Nine state-based health metrics to keep in mind this holiday season, highlighting potential risks for women

What state you live in can impact your health and access to healthcare. So can where you spend the holidays. Ranked on metrics like access to abortion care and hospital bed numbers, car crash statistics, and mental health risks, here are some states that may be more dangerous than others.

1. Abortion care access

Now, in the second holiday season without national protection of Roe v. Wade, people in need of abortion care experience state-based barriers to care and life-threatening risks to their health. Especially if factors like poor weather, lack of time, or lack of transportation get in the way, the state you gather in can influence your safety and access to care.

Abortion bans are present in Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, South Dakota, Tennessee, Texas, and West Virginia. Fifteen-week abortion bans are present in Arizona, Florida, Iowa, Kansas, Ohio, Utah, and Wisconsin. Six-week abortion bans are present in Georgia, Nebraska, North Carolina, and South Carolina.^[]

2. Car crash fatality statistics 

The holiday season usually brings with it long road trips home. It can also present unhealthy opportunities for drunk driving. Data shows that some states have more fatal car crashes than others. However, it is important to be mindful of safety regardless of where you travel or stay over the holidays. 

According to the Insurance Institute for Highway Safety (IIHS), which analyzed 2021 data from the US Department of Transportation’s Fatality Analysis Reporting System, Mississippi was the state with the highest number of deaths from car crashes, proportionally to the population. Mississippi’s fatality rate from car crashes was 26.2 per 100,000 people. This was followed by South Carolina (23.1), Arkansans (22.9), New Mexico (22.7), Montana (21.6), and Louisiana (21). Rhode Island was the state with the fewest number of fatalities from car crashes, with 5.7 per 100,000 people.^[]

3. COVID-19 hospitalization numbers

While most states are no longer in government-mandated lockdowns, coronavirus is still alive and circulating through the population. According to recent reports from the New York Times, which uses Centers for Disease Control (CDC) data to track COVID-19 hospitalizations, Delaware, Missouri, North Carolina, Pennsylvania, and Arizona are the states with the highest number of COVID-19 hospitalizations per 100,000 people. National COVID-19 numbers are lower than last spring and winter but much higher than this summer.^[]

4. Drug use

Drug use and drug-related deaths are a huge travesty in the US, and numbers vary in different states. Data from the Kaiser Family Foundation (KFF) shows that in 2021, West Virginia was the state with the highest number of drug-related deaths, with a rate of 90.9 deaths per 100,000 population. This was followed by the District of Columbia, Tennessee, Louisiana, Kentucky, and Delaware. Nebraska was the state with the lowest number of drug-related deaths in 2021, with 11.4 deaths per 100,000 population.^[]

Drug and alcohol-related overdoses increased across the US as a whole following the onset of COVID-19 in 2020.^[]

5. Hospital beds per population

According to 2021 data from KFF, the District of Columbia, South Dakota, North Dakota, Mississippi, West Virginia, and Nebraska were the states with the highest number of hospital beds per 1,000 population, in that order. Washington, Oregon, New Mexico, Utah, Maryland, and California were the states with the fewest number of hospital beds per 100,000 population.^[]

6. Hospital costs

Not considering insurance payments or patient billing, hospitals in different states incur different amounts of money to cover inpatient status. According to data from the KFF, California hospitals experience the highest expenses for a one-day inpatient stay.^[]

A one-day inpatient stay will cost a California hospital $4,181 in 2021. Other states with high hospital expenses include the District of Columbia, Oregon, Washington, and New York — which all incur more than $3,500 per inpatient day.

7. Insurance coverage rates

According to KFF, Texas is the state with the highest percentage of uninsured individuals, who accounted for 16.7% of the population in 2021, followed by Alaska (14% uninsured), Oklahoma (13.8% uninsured), Florida (12.7% uninsured), Georgia (12.3% uninsured), and Mississippi (11% uninsured). Vermont had the lowest percentage of uninsured individuals, accounting for 2.8% of the state’s population in 2021. Vermont was followed by Massachusetts and Michigan (both with 3% uninsured), Rhode Island (3.1% uninsured), Minnesota (3.6% uninsured), and Maine (3.7% uninsured).^[]

8. Life expectancy ratings

According to data from 2020, people in Hawaii have the highest life expectancy numbers — reaching 81.5 years. Hawaii is followed by Washington, Minnesota, and California, where life expectancy numbers hover around 79 years. People in Mississippi experienced the shortest life expectancy at just 71.9 years. Mississippi was closely followed by West Virginia, Louisiana, and Alabama, where numbers hovered between 72 and 74 years for the lowest life expectancy. Data shows that people in the South generally have shorter life expectancies than other states. And with an almost ten-year gap between Hawaii's and Mississippi's life expectancies, the difference is hard to ignore.^[]

Depending on how old you are, changing up which state you spend the holidays in might not change your numbers too much – but who knows? If you’re still in the process of laying your roots and starting traditions, however, this may be data to think about.

9. Mental health risks

The state you live in — or spend your holiday in — may impact your mental health status, too. A KFF analysis of the CDC's 2013-2022 Behavioral Risk Factor Surveillance System (BRFSS) compared the number of “poor mental health” days US adults experienced in 30 days to the state they live in. The results showed that, overall, adults in West Virginia experienced the highest number of poor mental health days, with an average of 5.9. This was followed by Louisiana, Tennessee, Arkansas, Oklahoma, Oregon, and Ohio, where adults reported five or more days. When separating results based on sex, West Virginia remained at the top. However, secondary results varied for males and females, with females reporting high numbers of poor mental health days in Missouri and Texas, which were not high scores among males. Females reported more poor mental health days across the board, with a high of 6.8, whereas men reported a high of 4.7.^[]

Especially if you’re prone to holiday-induced stress, it could be smart to think about stressors you experience based on the state you live in and if there are any self-care tactics you can practice to soothe your symptoms. Stay up to date on vaccinations, and bring any prescribed medications with you on your trip.

In Review

States with some type of ban on abortion care (Ordered alphabetically):

• Alabama

• Arizona

• Arkansas

• Florida

• Georgia

• Idaho

• Indiana

• Iowa

• Kansas

• Kentucky

• Louisiana

• Mississippi

• Missouri

• Nebraska

• North Dakota

• North Carolina

• Ohio

• South Carolina

• South Dakota

• Tennessee

• Texas

• Utah

• West Virginia

• Wisconsin

States with the highest number of deaths from car crashes per 100,000 people. (Ordered high to low):

• South Carolina

• Arkansans

• New Mexico

• Montana

• Louisiana

States with the highest number of COVID-19 hospitalizations per 100,000 people

• Delaware

• Missouri

• North Carolina

• Pennsylvania

• Arizona

States with the most drug-related deaths (Ordered high to low):

• West Virginia

• District of Columbia

• Tennessee

• Louisiana

• Kentucky

• Delaware

States with highest hospital expenses per inpatient stay (Ordered high to low):

• California

• District of Columbia

• Oregon

• Washington

• New York

States with the most uninsured people (Ordered high to low):

• Texas

• Alaska

• Oklahoma

• Florida

• Georgia

• Mississippi

States with the shortest life expectancy (Ordered low to high):

• Mississippi

• West Virginia

• Louisiana

• Alabama

States where people experience the highest number of poor mental health days (Ordered high to low):

• West Virginia

• Louisiana

• Tennessee

• Arkansas

• Oklahoma

• Oregon

• Ohio