Report: The health of women and children

The report, which analyzed 125 health and well-being measures across all 50 states, reveals several bright spots, particularly in the health of children. Childhood obesity rates improved by 7% between 2021-2022 and 2023-2024, suggesting that public health initiatives and increased awareness are making a difference. Early childhood education enrollment rose 4% from 2022 to 2023, and children's physical environments showed measurable improvements, with household smoke exposure decreasing 19% and neighborhood amenities improving by 6%.

Some health behaviors among women also showed positive momentum: Smoking during pregnancy decreased by 19% between 2022 and 2023, and well-woman visits improved by 3% from 2020-2021 to 2022-2023.

Despite the uptick in well-woman visits, women were increasingly likely to avoid needed medical care due to cost, fewer had a dedicated health care provider or received the flu vaccine, and some areas of their physical and mental health were suffering. For example, women experienced a 37% increase in frequent physical distress, with their overall health status worsening by 13% between 2020-2021 and 2022–2023.

Mentally, depression rates increased 11% among women aged 18-44 between 2020–2021 and 2022–2023, and a similar trend was seen among children just one year later, with a 9% increase in mental health conditions among those aged 3-17 between 2021-2022 and 2023-2024.

The most concerning statistics to come out of this report though were related to mortality rates. Child mortality increased 14% between 2018-2020 and 2021-2023, while infant mortality rose 4% between 2020-2021 and 2022-2023 — marking the first increase in infant mortality since the report's inception.

Among women, maternal mortality surged 36% between 2014-2019 and 2019-2023, despite overall mortality among women decreasing 8% between 2022 and 2023, which could be attributed to drug deaths among women plateauing for the first time since 2014.

The report also sheds light on significant geographic health disparities. Women living in rural areas experience higher rates of several chronic conditions compared to their metropolitan counterparts, though they show healthier rates of excessive drinking. This rural-urban gap reflects broader challenges in health care access, with rural communities often facing provider shortages, limited specialty care and greater distances to medical facilities.

State-level rankings reinforce these geographic disparities. Massachusetts topped the list as the healthiest state for women and children, followed by Vermont, Minnesota, New Hampshire and Utah. Louisiana ranked as the least healthy, with Arkansas, Mississippi, Oklahoma and West Virginia rounding out the bottom five.

Based on the insights brought forward in this report and the fact that women and children make up 40% of the U.S. population, employers, brokers and consultants may want to consider reviewing and tailoring their benefits strategies accordingly:

Prioritize comprehensive maternity coverage: The 36% increase in maternal mortality demands employer attention. Benefits packages should include robust prenatal and postpartum care, mental health support for new mothers, lactation consulting and more. Consider offering extended parental leave and gradual return-to-work programs to support maternal health and recovery.

Invest in preventive care: The decrease in women with a dedicated health care provider — down 2% between 2021 and 2022–2023 — is concerning. Employers should consider incentivizing well-woman visits, annual physicals and preventive screenings through low or no-cost copays. Building relationships with primary care providers can help identify and manage chronic conditions before they become severe.

Offer behavioral health support: With rising mental health challenges among both women and children, ensure benefits include a wide spectrum of behavioral health support and resources.

Address geographic disparities: For employers with employees in rural areas, consider virtual benefits that may bridge access gaps. Virtual care can provide specialized consultations, behavioral health support and chronic disease management without requiring lengthy travel.

Support working parents: The improvements in childhood obesity and early childhood education enrollment suggest that families are prioritizing their children's health when given the resources to do so. Employers can reinforce these positive trends by offering wellness programs that continue to encourage healthy behaviors in addition to flexible work arrangements, subsidized childcare or backup care services designed to help reduce parental stress and alleviate cost barriers associated with children getting the education they need.

Focus on chronic disease management: With rural women experiencing higher rates of chronic conditions, disease management programs that support the whole person and include medication coverage, specialist access and wellness programs targeting conditions like diabetes and cardiovascular issues can be essential.

Combat health disparities: The persistent racial gaps in maternal and child health outcomes call for culturally competent care. Work with a carrier that demonstrates a commitment to health equity, offers diverse provider networks and provides resources in multiple languages.