States with rankings 1-10 have lower prevalence of mental illness and higher rates of access to care for youth. States with rankings 39-51 indicate that youth have higher prevalence of mental illness and lower rates of access to care.
The 7 measures that make up the Youth Ranking include:
- Youth with At Least One Major Depressive Episode (MDE) in the Past Year
- Youth with Substance Use Disorder in the Past Year
- Youth with Severe MDE
- Youth with MDE who Did Not Receive Mental Health Services
- Youth with Severe MDE who Received Some Consistent Treatment
- Children with Private Insurance that Did Not Cover Mental or Emotional Problems
- Students Identified with Emotional Disturbance for an Individualized Education Program.
Statistical Data for Youth Data 2021
| Rank Sort descending | State |
|---|---|
| 01 | Vermont |
| 02 | Pennsylvania |
| 03 | District of Columbia |
| 04 | Maryland |
| 05 | Massachusetts |
| 06 | New Jersey |
| 07 | Rhode Island |
| 08 | Delaware |
| 09 | Maine |
| 10 | Minnesota |
| 11 | Ohio |
| 12 | New York |
| 13 | South Dakota |
| 14 | New Hampshire |
| 15 | Wisconsin |
| 16 | Louisiana |
| 17 | Connecticut |
| 18 | Mississippi |
| 19 | Kentucky |
| 20 | Virginia |
| 21 | Nebraska |
| 22 | Iowa |
| 23 | Hawaii |
| 24 | Alabama |
| 25 | North Dakota |
| 26 | Kansas |
| 27 | Michigan |
| 28 | Indiana |
| 29 | Georgia |
| 30 | Texas |
| 31 | Missouri |
| 32 | Utah |
| 33 | California |
| 34 | Tennessee |
| 35 | Washington |
| 36 | Illinois |
| 37 | Montana |
| 38 | Florida |
| 39 | West Virginia |
| 40 | Alaska |
| 41 | Oregon |
| 42 | Colorado |
| 43 | Wyoming |
| 44 | South Carolina |
| 45 | North Carolina |
| 46 | Oklahoma |
| 47 | Arkansas |
| 48 | Idaho |
| 49 | Arizona |
| 50 | New Mexico |
| 51 | Nevada |
13.84% of youth (age 12-17) report suffering from at least one major depressive episode (MDE) in the past year.
Childhood depression is more likely to persist into adulthood if gone untreated.
The number of youth experiencing MDE increased by 206,000 from last year's dataset.
The state prevalence of youth with MDE ranges from 10.53% in the District of Columbia to 17.57% in Oregon.
Statistical Data for Youth with At Least One Major Depressive Episode (MDE) in the Past Year 2021
| Rank Sort descending | State | Percentage | Number |
|---|---|---|---|
| 01 | District of Columbia | 10.53 | 3,000 |
| 02 | New York | 11.40 | 157,000 |
| 03 | Pennsylvania | 11.88 | 109,000 |
| 04 | New Jersey | 11.95 | 82,000 |
| 05 | Mississippi | 12.15 | 29,000 |
| 06 | Tennessee | 12.27 | 63,000 |
| 07 | Georgia | 12.52 | 108,000 |
| 08 | South Dakota | 12.53 | 9,000 |
| 09 | Louisiana | 12.84 | 46,000 |
| 10 | Hawaii | 12.93 | 12,000 |
| 11 | Maryland | 13.02 | 59,000 |
| 12 | Delaware | 13.05 | 9,000 |
| 13 | Alabama | 13.13 | 49,000 |
| 14 | Florida | 13.17 | 189,000 |
| 15 | Texas | 13.20 | 325,000 |
| 16 | Rhode Island | 13.40 | 10,000 |
| 17 | South Carolina | 13.56 | 51,000 |
| 18 | Kentucky | 13.61 | 46,000 |
| 19 | California | 13.71 | 415,000 |
| 20 | Ohio | 13.73 | 123,000 |
| 21 | North Dakota | 13.75 | 7,000 |
| 22 | Massachusetts | 13.86 | 67,000 |
| 23 | Colorado | 13.99 | 60,000 |
| 24 | Minnesota | 14.04 | 61,000 |
| 25 | Nebraska | 14.20 | 22,000 |
| 26 | Connecticut | 14.24 | 39,000 |
| 27 | Virginia | 14.28 | 90,000 |
| 28 | Montana | 14.40 | 11,000 |
| 29 | Vermont | 14.65 | 6,000 |
| 30 | West Virginia | 14.66 | 18,000 |
| 31 | Arkansas | 14.74 | 35,000 |
| 32 | Missouri | 14.78 | 69,000 |
| 33 | Illinois | 14.86 | 148,000 |
| 34 | Wyoming | 14.91 | 7,000 |
| 35 | Kansas | 14.95 | 35,000 |
| 36 | North Carolina | 15.05 | 119,000 |
| 37 | New Hampshire | 15.08 | 14,000 |
| 38 | Iowa | 15.09 | 37,000 |
| 39 | Nevada | 15.11 | 35,000 |
| 40 | Alaska | 15.21 | 9,000 |
| 41 | Wisconsin | 15.31 | 68,000 |
| 42 | Michigan | 15.36 | 117,000 |
| 43 | Maine | 15.45 | 14,000 |
| 44 | Washington | 15.66 | 85,000 |
| 45 | Indiana | 15.71 | 84,000 |
| 46 | Arizona | 15.93 | 89,000 |
| 47 | Oklahoma | 16.48 | 52,000 |
| 48 | Utah | 16.64 | 51,000 |
| 49 | Idaho | 16.70 | 26,000 |
| 50 | New Mexico | 17.43 | 29,000 |
| 51 | Oregon | 17.57 | 52,000 |
| 52 | National | 13.84 | 3,449,000 |
9.7% of youth (or over 2.3 million youth) cope with severe major depression. Depression in youth often co-occurs with other disorders like substance use, anxiety and disorderly behavior.
The number of youths experiencing Severe MDE increased by 126,000 from last year's dataset.
The state prevalence of youth with Severe MDE ranges from 6.3% in Mississippi to 13.5% in Maine.
Statistical Data for Youth with Severe Major Depressive Episode 2021
| Rank Sort descending | State | Percentage | Number |
|---|---|---|---|
| 01 | Mississippi | 6.3 | 15000 |
| 02 | Alabama | 6.4 | 23000 |
| 03 | District of Columbia | 6.8 | 2000 |
| 04 | Pennsylvania | 7.1 | 64000 |
| 05 | New York | 7.8 | 105000 |
| 06 | South Dakota | 8 | 5000 |
| 07 | New Jersey | 8.1 | 54000 |
| 08 | Hawaii | 8.5 | 8000 |
| 09 | North Dakota | 8.5 | 4000 |
| 10 | Massachusetts | 8.5 | 40000 |
| 11 | California | 8.7 | 256000 |
| 12 | Colorado | 8.7 | 36000 |
| 13 | New Hampshire | 8.7 | 8000 |
| 14 | Connecticut | 9 | 24000 |
| 15 | Nebraska | 9 | 14000 |
| 16 | Ohio | 9.1 | 79000 |
| 17 | Texas | 9.2 | 219000 |
| 18 | Louisiana | 9.2 | 33000 |
| 19 | Tennessee | 9.2 | 46000 |
| 20 | Florida | 9.3 | 128000 |
| 21 | Georgia | 9.3 | 78000 |
| 22 | Delaware | 9.3 | 6000 |
| 23 | Rhode Island | 9.5 | 7000 |
| 24 | Kentucky | 9.6 | 31000 |
| 25 | Iowa | 9.8 | 23000 |
| 26 | Maryland | 9.8 | 42000 |
| 27 | Minnesota | 9.8 | 41000 |
| 28 | South Carolina | 9.8 | 36000 |
| 29 | Kansas | 9.9 | 23000 |
| 30 | Virginia | 10.2 | 62000 |
| 31 | Washington | 10.3 | 53000 |
| 32 | Montana | 10.4 | 8000 |
| 33 | Missouri | 10.4 | 47000 |
| 34 | Alaska | 10.7 | 6000 |
| 35 | Arkansas | 10.7 | 25000 |
| 36 | Vermont | 10.7 | 4000 |
| 37 | Illinois | 11 | 104000 |
| 38 | Michigan | 11.3 | 84000 |
| 39 | Nevada | 11.8 | 26000 |
| 40 | Utah | 11.9 | 36000 |
| 41 | Wyoming | 12 | 5000 |
| 42 | West Virginia | 12.5 | 15000 |
| 43 | Arizona | 12.5 | 66000 |
| 44 | North Carolina | 12.6 | 98000 |
| 45 | Idaho | 12.7 | 19000 |
| 46 | Indiana | 12.7 | 66000 |
| 47 | Oklahoma | 12.7 | 39000 |
| 48 | Oregon | 13.1 | 37000 |
| 49 | New Mexico | 13.1 | 21000 |
| 50 | Wisconsin | 13.4 | 58000 |
| 51 | Maine | 13.5 | 12000 |
| 52 | National | 9.7 | 2343000 |
3.83% of youth in the U.S. reported having a substance use disorder in the past year.
1.69% had an alcohol use disorder in the past year, while 2.85% had an illicit drug use disorder.
The state prevalence of youth with substance use disorder ranges from 3.16% in Utah to 5.61% in Vermont.
Statistical Data for Youth with Substance Use Disorder in the Past Year 2021
| Rank Sort descending | State | Percentage | Number |
|---|---|---|---|
| 01 | Utah | 3.16 | 10,000 |
| 02 | Georgia | 3.20 | 28,000 |
| 03 | Texas | 3.24 | 80,000 |
| 04 | Maryland | 3.26 | 15,000 |
| 05 | Mississippi | 3.30 | 8,000 |
| 06 | Indiana | 3.37 | 18,000 |
| 07 | New York | 3.41 | 47,000 |
| 08 | New Jersey | 3.42 | 23,000 |
| 09 | Pennsylvania | 3.42 | 31,000 |
| 10 | Virginia | 3.56 | 22,000 |
| 11 | North Carolina | 3.57 | 28,000 |
| 12 | Louisiana | 3.58 | 13,000 |
| 13 | Kansas | 3.63 | 9,000 |
| 14 | Alabama | 3.63 | 14,000 |
| 15 | Michigan | 3.64 | 28,000 |
| 16 | Missouri | 3.69 | 17,000 |
| 17 | Nebraska | 3.69 | 6,000 |
| 18 | Kentucky | 3.77 | 13,000 |
| 19 | Minnesota | 3.86 | 17,000 |
| 20 | Connecticut | 3.86 | 11,000 |
| 21 | Tennessee | 3.91 | 20,000 |
| 22 | Massachusetts | 3.92 | 19,000 |
| 23 | South Carolina | 3.95 | 15,000 |
| 24 | Idaho | 3.97 | 6,000 |
| 25 | Ohio | 3.97 | 36,000 |
| 26 | Hawaii | 4.04 | 4,000 |
| 27 | California | 4.04 | 122,000 |
| 28 | Illinois | 4.04 | 40,000 |
| 29 | Rhode Island | 4.05 | 3,000 |
| 30 | Wisconsin | 4.07 | 18,000 |
| 31 | Arizona | 4.08 | 23,000 |
| 32 | West Virginia | 4.08 | 5,000 |
| 33 | Arkansas | 4.11 | 10,000 |
| 34 | Delaware | 4.15 | 3,000 |
| 35 | Oklahoma | 4.19 | 13,000 |
| 36 | Iowa | 4.21 | 10,000 |
| 37 | Florida | 4.34 | 62,000 |
| 38 | Alaska | 4.37 | 3,000 |
| 39 | North Dakota | 4.38 | 2,000 |
| 40 | New Hampshire | 4.41 | 4,000 |
| 41 | Maine | 4.59 | 4,000 |
| 42 | Wyoming | 4.63 | 2,000 |
| 43 | Oregon | 4.65 | 14,000 |
| 44 | South Dakota | 4.78 | 3,000 |
| 45 | New Mexico | 4.80 | 8,000 |
| 46 | Washington | 5.01 | 27,000 |
| 47 | Nevada | 5.09 | 12,000 |
| 48 | Colorado | 5.12 | 22,000 |
| 49 | Montana | 5.18 | 4,000 |
| 50 | District of Columbia | 5.42 | 2,000 |
| 51 | Vermont | 5.61 | 2,000 |
| 52 | National | 3.83 | 954,000 |
59.6% of youth with major depression do not receive any mental health treatment.
Youth experiencing MDE continue to go untreated. Even among the states with greatest access for youth, over 1 in 3 youth are still not receiving the mental health services they need.
The state prevalence of untreated youth with depression ranges from 38.6% in Maine to 71.0% in Nevada.
Statistical Data for Youth with MDE who Did Not Receive Mental Health Services
| Rank Sort descending | State | Percentage | Number |
|---|---|---|---|
| 01 | Maine | 38.6 | 6000 |
| 02 | District of Columbia | 38.8 | 1000 |
| 03 | Vermont | 40.7 | 2000 |
| 04 | Maryland | 41.3 | 23000 |
| 05 | Utah | 45.2 | 22000 |
| 06 | Washington | 47 | 38000 |
| 07 | Wisconsin | 47.2 | 33000 |
| 08 | Delaware | 47.9 | 4000 |
| 09 | Kentucky | 49.3 | 19000 |
| 10 | South Dakota | 49.7 | 3000 |
| 11 | Ohio | 52.2 | 59000 |
| 12 | Virginia | 53 | 51000 |
| 13 | Indiana | 53 | 48000 |
| 14 | Iowa | 53 | 20000 |
| 15 | North Dakota | 53.4 | 3000 |
| 16 | Rhode Island | 53.4 | 5000 |
| 17 | Oregon | 53.9 | 30000 |
| 18 | Kansas | 54.7 | 19000 |
| 19 | Louisiana | 54.9 | 24000 |
| 20 | Minnesota | 55.4 | 32000 |
| 21 | Nebraska | 55.4 | 12000 |
| 22 | Montana | 55.6 | 5000 |
| 23 | Michigan | 55.7 | 66000 |
| 24 | New Jersey | 55.7 | 40000 |
| 25 | Hawaii | 56.2 | 5000 |
| 26 | Wyoming | 56.6 | 4000 |
| 27 | New Hampshire | 56.9 | 9000 |
| 28 | Pennsylvania | 57.5 | 56000 |
| 29 | Alaska | 57.8 | 5000 |
| 30 | Missouri | 58.8 | 40000 |
| 31 | New York | 59.1 | 85000 |
| 32 | Connecticut | 59.1 | 24000 |
| 33 | West Virginia | 59.3 | 11000 |
| 34 | Arizona | 59.6 | 52000 |
| 35 | North Carolina | 60.2 | 77000 |
| 36 | Colorado | 60.9 | 29000 |
| 37 | Oklahoma | 61.1 | 35000 |
| 38 | Idaho | 61.2 | 15000 |
| 39 | Massachusetts | 61.2 | 41000 |
| 40 | Tennessee | 61.5 | 35000 |
| 41 | Illinois | 62.1 | 90000 |
| 42 | New Mexico | 62.9 | 20000 |
| 43 | Arkansas | 63.9 | 23000 |
| 44 | Florida | 64.7 | 116000 |
| 45 | California | 66 | 259000 |
| 46 | Mississippi | 66.3 | 18000 |
| 47 | Texas | 67.1 | 209000 |
| 48 | South Carolina | 68 | 36000 |
| 49 | Alabama | 69.7 | 31000 |
| 50 | Georgia | 70.4 | 73000 |
| 51 | Nevada | 71 | 23000 |
| 52 | National | 59.60% | 1988000 |
High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes.
Nationally, only 27.3% of youth with severe depression receive some consistent treatment (7-25+ visits in a year).
Late recognition in primary care settings and limited coverage of mental health services often prevent youth from receiving timely and effective treatment.
The state prevalence of youth with severe depression who received some outpatient treatment ranges from 50.0% in Maine to 11.2% in Nevada.
Statistical Data for Youth with Severe MDE who Received Some Consistent Treatment 2021
| Rank Sort descending | State | Percentage | Number |
|---|---|---|---|
| 01 | Maine | 50 | 5000 |
| 02 | Maryland | 49.2 | 21000 |
| 03 | Vermont | 45.4 | 2000 |
| 04 | Delaware | 41.5 | 2000 |
| 05 | Rhode Island | 41.2 | 3000 |
| 06 | Wisconsin | 40.4 | 23000 |
| 07 | Oregon | 37.9 | 14000 |
| 08 | Massachusetts | 37.7 | 15000 |
| 09 | District of Columbia | 37.3 | 1000 |
| 10 | Pennsylvania | 37.1 | 23000 |
| 11 | Wyoming | 36.3 | 2000 |
| 12 | Ohio | 36 | 28000 |
| 13 | Nebraska | 35.9 | 5000 |
| 14 | Idaho | 35.8 | 6000 |
| 15 | New Hampshire | 34.9 | 3000 |
| 16 | Kentucky | 34.2 | 10000 |
| 17 | Minnesota | 33.7 | 13000 |
| 18 | North Dakota | 33 | 1000 |
| 19 | New Jersey | 32.5 | 16000 |
| 20 | Louisiana | 32 | 9000 |
| 21 | Kansas | 31.1 | 7000 |
| 22 | Arkansas | 30 | 7000 |
| 23 | Alaska | 29.9 | 2000 |
| 24 | Michigan | 29.8 | 24000 |
| 25 | Montana | 29.3 | 2000 |
| 26 | South Dakota | 29.2 | 1000 |
| 27 | Iowa | 28.8 | 7000 |
| 28 | South Carolina | 28.3 | 9000 |
| 29 | Hawaii | 28.3 | 2000 |
| 30 | West Virginia | 27.8 | 4000 |
| 31 | Tennessee | 27.3 | 12000 |
| 32 | Washington | 26.7 | 13000 |
| 33 | Indiana | 26.1 | 16000 |
| 34 | Virginia | 26.1 | 16000 |
| 35 | Alabama | 25.9 | 6000 |
| 36 | Texas | 25 | 54000 |
| 37 | Illinois | 25 | 26000 |
| 38 | Arizona | 24.7 | 15000 |
| 39 | California | 24.6 | 59000 |
| 40 | Utah | 24.5 | 8000 |
| 41 | Oklahoma | 23.5 | 8000 |
| 42 | New Mexico | 22.6 | 5000 |
| 43 | New York | 21.9 | 22000 |
| 44 | North Carolina | 21.9 | 21000 |
| 45 | Connecticut | 21.6 | 5000 |
| 46 | Colorado | 21.5 | 8000 |
| 47 | Florida | 19.7 | 24000 |
| 48 | Georgia | 19.2 | 15000 |
| 49 | Missouri | 19 | 9000 |
| 50 | Mississippi | 14.9 | 2000 |
| 51 | Nevada | 11.2 | 3000 |
| 52 | National | 27.3 | 614000 |
The Mental Health Parity and Addiction Equity law (MHPAE) was enacted in 2008, and promised the equal coverage of mental health and substance use services. The rate of children with private insurance that does not cover mental or emotional problems decreased 0.3% from last year's dataset. However, there are still 901,000 youth without coverage for their behavioral health.
In 2019, a Milliman research report found large disparities between behavioral health and medical/surgical services, including that patients saw out-of-network behavioral health providers at much higher rates than physical health providers. It also found that these disparities were worse for children. In 2017, a behavioral health visit for a child was over 10 times more likely to be out-of-network than a primary care office visit. This was over two times the disparity shown for adults.
To improve the worsening mental health of children and adolescents in the U.S., insurance companies must not only achieve parity in coverage of services, but also in network adequacy, so people are able to access those services when they need them.
The state prevalence of children lacking mental health coverage ranges from 0.6% in Vermont to 14.8% in South Carolina.
Statistical Data for Children with Private Insurance that Did Not Cover Mental or Emotional Problems 2021
| Rank Sort descending | State | Percentage | Number |
|---|---|---|---|
| 01 | Vermont | 0.6 | 0 |
| 02 | Massachusetts | 1.2 | 4000 |
| 03 | New Hampshire | 2.5 | 1000 |
| 04 | Connecticut | 3.3 | 5000 |
| 05 | Maine | 3.4 | 2000 |
| 06 | New Jersey | 4 | 14000 |
| 07 | District of Columbia | 4.6 | 1000 |
| 08 | Washington | 5.2 | 16000 |
| 09 | Rhode Island | 5.3 | 2000 |
| 10 | Montana | 5.4 | 2000 |
| 11 | South Dakota | 5.4 | 2000 |
| 12 | Michigan | 5.5 | 23000 |
| 13 | Wisconsin | 5.5 | 16000 |
| 14 | Ohio | 5.9 | 26000 |
| 15 | Missouri | 5.9 | 14000 |
| 16 | Alabama | 5.9 | 7000 |
| 17 | Pennsylvania | 6.1 | 29000 |
| 18 | Georgia | 6.5 | 23000 |
| 19 | Virginia | 6.6 | 21000 |
| 20 | Oregon | 6.7 | 10000 |
| 21 | Delaware | 6.9 | 3000 |
| 22 | Indiana | 7.1 | 22000 |
| 23 | Illinois | 7.2 | 34000 |
| 24 | Maryland | 7.2 | 18000 |
| 25 | West Virginia | 7.2 | 4000 |
| 26 | California | 7.5 | 100000 |
| 27 | Minnesota | 7.5 | 20000 |
| 28 | Mississippi | 7.5 | 6000 |
| 29 | Iowa | 7.5 | 10000 |
| 30 | Louisiana | 7.6 | 10000 |
| 31 | New Mexico | 7.8 | 4000 |
| 32 | Utah | 7.8 | 16000 |
| 33 | Oklahoma | 7.9 | 11000 |
| 34 | Kansas | 7.9 | 9000 |
| 35 | New York | 8.3 | 49000 |
| 36 | Colorado | 8.3 | 17000 |
| 37 | Hawaii | 9.2 | 3000 |
| 38 | Florida | 9.4 | 52000 |
| 39 | North Carolina | 10 | 33000 |
| 40 | Alaska | 10.3 | 2000 |
| 41 | Kentucky | 11 | 17000 |
| 42 | Texas | 11.5 | 108000 |
| 43 | Wyoming | 12 | 3000 |
| 44 | Arizona | 12.1 | 32000 |
| 45 | Nevada | 12.6 | 13000 |
| 46 | Nebraska | 12.6 | 10000 |
| 47 | Idaho | 12.7 | 10000 |
| 48 | North Dakota | 13.5 | 5000 |
| 49 | Tennessee | 13.5 | 27000 |
| 50 | Arkansas | 14.4 | 13000 |
| 51 | South Carolina | 14.8 | 23000 |
| 52 | National | 7.8 | 901000 |
High percentages are associated with positive outcomes and low percentages are associated with poorer outcomes
Only .757% of students are identified as having an Emotional Disturbance (ED) for an Individualized Education Program (IEP).
For purposes of an IEP, the term ìEmotional Disturbanceî is used to define youth with a mental illness that is affecting their ability to succeed in school.
Early identification for IEPs is critical. IEPs provide the services, accommodations and support students with ED need to receive a quality education. Inadequate education leads to poor outcomes such as low academic achievement, social isolation, unemployment, and involvement in the juvenile system. Further, the federal eligibility criteria to identify students as having an emotional disturbance for an IEP have indicated extremely poor reliability among school psychologists,2 and therefore must be revised to adequately identify students in need of more supports.
The rate for this measure is shown as a rate per 1,000 students.
The calculation was made this way for ease of reading.Unfortunately, doing so hides the fact that the percentages are significantly lower. If states were doing a better job of identifying whether youth had emotional difficulties that could be better supported through an IEP ñ the rates would be closer to 8% instead of .8 percent.
The state rate of students identified as having an emotional disturbance for an IEP ranges from 30.41 per 1,000 students in Vermont to 2.09 per 1,000 students in Alabama.
Statistical Data for Students Identified with Emotional Disturbance for an Individualized Education Program
| Rank Sort descending | State | Percentage | Number |
|---|---|---|---|
| 01 | Vermont | 30.41 | 2233 |
| 02 | Minnesota | 20.69 | 16510 |
| 03 | Massachusetts | 19.51 | 16935 |
| 04 | Wisconsin | 16.18 | * |
| 05 | Pennsylvania | 15.76 | 25166 |
| 06 | Maine | 14.35 | 2328 |
| 07 | Indiana | 13.41 | 12838 |
| 08 | Iowa | 13.31 | 5896 |
| 09 | New Hampshire | 12.77 | 2095 |
| 10 | Rhode Island | 12.38 | 1615 |
| 11 | District of Columbia | 12.32 | 827 |
| 12 | Connecticut | 11.94 | 5691 |
| 13 | North Dakota | 11.85 | 1183 |
| 14 | Illinois | 10.19 | 18237 |
| 15 | Nebraska | 10.06 | 2846 |
| 16 | Ohio | 9.97 | 15377 |
| 17 | South Dakota | 9.89 | 1213 |
| 18 | Oregon | 9.81 | 5286 |
| 19 | Delaware | 9.25 | 1152 |
| 20 | New York | 9.15 | 22553 |
| 21 | Missouri | 8.66 | 7072 |
| 22 | Michigan | 8.45 | 11458 |
| 23 | Virginia | 8.38 | 9782 |
| 24 | Maryland | 7.64 | 6107 |
| 25 | Mississippi | 7.62 | 3326 |
| 26 | Arizona | 7.61 | 7742 |
| 27 | Kentucky | 7.45 | 4524 |
| 28 | Oklahoma | 6.89 | 4142 |
| 29 | Colorado | 6.88 | 5596 |
| 30 | Wyoming | 6.72 | 579 |
| 31 | Texas | 6.60 | 31519 |
| 32 | Montana | 6.50 | 881 |
| 33 | Georgia | 6.45 | 10286 |
| 34 | Alaska | 6.26 | 745 |
| 35 | New Mexico | 6.16 | 1853 |
| 36 | New Jersey | 5.98 | 7485 |
| 37 | Hawaii | 5.74 | 947 |
| 38 | Florida | 5.68 | 14604 |
| 39 | Kansas | 5.53 | 2436 |
| 40 | Washington | 5.25 | 5324 |
| 41 | Idaho | 4.95 | 1372 |
| 42 | West Virginia | 4.80 | 1133 |
| 43 | Nevada | 4.43 | 1959 |
| 44 | California | 4.42 | 25118 |
| 45 | Tennessee | 3.76 | 3381 |
| 46 | North Carolina | 3.72 | 5275 |
| 47 | Utah | 3.17 | 1918 |
| 48 | South Carolina | 3.04 | 2112 |
| 49 | Louisiana | 2.70 | 1715 |
| 50 | Arkansas | 2.42 | 1070 |
| 51 | Alabama | 2.09 | 1406 |
| 52 | National | 7.57 | 344473 |