5 key findings on the state of health care across the U.S.
New report finds positive trends in mortality and preventive care, while chronic conditions and health care access challenges grow.
The America's Health Rankings 2025 Annual Report, released January 2026, presents a comprehensive analysis of the nation's health landscape, examining 99 measures of health and well-being across 31 distinct data sources. As the longest-running state-by-state analysis of the nation's health, now in its 36th edition, this report provides critical insights for employers who offer employer-sponsored health insurance, among other stakeholders.
The findings reveal a complex picture: encouraging progress in mortality rates and preventive care alongside concerning increases in chronic conditions and health care access challenges. For employers navigating rising health care costs — projected to grow at nearly 9% for 2026,1 the highest rate in more than a decade — understanding these trends is essential for strategic benefits planning and workforce health management.
1. The surge in multiple chronic conditions
The percentage of American adults living with 3 or more chronic conditions increased 6% between 2023 and 2024, rising from 10.7% to 11.3%. This translates to millions more Americans managing complex health needs simultaneously. The chronic conditions tracked include arthritis, asthma, cancer, cardiovascular diseases, chronic kidney disease, chronic obstructive pulmonary disease (COPD) and diabetes, among others.
The burden of multiple chronic conditions falls disproportionately on certain populations. Adults with disabilities face rates 8.8 times higher than those without disabilities, while those 65 and older experience rates 6.6 times higher than adults ages 18—44.
What this means for employers
Employees with chronic conditions generate high costs through specialty medications, frequent health care utilization and increased absenteeism that can impact organizational productivity. Strategic investment in proactive condition management programs can help deliver measurable returns by addressing these cost drivers through early intervention and sustained support.
2. Wins and losses with mortality rates
Despite challenges in chronic disease management, the 2025 report reveals significant improvements in mortality measures across multiple categories. Nationally, the premature death rate decreased 8% between 2022 and 2023, dropping from 8,522 to 7,862 years lost before age 75 per 100,000 population. This represents substantial progress in preventing early deaths.
Drug overdose deaths, which had increased almost continuously for 2 decades, finally declined by 3% nationally, falling from 32.4 to 31.4 deaths per 100,000 population between 2022 and 2023. In 2023, 105,000 people in the U.S. died of drug overdoses — 2,900 fewer deaths than in 2022. Provisional 2024 data suggests this positive trend is continuing, with nearly a 24% decline in drug overdose deaths.
Firearm deaths decreased 3% from 14.5 to 14.0 deaths per 100,000 population, while the homicide rate showed even more dramatic improvement, decreasing 13% from 7.7 to 6.7 deaths per 100,000 population between 2020—2021 and 2022—2023.
However, these improvements haven't been universal. Drug death rates increased among adults 65—74 (up 12%) and Black populations (up 3%), highlighting persistent health disparities.
What this means for employers
Lower premature death rates enhance workforce stability. Despite these improvements, persistent substance use disorder challenges among older workers necessitate robust behavioral health solutions, comprehensive addiction treatment coverage and harm-reduction strategies, including medication-assisted treatment options. These mortality trends reinforce the critical value of preventive care and early intervention that simultaneously reduce human tragedy and long-term health care costs.
3. Growing barriers to health care access
Americans faced increasing difficulties accessing health care. The percentage of adults who reported avoiding needed medical care due to cost increased 8% between 2023 and 2024, rising from 10.6% to 11.5%. This means nearly 30M American adults didn't see a doctor when needed because of financial barriers.
Simultaneously, the percentage of uninsured Americans increased 4% from 7.9% to 8.2% between 2023 and 2024. Nearly 27.5M people in the U.S. lacked health insurance in 2024, an increase of 1.3M since 2023.
These access barriers varied dramatically by income and education level. Adults with annual household incomes below $25,000 were 7.8 times more likely to avoid care due to cost compared to those earning $150,000 or more. Similarly, the uninsured rate was 5.7 times higher among those without a high school education compared to college graduates.
Geographic disparities were also stark. The uninsured rate in Texas (16.7%) was 6 times higher than in Massachusetts (2.8%), while the percentage avoiding care due to cost was 2.7 times higher in Texas (17.4%) than in Hawaii (6.4%).
What this means for employers
Rising cost barriers can cause employees to delay essential care, which can lead to higher costs later on through preventable hospitalizations and emergency room visits and potential increased absenteeism. Employers who reduce cost-sharing for essential services — including eliminating copayments for primary care and offering zero-cost generic medications — can help improve access to care and may also see significant decreases in emergency room utilization and expensive late-stage treatments.
4. Significant expansion in cancer screenings
One of the most encouraging trends in the 2025 report is the substantial increase in cancer screenings. The combined measure of cancer screenings (including both breast and colorectal cancer) increased 15% between 2022 and 2024, rising from 56.0% to 64.5% of the eligible adult population.
Breaking this down by screening type:
- Breast cancer screenings increased 3% from 72.1% to 74.5% among women ages 40—74
- Colorectal cancer screenings jumped 15% from 61.8% to 71.1% among adults ages 45—75
The improvements were widespread, with 47 states and the District of Columbia showing significant increases in cancer screening rates during this period. States like New Jersey, Vermont and New Hampshire led the way with increases of 24—28%.
Screening rates improved across nearly all demographic groups, with notable gains among adults with lower educational attainment and those in lower income brackets, helping to narrow some health disparities.
What this means for employers
Cancer remains the primary driver of employer health care costs, with early-stage detection dramatically reducing treatment expenses compared to late-stage disease, which can generate catastrophic and oftentimes million-dollar claims. While screening rates have improved, there is still room for improvement. Employers can encourage screenings by eliminating cost-sharing for preventive screenings, providing paid time off for appointments, offering on-site or mobile screening services and sending communications to remind employees of recommended preventive care and drive completion rates.
5. Expanding behavioral health provider network
Access to behavioral health care continued to improve, with mental health providers increasing 5% nationally between 2024 and 2025, rising from 344.9 to 362.6 providers per 100,000 population. This represents a substantial 57% increase since 2018, reflecting sustained growth in the behavioral health workforce.
In fact, 34 states saw increases of 5% or more during the most recent year, with states like Nebraska, North Dakota, Montana, West Virginia, Virginia and Maryland leading with gains of 8—10%.
Despite this provider growth, behavioral health challenges remained stable rather than improving. The percentage of adults reporting frequent mental distress (mental health not good 14 or more days in the past 30 days) held steady at 15.6% between 2023 and 2024. Depression remained constant at 22.0% of adults, and the suicide rate did not change significantly.
The need remains substantial: In 2024, 14.3M adults seriously thought about suicide, 4.6M made a plan and 2.2M attempted suicide. Furthermore, only 26.4% of the population's mental health care needs are currently being met, with more than 122M Americans living in areas with mental health professional shortages.
What this means for employers
Despite an increase in mental health providers since 2018, mental health challenges remain persistently high and significantly impact workplace productivity through absenteeism, turnover and costly complications when co-occurring with chronic physical conditions. Stable rates of mental distress despite expanded provider availability reflect growing awareness revealing previously hidden needs, ongoing societal stressors and persistent access gaps particularly in rural and underserved areas. Employers can further capitalize on expanded provider networks by ensuring comprehensive mental health coverage is at parity with physical health benefits, eliminating cost-sharing barriers for services like teletherapy, educating employees about self-help options for lower severity needs and fostering supportive workplace cultures that reduce stigma while addressing root causes such as workload and job security concerns.
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