Best and worst states for women's health

Women's health score: 54.5

Women reporting fair or poor health status: 24% (Rank: #47)

Women reporting poor mental health status: 42% (Rank: #41)

Women uninsured: 12% (Rank: #42)

Breast cancer incidence: 123.3 per 100,000 women (Rank: #40)

Ovarian cancer incidence: 11.2 per 100,000 women (Rank: #45)

Deaths due to heart disease: 181.9 per 100,000 women (Rank: #47)

Women receiving inadequate prenatal care: 17.8% (Rank: #43)

Women ages 65+ up to date on key preventative services: 42.2% (Rank: #48)

Alabama’s health system as a whole is struggling, in part due to its failure to expand Medicaid under the Affordable Care Act and its rural location. Studies have shown that expanding Medicaid would benefit women in particular by reducing the rate of uninsured women and giving them access to reproductive care that previous insurance plans were not required to provide. Recently, the state’s attempt to ban the most common method of second-trimester abortion was overturned by a U.S. appeals court, a case reproductive rights advocates saw as a victory for women’s health.

Women's health score: 55

Women reporting fair or poor health status: 26% (Rank: #50)

Women reporting poor mental health status: 42% (Rank: #43)

Women uninsured: 10% (Rank: #38)

Breast cancer incidence: 117.1 per 100,000 women (Rank: #25)

Ovarian cancer incidence: 12.0 per 100,000 women (Rank: #50)

Deaths due to heart disease: 175.1 per 100,000 women (Rank: #46)

Women receiving inadequate prenatal care: 23.0% (Rank: #51)

Women ages 65+ up to date on key preventative services: 48.0% (Rank: #33)

Arkansas has recently implemented laws that encourage breastfeeding and provide local health units offering prenatal services to women regardless of their ability to pay. These units were set up to combat the number of women who currently receive poor prenatal care. However, the state’s high rates of obesity increase the rates of women's death related to heart disease. Also, cancer patients in Arkansas are more likely to die than those in other states because of the state’s high poverty and poor access to transportation in its many rural areas.

Women's health score: 55.1

Women reporting fair or poor health status: 27% (Rank: #51)

Women reporting poor mental health status: 41% (Rank: #36)

Women uninsured: 10% (Rank: #36)

Breast cancer incidence: 119.6 per 100,000 women (Rank: #31)

Ovarian cancer incidence: 12.4 per 100,000 women (Rank: #51)

Deaths due to heart disease: 155.7 per 100,000 women (Rank: #42)

Women receiving inadequate prenatal care: 14.0% (Rank: #20)

Women ages 65+ up to date on key preventative services: 39.0% (Rank: #50)

West Virginia made the news earlier this year when one of its two abortion clinics closed. The opioid crisis has also hit the state hard, and the rate of overdose deaths in women is almost double that of men. Recovery from addiction is made more difficult by a lack of access to mental health services. This is particularly worrying in a state that has suffered the collapse of the coal industry and other local economies.

Women's health score: 55.2

Women reporting fair or poor health status: 24% (Rank: #46)

Women reporting poor mental health status: 43% (Rank: #48)

Women uninsured: 12% (Rank: #43)

Breast cancer incidence: 126.7 per 100,000 women (Rank: #43)

Ovarian cancer incidence: 10.2 per 100,000 women (Rank: #28)

Deaths due to heart disease: 169.3 per 100,000 women (Rank: #45)

Women receiving inadequate prenatal care: 16.4% (Rank: #36)

Women ages 65+ up to date on key preventative services: 45.0% (Rank: #43)

After being ranked last in women’s health in 2015 by America’s Health Rating, and being given an F rating in 2016 by the Institute for Women’s Health Policy Research, Louisiana expanded Medicaid in hopes of enabling more women to access preventative care that they otherwise might have to forgo due to cost. Tulane University also hosted its 3rd Biennial Black Women’s Health Conference, which aims reduce health disparities between white and black women.

Women's health score: 56.2

Women reporting fair or poor health status: 26% (Rank: #49)

Women reporting poor mental health status: 40% (Rank: #28)

Women uninsured: 15% (Rank: #48)

Breast cancer incidence: 117.3 per 100,000 women (Rank: #26)

Ovarian cancer incidence: 9.0 per 100,000 women (Rank: #13)

Deaths due to heart disease: 187.1 per 100,000 women (Rank: #48)

Women receiving inadequate prenatal care: 13.2% (Rank: #18)

Women ages 65+ up to date on key preventative services: 46.1% (Rank: #40)

Mississippi is the state with the most abortion restrictions. A law was recently signed banning abortions any later than 15 weeks after a woman's last menstrual cycle. The state's one remaining clinic filed a lawsuit against this and other restrictive laws. The Women's Health Foundation of Mississippi aims to reduce poverty and increases a woman's positive health outcomes by working with teenagers to prevent teen pregnancy, inform them about sexual health, and give them access to higher education.

Women's health score: 56.3

Women reporting fair or poor health status: 22% (Rank: #45)

Women reporting poor mental health status: 41% (Rank: #35)

Women uninsured: 13% (Rank: #45)

Breast cancer incidence: 122.2 per 100,000 women (Rank: #38)

Ovarian cancer incidence: 10.6 per 100,000 women (Rank: #34)

Deaths due to heart disease: 162.8 per 100,000 women (Rank: #44)

Women receiving inadequate prenatal care: 16.2% (Rank: #35)

Women ages 65+ up to date on key preventative services: 40.7% (Rank: #49)

Tennessee’s high rates of maternal mortality, excessive drinking, and obesity all contribute to the state’s consistently low rankings in women’s health. Organizations like Tennessee Women’s Care are working to improve access and care. In particular, the group has teamed up with Saint Thomas Hospital to expand its reach and integrate more services.

Women's health score: 57

Women reporting fair or poor health status: 22% (Rank: #44)

Women reporting poor mental health status: 40% (Rank: #27)

Women uninsured: 12% (Rank: #40)

Breast cancer incidence: 121.5 per 100,000 women (Rank: #37)

Ovarian cancer incidence: 10.6 per 100,000 women (Rank: #33)

Deaths due to heart disease: 188.6 per 100,000 women (Rank: #49)

Women receiving inadequate prenatal care: 17.8% (Rank: #44)

Women ages 65+ up to date on key preventative services: 47.6% (Rank: #36)

Oklahoma has made cuts to health care providers, increased co-pays for SoonerCare (the state’s name for Medicaid), and cut funding for suicide-prevention initiatives and to community health care in underserved areas. In a more progressive move, Oklahoma’s Supreme Court in 2016 blocked a law that would have allowed law enforcement to enact heavy criminal penalties on health care clinics providing abortion services to women.

Women's health score: 58

Women reporting fair or poor health status: 25% (Rank: #48)

Women reporting poor mental health status: 42% (Rank: #42)

Women uninsured: 8% (Rank: #33)

Breast cancer incidence: 126.8 per 100,000 women (Rank: #44)

Ovarian cancer incidence: 10.6 per 100,000 women (Rank: #36)

Deaths due to heart disease: 157.0 per 100,000 women (Rank: #43)

Women receiving inadequate prenatal care: 14.0% (Rank: #21)

Women ages 65+ up to date on key preventative services: 45.0% (Rank: #42)

Like many rural areas, Kentucky struggles with enabling equal access to health services for those in fringe parts of the state. To combat this, several centers that focus specifically on women’s health have opened—including a women’s center in the Topeka Department of Veterans Affairs and a specialty OB-GYN clinic.

Women's health score: 59.1

Women reporting fair or poor health status: 21% (Rank: #42)

Women reporting poor mental health status: 37% (Rank: #13)

Women uninsured: 19% (Rank: #50)

Breast cancer incidence: 112.2 per 100,000 women (Rank: #14)

Ovarian cancer incidence: 10.5 per 100,000 women (Rank: #32)

Deaths due to heart disease: 133.5 per 100,000 women (Rank: #34)

Women receiving inadequate prenatal care: 22.4% (Rank: #49)

Women ages 65+ up to date on key preventative services: 46.9% (Rank: #37)

Texas defunded Planned Parenthood in 2013, leaving many low-income women without reproductive care and other health services. The program created to fill this gap, Texas Healthy Women, has not achieved that goal: Almost half the centers in the network didn't see any patients in 2017’s fiscal year.

Women's health score: 59.2

Women reporting fair or poor health status: 19% (Rank: #35)

Women reporting poor mental health status: 42% (Rank: #40)

Women uninsured: 10% (Rank: #37)

Breast cancer incidence: 134.5 per 100,000 women (Rank: #50)

Ovarian cancer incidence: 11.5 per 100,000 women (Rank: #48)

Deaths due to heart disease: 133.5 per 100,000 women (Rank: #35)

Women receiving inadequate prenatal care: 14.8% (Rank: #25)

Women ages 65+ up to date on key preventative services: 42.7% (Rank: #47)

Illinois has implemented the Breast and Cervical Cancer Program to offer women mammograms, breast exams, pelvic exams, and Pap smears in the hopes of catching and treating health issues early on. The state also hosted the Be Aware Women's Fair, designed to raise awareness about different issues in women's health.

Women's health score: 59.7

Women reporting fair or poor health status: 20% (Rank: #40)

Women reporting poor mental health status: 39% (Rank: #22)

Women uninsured: 11% (Rank: #39)

Breast cancer incidence: 129.9 per 100,000 women (Rank: #46)

Ovarian cancer incidence: 10.7 per 100,000 women (Rank: #39)

Deaths due to heart disease: 155.0 per 100,000 women (Rank: #41)

Women receiving inadequate prenatal care: 14.5% (Rank: #24)

Women ages 65+ up to date on key preventative services: 49.0% (Rank: #26)

Women’s health has been making news in Missouri after the legality of fake women’s health centers, or “crisis pregnancy centers,” where people who are not health care professionals give advice to pregnant women, was called into question. This comes amid a rapid decline in health outcomes for Missouri women, owed in part to increased maternal mortality, high use of drugs, tobacco, and alcohol.

Women's health score: 59.8

Women reporting fair or poor health status: 20% (Rank: #39)

Women reporting poor mental health status: 41% (Rank: #34)

Women uninsured: 12% (Rank: #41)

Breast cancer incidence: 129.9 per 100,000 women (Rank: #47)

Ovarian cancer incidence: 9.3 per 100,000 women (Rank: #16)

Deaths due to heart disease: 137.0 per 100,000 women (Rank: #37)

Women receiving inadequate prenatal care: 18.0% (Rank: #45)

Women ages 65+ up to date on key preventative services: 48.3% (Rank: #32)

Affordability and access are some of the biggest issues that stymie women’s health in South Carolina, one of the worst states for high out-of-pocket costs that lead many to skip potentially life-saving check-ups. Psychiatrists have also struggled with increased demand in recent years; a problem somewhat alleviated by a collaboration with South Carolina primary care physicians to reduce the number of necessary psychiatric visits while upholding the quality of care.

Women's health score: 60.4

Women reporting fair or poor health status: 19% (Rank: #34)

Women reporting poor mental health status: 36% (Rank: #6)

Women uninsured: 15% (Rank: #47)

Breast cancer incidence: 126.4 per 100,000 women (Rank: #42)

Ovarian cancer incidence: 10.6 per 100,000 women (Rank: #35)

Deaths due to heart disease: 143.6 per 100,000 women (Rank: #38)

Women receiving inadequate prenatal care: 17.5% (Rank: #42)

Women ages 65+ up to date on key preventative services: 45.6% (Rank: #41)

The Women of W.O.R.T.H. clinic in Rome, Ga., seeks to provide low-cost health care to everyone who walks through the door. The clinic offers preventative screenings to uninsured women who often can’t afford important tests, including Pap smears and breast exams. The services it offers focus in particular on cancer detection and treatment; often these are not available at other free clinics.

Women's health score: 76.3

Women reporting fair or poor health status: 16% (Rank: #23)

Women reporting poor mental health status: 40% (Rank: #25)

Women uninsured: n/a (Rank: n/a)

Breast cancer incidence: 136.6 per 100,000 women (Rank: #51)

Ovarian cancer incidence: 10.1 per 100,000 women (Rank: #26)

Deaths due to heart disease: 122.2 per 100,000 women (Rank: #27)

Women receiving inadequate prenatal care: 6.0% (Rank: #2)

Women ages 65+ up to date on key preventative services: 53.4% (Rank: #8)

Rhode Island’s governor recently signed a suite of three women’s health bills into law. These initiatives increase access to mastectomies (often needed by women with breast cancer), provide a full year of access to contraceptive care, and allow pregnant minors to get prenatal care without contacting their parents for permission.

(Note: Rhode Island had no insurance data available and has been indexed to 80.)

Women's health score: 61.1

Women reporting fair or poor health status: 20% (Rank: #38)

Women reporting poor mental health status: 37% (Rank: #12)

Women uninsured: 13% (Rank: #44)

Breast cancer incidence: 132.6 per 100,000 women (Rank: #49)

Ovarian cancer incidence: 10.6 per 100,000 women (Rank: #37)

Deaths due to heart disease: 124.9 per 100,000 women (Rank: #28)

Women receiving inadequate prenatal care: 16.0% (Rank: #33)

Women ages 65+ up to date on key preventative services: 52.9% (Rank: #11)

North Carolina's Women's Health Report Card is released every two years and allows the state to determine the areas it needs to target in order to improve women's health. The findings for 2018 included data showing that one in every five Rhode Island women didn't see a doctor due to the cost of visits; and that women of color in the state were less likely to be diagnosed with an illness or see a doctor.

Women's health score: 62.7

Women reporting fair or poor health status: 20% (Rank: #37)

Women reporting poor mental health status: 35% (Rank: #4)

Women uninsured: 16% (Rank: #49)

Breast cancer incidence: 113.8 per 100,000 women (Rank: #17)

Ovarian cancer incidence: 10.7 per 100,000 women (Rank: #38)

Deaths due to heart disease: 115.1 per 100,000 women (Rank: #23)

Women receiving inadequate prenatal care: 16.6% (Rank: #38)

Women ages 65+ up to date on key preventative services: 50.6% (Rank: #20)

Despite Florida’s comparatively low number of women who report poor mental health, rates of suicide have increased across the state along with instances of abuse and chronic disease. One explanation given for the increases has been Florida’s refusal to expand Medicaid under the Affordable Care Act. Despite Florida being home to 20% of the 3 million people who could be covered by Medicaid under such an expansion, outgoing governor Rick Scott rejected a proposal to expand it in 2015.

Women's health score: 64.3

Women reporting fair or poor health status: 13% (Rank: #5)

Women reporting poor mental health status: 47% (Rank: #50)

Women uninsured: 14.% (Rank: #46)

Breast cancer incidence: 113.4 per 100,000 women (Rank: #16)

Ovarian cancer incidence: 11.5 per 100,000 women (Rank: #47)

Deaths due to heart disease: 130.5 per 100,000 women (Rank: #31)

Women receiving inadequate prenatal care: 10.2% (Rank: #8)

Women ages 65+ up to date on key preventative services: 48.4% (Rank: #30)

Utah passed a law in early 2018 that would allow women to renew their contraceptives directly from a pharmacist without needing to go to the doctor’s office. This move is especially helpful to low-income women who often don’t have room in their work schedules for these appointments—or the money to pay for them. The law has yet to go into effect while the state determines what training pharmacists will receive and which rules will accompany the transition. The law is expected to take effect by the end of the year.

Women's health score: 66.1

Women reporting fair or poor health status: 22% (Rank: #43)

Women reporting poor mental health status: 38% (Rank: #18)

Women uninsured: 12% (Rank: #29)

Breast cancer incidence: 107.8 per 100,000 women (Rank: #3)

Ovarian cancer incidence: 12.8 per 100,000 women (Rank: #49)

Deaths due to heart disease: 111.3 per 100,000 women (Rank: #7)

Women receiving inadequate prenatal care: 22.9% (Rank: #50)

Women ages 65+ up to date on key preventative services: 48.6% (Rank: #28)

Indigenous women in New Mexico are rethinking women’s health and seeking to provide traditional and culturally relevant care to those giving birth. One such woman, Navajo midwife Nicolle Gonzales, started the Changing Women Initiative. That organization aims to open a reproductive center where staff members are aware of cultural practices and connect the experience of giving birth to patients' cultural histories.

Women's health score: 67.1

Women reporting fair or poor health status: 21% (Rank: #41)

Women reporting poor mental health status: 38% (Rank: #17)

Women uninsured: 11% (Rank: #27)

Breast cancer incidence: 104.7 per 100,000 women (Rank: #2)

Ovarian cancer incidence: 9.5 per 100,000 women (Rank: #6)

Deaths due to heart disease: 151.6 per 100,000 women (Rank: #36)

Women receiving inadequate prenatal care: 17.4% (Rank: #40)

Women ages 65+ up to date on key preventative services: 37.9% (Rank: #51)

New Nevada laws went into effect in early 2018 guaranteeing all women access to contraception, preventative care screenings, and vaccines. The legislation also added workplace protections for victims of domestic violence—the majority of whom are women—and improved daycare facilities for children.

Women's health score: 68.4

Women reporting fair or poor health status: 20% (Rank: #36)

Women reporting poor mental health status: 44% (Rank: #49)

Women uninsured: 8% (Rank: #16)

Breast cancer incidence: 121.3 per 100,000 women (Rank: #8)

Ovarian cancer incidence: 9.9 per 100,000 women (Rank: #11)

Deaths due to heart disease: 143.0 per 100,000 women (Rank: #30)

Women receiving inadequate prenatal care: 15.8% (Rank: #32)

Women ages 65+ up to date on key preventative services: 47.6% (Rank: #35)

Indiana Women in Need is a charity focused on supporting women who are receiving breast cancer treatment in the state. The organization pays for non-medical costs that arise during treatment such as meals, childcare, and yard maintenance.

Women's health score: 68.6

Women reporting fair or poor health status: 19% (Rank: #33)

Women reporting poor mental health status: 38% (Rank: #16)

Women uninsured: 15% (Rank: #34)

Breast cancer incidence: 110.9 per 100,000 women (Rank: #4)

Ovarian cancer incidence: 9.9 per 100,000 women (Rank: #10)

Deaths due to heart disease: 107.0 per 100,000 women (Rank: #5)

Women receiving inadequate prenatal care: 18.9% (Rank: #46)

Women ages 65+ up to date on key preventative services: 52.4% (Rank: #14)

Health care in Arizona has dramatically improved in recent years as more and more women have entered the field. A state with large stretches of rural desert communities, the Arizona Rural Women’s Health Network formed in order to disseminate vital health information to even the most remote parts of the state.

Women's health score: 68.7

Women reporting fair or poor health status: 15% (Rank: #16)

Women reporting poor mental health status: 41% (Rank: #31)

Women uninsured: 15% (Rank: #35)

Breast cancer incidence: 122.0 per 100,000 women (Rank: #10)

Ovarian cancer incidence: 9.3 per 100,000 women (Rank: #4)

Deaths due to heart disease: n/a per 100,000 women (Rank: #n/a)

Women receiving inadequate prenatal care: 17.2% (Rank: #39)

Women ages 65+ up to date on key preventative services: 46.6% (Rank: #38)

Alaska passed a law in 2016 limiting the kinds of sexual education schools could teach, stoking concerns among sexual and reproductive health advocates over the state's already high rates of STDs and teenage pregnancies. Alaska did recently open the Alaska Native Women’s Center, which works to combat high rates of domestic violence suffered by Native Alaskan women in the state.

(NOTE: Alaska has no available data for heart disease rate and has been indexed to 90.)

Women's health score: 69.5

Women reporting fair or poor health status: 15% (Rank: #15)

Women reporting poor mental health status: 42% (Rank: #38)

Women uninsured: 12% (Rank: #31)

Breast cancer incidence: 124.7 per 100,000 women (Rank: #15)

Ovarian cancer incidence: 10.3 per 100,000 women (Rank: #15)

Deaths due to heart disease: 123.5 per 100,000 women (Rank: #19)

Women receiving inadequate prenatal care: 11.9% (Rank: #14)

Women ages 65+ up to date on key preventative services: 42.9% (Rank: #46)

Lawmakers in 2018 asked an Idaho judge to suspend a new law requiring abortion providers to turn over to the state personal information about women who received abortions. Idaho also suffers from a fragmented mental health system, which doesn’t give many people access to treatment for mental illness, drug, or alcohol abuse, adversely affecting women’s mental health overall.

Women's health score: 69.5

Women reporting fair or poor health status: 18% (Rank: #29)

Women reporting poor mental health status: 34% (Rank: #3)

Women uninsured: 10% (Rank: #23)

Breast cancer incidence: 134.9 per 100,000 women (Rank: #36)

Ovarian cancer incidence: 12.2 per 100,000 women (Rank: #43)

Deaths due to heart disease: 132.7 per 100,000 women (Rank: #26)

Women receiving inadequate prenatal care: 15.0% (Rank: #26)

Women ages 65+ up to date on key preventative services: 44.6% (Rank: #44)

New Jersey Gov. Phil Murphy’s first law passed following his 2017 election was to add $7.5 million to women's health care funding in the state. A recent rise in STD rates in the state have led to calls by some legislators for additional funding for women’s health centers.

Women's health score: 69.6

Women reporting fair or poor health status: 16% (Rank: #22)

Women reporting poor mental health status: 39% (Rank: #20)

Women uninsured: 13% (Rank: #32)

Breast cancer incidence: 104.0 per 100,000 women (Rank: #1)

Ovarian cancer incidence: 12.2 per 100,000 women (Rank: #42)

Deaths due to heart disease: 124.8 per 100,000 women (Rank: #22)

Women receiving inadequate prenatal care: 14.1% (Rank: #22)

Women ages 65+ up to date on key preventative services: 48.8% (Rank: #27)

For the high number of pregnant women living in rural parts of Wyoming, getting prenatal care is incredibly difficult. Expecting mothers are forced to endure long drives, and those with complicated pregnancies or births find themselves without the care they need. Proposals to defund Planned Parenthood clinics, if passed, would make this an even steeper challenge as many low-income women visit the single facility in the state to receive their care.

Women's health score: 69.9

Women reporting fair or poor health status: 17% (Rank: #25)

Women reporting poor mental health status: 37% (Rank: #11)

Women uninsured: 12% (Rank: #28)

Breast cancer incidence: 124.5 per 100,000 women (Rank: #13)

Ovarian cancer incidence: 10.9 per 100,000 women (Rank: #18)

Deaths due to heart disease: 122.2 per 100,000 women (Rank: #17)

Women receiving inadequate prenatal care: 12.3% (Rank: #15)

Women ages 65+ up to date on key preventative services: 49.7% (Rank: #24)

Medicaid coverage has been expanded throughout Virginia and is slated for implementation in 2019. That expansion is expected to reduce the percentage of uninsured people in the state and allow women affordable access to the care they need.

Women's health score: 70.4

Women reporting fair or poor health status: 19% (Rank: #32)

Women reporting poor mental health status: 40% (Rank: #26)

Women uninsured: 9% (Rank: #21)

Breast cancer incidence: 121.4 per 100,000 women (Rank: #9)

Ovarian cancer incidence: 11.5 per 100,000 women (Rank: #29)

Deaths due to heart disease: 112.2 per 100,000 women (Rank: #9)

Women receiving inadequate prenatal care: 9.6% (Rank: #5)

Women ages 65+ up to date on key preventative services: 44.3% (Rank: #45)

Despite the increase in maternal mortality in the country as a whole, California has become a pioneer in the push to decrease the number of women who die in childbirth. The state's development of the CA-PAMR maternal mortality review worked to discover the most common causes of maternal mortality and improve hospitals’ ability to combat them in a triage setting. California is also a leader in providing family planning services and has successfully decreased rates of teen pregnancy throughout the state.

Women's health score: 70.8

Women reporting fair or poor health status: 19% (Rank: #31)

Women reporting poor mental health status: 36% (Rank: #5)

Women uninsured: 10% (Rank: #24)

Breast cancer incidence: 136.2 per 100,000 women (Rank: #39)

Ovarian cancer incidence: 8.9 per 100,000 women (Rank: #2)

Deaths due to heart disease: 129.6 per 100,000 women (Rank: #24)

Women receiving inadequate prenatal care: 15.7% (Rank: #30)

Women ages 65+ up to date on key preventative services: 51.3% (Rank: #18)

Delaware has quietly gone from having one of the highest rates of unplanned pregnancy in the country to becoming a leader in expanding access to birth control and family planning services for its residents. Unplanned pregnancies in Delaware dropped by 15% following the implementation of the Delaware CAN (Contraceptive Access Now) program, which integrates primary and reproductive care and was offered free of charge.

Women's health score: 71.1

Women reporting fair or poor health status: 19% (Rank: #30)

Women reporting poor mental health status: 43% (Rank: #47)

Women uninsured: 7% (Rank: #11)

Breast cancer incidence: 119.0 per 100,000 women (Rank: #6)

Ovarian cancer incidence: 10.2 per 100,000 women (Rank: #14)

Deaths due to heart disease: 160.6 per 100,000 women (Rank: #39)

Women receiving inadequate prenatal care: 12.5% (Rank: #17)

Women ages 65+ up to date on key preventative services: 50.4% (Rank: #22)

Reforming Michigan's shaky mental health system became a political issue leading up to the 2018 midterms. A bipartisan group of legislators recently came together in an attempt to come up with their own bill to tackle the problem, and four local community organizations were given an infusion of $4 million each to boost their services in their communities.

Women's health score: 71.1

Women reporting fair or poor health status: 18% (Rank: #28)

Women reporting poor mental health status: 41% (Rank: #33)

Women uninsured: 7% (Rank: #9)

Breast cancer incidence: 127.9 per 100,000 women (Rank: #20)

Ovarian cancer incidence: 11.0 per 100,000 women (Rank: #20)

Deaths due to heart disease: 148.3 per 100,000 women (Rank: #33)

Women receiving inadequate prenatal care: 16.5% (Rank: #37)

Women ages 65+ up to date on key preventative services: 48.5% (Rank: #29)

Appalachian Ohio suffers from a similar coverage gap as other rural areas of the country, with 30% fewer primary care physicians than the rest of the state. The Appalachian Women's Health Fund has partnered with the Foundation for Appalachian Ohio in hopes of expanding the work of Planned Parenthood's Athens Health Center in the 23 counties in which it operates with an infusion of funding.

Women's health score: 71.5

Women reporting fair or poor health status: 18% (Rank: #27)

Women reporting poor mental health status: 39% (Rank: #21)

Women uninsured: 7% (Rank: #8)

Breast cancer incidence: 134.0 per 100,000 women (Rank: #33)

Ovarian cancer incidence: 12.1 per 100,000 women (Rank: #41)

Deaths due to heart disease: 145.6 per 100,000 women (Rank: #32)

Women receiving inadequate prenatal care: 12.5% (Rank: #16)

Women ages 65+ up to date on key preventative services: 48.3% (Rank: #31)

Health care disparities between white women and women of color continue to be an issue in New York, with black women 12 times as likely as white women to die of pregnancy-related causes in New York City. And while New York was one of the first states to legalize abortion in 1970, its laws haven’t been changed since. Pro-choice and women’s health advocates are pushing for updates, claiming the procedure is technically a crime if performed after 24 weeks, with the exception of saving the life of the woman.

Women's health score: 71.5

Women reporting fair or poor health status: 16% (Rank: #21)

Women reporting poor mental health status: 37% (Rank: #10)

Women uninsured: 10% (Rank: #25)

Breast cancer incidence: 130.1 per 100,000 women (Rank: #24)

Ovarian cancer incidence: 11.2 per 100,000 women (Rank: #24)

Deaths due to heart disease: 118.3 per 100,000 women (Rank: #15)

Women receiving inadequate prenatal care: 16.1% (Rank: #34)

Women ages 65+ up to date on key preventative services: 47.9% (Rank: #34)

A breast cancer survivor with years of experience in the health care field has opened a new practice aiming to help Montana's women battling the same disease. Michelle Knowles hopes to aid those struggling to figure out the best way forward and provide information to help them make the best decisions for their family.

Women's health score: 71.8

Women reporting fair or poor health status: 16% (Rank: #20)

Women reporting poor mental health status: 40% (Rank: #24)

Women uninsured: 10% (Rank: #26)

Breast cancer incidence: 133.1 per 100,000 women (Rank: #32)

Ovarian cancer incidence: 9.8 per 100,000 women (Rank: #9)

Deaths due to heart disease: 111.7 per 100,000 women (Rank: #8)

Women receiving inadequate prenatal care: 13.6% (Rank: #19)

Women ages 65+ up to date on key preventative services: 49.1% (Rank: #25)

North Dakota moved to improve the health of the state’s Native population by approving funding for a new, tribal health initiative. More than $300,000 were allocated to the Tribal Maternal, Infant, and Early Childhood Home Visiting program on the Lake Traverse Reservation. The money will be used to ensure the healthy development of and support for women and their families.

Women's health score: 72.2

Women reporting fair or poor health status: 15% (Rank: #14)

Women reporting poor mental health status: 42% (Rank: #37)

Women uninsured: 12% (Rank: #30)

Breast cancer incidence: 123.4 per 100,000 women (Rank: #11)

Ovarian cancer incidence: 9.8 per 100,000 women (Rank: #8)

Deaths due to heart disease: 100.6 per 100,000 women (Rank: #2)

Women receiving inadequate prenatal care: 15.7% (Rank: #29)

Women ages 65+ up to date on key preventative services: 55.2% (Rank: #3)

The Women’s Foundation of Colorado received a $1 million grant in September 2018 to help the organization expand its existing infrastructures in the state. Women in Colorado are still more likely than men to suffer from poor health. The foundation provides economic support to relieve financial stress and in turn improve overall health outcomes.

Women's health score: 73

Women reporting fair or poor health status: 18% (Rank: #26)

Women reporting poor mental health status: 47% (Rank: #51)

Women uninsured: 7% (Rank: #12)

Breast cancer incidence: 115.6 per 100,000 women (Rank: #5)

Ovarian cancer incidence: 11.3 per 100,000 women (Rank: #27)

Deaths due to heart disease: 104.5 per 100,000 women (Rank: #4)

Women receiving inadequate prenatal care: 11.6% (Rank: #13)

Women ages 65+ up to date on key preventative services: 50.2% (Rank: #23)

Oregonians will vote at the ballot box this year on Measure 106 to determine whether the state should stop using public funds to pay for abortions. Opponents of the measure argue that it makes it difficult for low-income women to take control of their reproductive health, while supporters point out that women will still be able to seek the procedure in the state sans public funds.

Women's health score: 73.3

Women reporting fair or poor health status: 16% (Rank: #19)

Women reporting poor mental health status: 41% (Rank: #32)

Women uninsured: 8% (Rank: #14)

Breast cancer incidence: 129.0 per 100,000 women (Rank: #22)

Ovarian cancer incidence: 11.5 per 100,000 women (Rank: #30)

Deaths due to heart disease: 121.0 per 100,000 women (Rank: #16)

Women receiving inadequate prenatal care: 11.0% (Rank: #9)

Women ages 65+ up to date on key preventative services: 55.2% (Rank: #2)

Wisconsin's Well Woman Program provides free preventative screenings to women who are underinsured or lack insurance altogether. However, the program was restructured and downsized in 2015, decreasing the number of program coordinators and providers offering these services.

Women's health score: 73.7

Women reporting fair or poor health status: 17% (Rank: #24)

Women reporting poor mental health status: 43% (Rank: #46)

Women uninsured: 6% (Rank: #5)

Breast cancer incidence: 131.3 per 100,000 women (Rank: #28)

Ovarian cancer incidence: 11.6 per 100,000 women (Rank: #31)

Deaths due to heart disease: 140.2 per 100,000 women (Rank: #29)

Women receiving inadequate prenatal care: 15.6% (Rank: #28)

Women ages 65+ up to date on key preventative services: 52.3% (Rank: #15)

The bipartisan legislative caucus on Women’s Health in Pennsylvania released a suite of bills in 2017 aimed at improving women’s health in three key areas: safety and dignity, economic security, and access to health care. The agenda has persisted into 2018, as the caucus advocates for workplace accommodations for pregnant and working mothers, improving nursing home care, increasing the minimum wage, and pushing for reforms on how sexual assault is handled on college campuses.

Women's health score: 73.9

Women reporting fair or poor health status: 16% (Rank: #18)

Women reporting poor mental health status: 37% (Rank: #9)

Women uninsured: 9% (Rank: #18)

Breast cancer incidence: 129.7 per 100,000 women (Rank: #23)

Ovarian cancer incidence: 10.5 per 100,000 women (Rank: #17)

Deaths due to heart disease: 123.5 per 100,000 women (Rank: #20)

Women receiving inadequate prenatal care: 10.1% (Rank: #6)

Women ages 65+ up to date on key preventative services: 50.4% (Rank: #21)

Topeka Veterans Affairs opened a new center for women in October of 2018 in order to better meet the needs of increasing numbers of female veterans. This marks a huge step forward for the 4,000 women now using the service. Just one decade ago, the VA had a single provider for women that operated out of one room.

Women's health score: 73.9

Women reporting fair or poor health status: 15% (Rank: #13)

Women reporting poor mental health status: 39% (Rank: #19)

Women uninsured: 8% (Rank: #13)

Breast cancer incidence: 143.9 per 100,000 women (Rank: #45)

Ovarian cancer incidence: 12.2 per 100,000 women (Rank: #44)

Deaths due to heart disease: 115.6 per 100,000 women (Rank: #12)

Women receiving inadequate prenatal care: 11.1% (Rank: #10)

Women ages 65+ up to date on key preventative services: 52.4% (Rank: #13)

Using the existing framework provided by the Affordable Care Act, Connecticut has passed bills hoping to codify the provisions that protect women’s health into state law. Meanwhile, one women’s health center recently opened in Glastonbury that offers evening appointments in order to allow women to chose times that fit their schedules.

Women's health score: 74.2

Women reporting fair or poor health status: 15% (Rank: #12)

Women reporting poor mental health status: 38% (Rank: #15)

Women uninsured: 9% (Rank: #19)

Breast cancer incidence: 127.7 per 100,000 women (Rank: #19)

Ovarian cancer incidence: 11.0 per 100,000 women (Rank: #19)

Deaths due to heart disease: 113.7 per 100,000 women (Rank: #10)

Women receiving inadequate prenatal care: 14.3% (Rank: #23)

Women ages 65+ up to date on key preventative services: 51.1% (Rank: #19)

Nebraska has implemented a new, state-government policy to allow new mothers to take time off with their children. In this system, coworkers may donate paid days off so new mothers can spend extra time with infants without the associated financial burden. The U.S. is the only high-income country in the world lacking a national policy of paid parental leave, which tends to raise wages for working moms and improve their health.

Women's health score: 75.2

Women reporting fair or poor health status: 15% (Rank: #11)

Women reporting poor mental health status: 38% (Rank: #14)

Women uninsured: 7% (Rank: #7)

Breast cancer incidence: 131.4 per 100,000 women (Rank: #29)

Ovarian cancer incidence: 11.9 per 100,000 women (Rank: #40)

Deaths due to heart disease: 131.1 per 100,000 women (Rank: #25)

Women receiving inadequate prenatal care: 19.6% (Rank: #47)

Women ages 65+ up to date on key preventative services: 52.3% (Rank: #16)

The rising rate of maternal mortality in the United States has not spared Maryland, and hospitals in the state are taking on their own initiatives in hopes of reversing the trend. Baltimore’s Healthy Start Inc. now offers gift cards to new mothers to incentivize coming back to the doctor’s office after giving birth, and provides transportation and daycare to make sure appointments are kept. The non-profit also trains moms to advocate for themselves in the face of doctors who sometimes don’t take their pain or other symptoms seriously.

Women's health score: 75.8

Women reporting fair or poor health status: 15% (Rank: #10)

Women reporting poor mental health status: 43% (Rank: #45)

Women uninsured: 7% (Rank: #10)

Breast cancer incidence: 132.0 per 100,000 women (Rank: #30)

Ovarian cancer incidence: 11.1 per 100,000 women (Rank: #23)

Deaths due to heart disease: 104.3 per 100,000 women (Rank: #3)

Women receiving inadequate prenatal care: 15.2% (Rank: #27)

Women ages 65+ up to date on key preventative services: 53.3% (Rank: #9)

Washington has one of the lowest rates of unplanned pregnancies—35% in comparison to the 45% national average. In early 2018, the state passed a series of women’s health laws to enforce Washington's robust protection of reproductive health, including one law requiring insurance companies to cover contraceptives without copays in addition to maternal care and abortion services.

Women's health score: 76.7

Women reporting fair or poor health status: 16% (Rank: #17)

Women reporting poor mental health status: 42% (Rank: #39)

Women uninsured: 8% (Rank: #15)

Breast cancer incidence: 124.5 per 100,000 women (Rank: #12)

Ovarian cancer incidence: 8.3 per 100,000 women (Rank: #1)

Deaths due to heart disease: 117.6 per 100,000 women (Rank: #14)

Women receiving inadequate prenatal care: 9.0% (Rank: #3)

Women ages 65+ up to date on key preventative services: 55.1% (Rank: #4)

One Maine primary practice is working to better support women in the weeks and months after they’ve given birth. Patients at InterMed will visit with a nurse shortly before they give birth to get all the information they need to lay out a plan for their postpartum period. In addition to the typical doctor’s visit six weeks after the birth, doctors will also make multiple check-in phone calls to make sure everything is running smoothly.

Women's health score: 77.3

Women reporting fair or poor health status: 13% (Rank: #4)

Women reporting poor mental health status: 40% (Rank: #23)

Women uninsured: 9% (Rank: #20)

Breast cancer incidence: 145.9 per 100,000 women (Rank: #48)

Ovarian cancer incidence: 9.1 per 100,000 women (Rank: #3)

Deaths due to heart disease: 116.7 per 100,000 women (Rank: #13)

Women receiving inadequate prenatal care: 9.4% (Rank: #4)

Women ages 65+ up to date on key preventative services: 54.7% (Rank: #6)

The New Hampshire Breast Cancer Coalition is a grass-roots, statewide campaign hoping to eradicate the disease and provide funds for low-income women struggling to pay for treatment. Members focus on research as well as politics, pushing politicians in Washington to advocate for policies that will support efforts to eradicate breast cancer.

Women's health score: 78.1

Women reporting fair or poor health status: 14.% (Rank: #7)

Women reporting poor mental health status: 33% (Rank: #1)

Women uninsured: 10% (Rank: #22)

Breast cancer incidence: 127.4 per 100,000 women (Rank: #18)

Ovarian cancer incidence: 9.4 per 100,000 women (Rank: #5)

Deaths due to heart disease: 114.4 per 100,000 women (Rank: #11)

Women receiving inadequate prenatal care: 15.8% (Rank: #31)

Women ages 65+ up to date on key preventative services: 52.7% (Rank: #12)

South Dakota's sprawling nature, as with rural outposts across the country, makes access to health care a challenge for many women. Rural South Dakotans face some of the biggest gaps in maternity care and highest infant mortality rates in the country. These gaps are only expanding as the state struggles to keep doctors within its borders. There is currently no residency program for aspiring OB-GYNs in South Dakota.

Women's health score: 78.4

Women reporting fair or poor health status: 15% (Rank: #9)

Women reporting poor mental health status: 43% (Rank: #44)

Women uninsured: 6% (Rank: #4)

Breast cancer incidence: 137.7 per 100,000 women (Rank: #41)

Ovarian cancer incidence: 11.2 per 100,000 women (Rank: #25)

Deaths due to heart disease: 107.1 per 100,000 women (Rank: #6)

Women receiving inadequate prenatal care: 10.2% (Rank: #7)

Women ages 65+ up to date on key preventative services: 53.8% (Rank: #7)

A ballot initiative in Massachusetts this November asks voters to approve specified nurse-to-patient ratios, which varies based on the type of care being provided. Supporters argue that this improves patient health and outcomes, while opponents say it takes the flexibility away from workplaces and may not actually improve patient health.

Women's health score: 80.5

Women reporting fair or poor health status: 13% (Rank: #3)

Women reporting poor mental health status: 41% (Rank: #30)

Women uninsured: 5% (Rank: #1)

Breast cancer incidence: 121.1 per 100,000 women (Rank: #7)

Ovarian cancer incidence: 12.5 per 100,000 women (Rank: #46)

Deaths due to heart disease: 161.9 per 100,000 women (Rank: #40)

Women receiving inadequate prenatal care: 21.7% (Rank: #48)

Women ages 65+ up to date on key preventative services: 46.4% (Rank: #39)

As the capital of the United States, Washington D.C. is not part of any state and has no representation in Congress. Instead, the local government creates laws within the city, but Congress holds the right to veto any laws passed. This has caused some tension between the two, especially in the realm of women’s health. While Congress attempted to repeal the Affordable Care Act in 2017, which would remove contraceptive benefits and cause women to be charged more for their insurance, the D.C. government quietly worked to protect those rights with the knowledge that Congress could overturn them as well.

Women's health score: 81

Women reporting fair or poor health status: 15% (Rank: #8)

Women reporting poor mental health status: 37% (Rank: #8)

Women uninsured: 6% (Rank: #2)

Breast cancer incidence: 129.0 per 100,000 women (Rank: #21)

Ovarian cancer incidence: 9.6 per 100,000 women (Rank: #7)

Deaths due to heart disease: 124.7 per 100,000 women (Rank: #21)

Women receiving inadequate prenatal care: 11.2% (Rank: #12)

Women ages 65+ up to date on key preventative services: 51.5% (Rank: #17)

Iowa may have excellent maternity care right now, but some worry that could be jeopardized by a recent state law that bans abortion after a fetal heartbeat can be detected (usually around six weeks). The law could lead to an OB-GYN shortage, as the University of Iowa’s obstetrics and gynecology program must meet federal requirements that students get experience with all form of contraception and abortion if they so choose.

Women's health score: 81.2

Women reporting fair or poor health status: 14.% (Rank: #6)

Women reporting poor mental health status: 34% (Rank: #2)

Women uninsured: 7% (Rank: #6)

Breast cancer incidence: 134.8 per 100,000 women (Rank: #35)

Ovarian cancer incidence: 9.9 per 100,000 women (Rank: #12)

Deaths due to heart disease: n/a per 100,000 women (Rank: #n/a)

Women receiving inadequate prenatal care: 17.5% (Rank: #41)

Women ages 65+ up to date on key preventative services: 53.1% (Rank: #10)

The Office of Hawaiian affairs released a 150-page report last May outlining the health and well-being of Native Hawaiian women on the islands. Taking into account data on mental and physical health, chronic illness, domestic violence, wage gaps, and other crucial data points, the report highlights areas in which these women’s unique culture can be used to improve their health. This could mean introducing more holistic methods, which might be used in other regions or with other groups in the country.

(NOTE: Hawaii has no data on heart disease deaths and has been indexed to 90.)

Women's health score: 81.3

Women reporting fair or poor health status: 12% (Rank: #1)

Women reporting poor mental health status: 37% (Rank: #7)

Women uninsured: 9% (Rank: #17)

Breast cancer incidence: 134.5 per 100,000 women (Rank: #34)

Ovarian cancer incidence: 11.0 per 100,000 women (Rank: #21)

Deaths due to heart disease: 88.0 per 100,000 women (Rank: #1)

Women receiving inadequate prenatal care: 11.2% (Rank: #11)

Women ages 65+ up to date on key preventative services: 54.8% (Rank: #5)

A Minnesota venture capital firm called Capita3 recently raised $1.2 million to fund between seven and 10 women-led health startups over the course of the next two years. The firm seeks to make strides in a variety of fields, including genomics and women's health more generally. This can be vitally important for women who feel the health field doesn't listen to them and their needs. This is exactly what inspired Dr. Donna Block in 2004 to start her own clinic in Edina, Minn., where women's health and wellness needs would be listened to.

Women's health score: 83.8

Women reporting fair or poor health status: 13% (Rank: #2)

Women reporting poor mental health status: 41% (Rank: #29)

Women uninsured: 6% (Rank: #3)

Breast cancer incidence: 130.5 per 100,000 women (Rank: #27)

Ovarian cancer incidence: 11.1 per 100,000 women (Rank: #22)

Deaths due to heart disease: 122.8 per 100,000 women (Rank: #18)

Women receiving inadequate prenatal care: 4.9% (Rank: #1)

Women ages 65+ up to date on key preventative services: 56.1% (Rank: #1)

Vermont in 2017 implemented the Women’s Health Initiative, which provides women access to a number of preventative care services at OB-GYN offices and other women’s health clinics. This initiative offers improved psychosocial screening, family planning, and access to long-acting, reversible contraception.  The recent increase in staff ensures that women have access to this without extended waiting periods.