates of infant mortality (per 1,000 live births) vary by almost 2.5 times between states – New Hampshire’s rate of 4.8 (comparable to Canada) stands in stark contrast Washington D.C.’s rate of 11.6 (comparable to Libya). Likewise, rates of teen birth vary by 3.5 times – from 13.8 per 1,000 in New Hampshire to 47.5 per 1,000 in New Mexico.
The reports, titled The Health of the States: Supplement 3: Spotlight on Birth Outcomes and The Health of the States: Supplement 4: Spotlight on Child and Adolescent Health, are part of a series of reports from the Health of the States project. A Summary Report and the first supplement, Spotlight on Methods, were released in October 2016, followed by The Health of the States: Supplement 2: Spotlight on Life Expectancy and Mortality, released in January of this year. The supplements released today take a more detailed look at how states perform on several measures of birth and childhood health outcomes, including: infant mortality, low birth weight, child overweight/obesity, child/adolescent asthma, and teen birth rates. For each of these measures and more, researchers provide data on outcomes for all 50 states and Washington, D.C., depict findings in maps and figures, and discuss regional trends.
In addition, researchers explore the connections between outcomes and 123 determinants of health – highlighting the strongest of those connections and providing context for why states may perform well or not. For example, infant mortality and low birth weight correlate strongly with health behavior measures such as smoking, breastfeeding, and physical activity, but also with social and environmental measures such as neighborhood resources for children and children living in poverty. Low birth weight especially correlates highly with how parents rate the safety of their children’s schools. Likewise, the 10 states with the highest incidence of low birth weight have twice as many residents living in concentrated poverty as the 10 states with the lowest prevalence of low birth weight.
Funded by the Robert Wood Johnson Foundation (RWJF), the HOTS project is distinct from other health scorecards and rankings in the number of health outcomes and determinants included. By assessing and assembling 39 health outcomes and 123 determinants of health, the project provides a nuanced and textured profile of the links between health and potential drivers, such as safety of schools and neighborhoods, exposure to adverse childhood experiences (ACES), expanded Medicaid coverage, and investments in transit and social programs. This data is exposing new patterns in health outcomes and drivers that could be used to develop new policies and practices to improve population health and wellbeing.
In the coming months, the Center will release the remaining supplements, offering more detail on the relationships discovered between selections of health outcomes and the 123 determinants examined. The remaining Health of the States supplemental reports are as follows:
• Spotlight on sexually transmitted infections
• Spotlight on injury fatalities
• Spotlight on adult health status
• Spotlight on overweight/obesity, diabetes, and cardiovascular conditions
• Spotlight on cancer, lower respiratory disease, influenza and pneumonia, and Alzheimer’s disease
Visit the Center’s website to learn more about HOTS, download the reports, and explore the data.