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Every month, the CDC releases Vital Signs—a data-driven alarm bell highlighting the most urgent health threats facing Americans. These are early warning signals about crises that could affect you, your family, and your community.
The picture that emerges from these reports is sobering. Healthcare workers are burning out at unprecedented rates, threatening the stability of our medical system. Preventable infections are killing thousands in hospitals that should be healing them. Millions of Americans lack basic health insurance, turning treatable conditions into life-threatening emergencies. Mental health crises are driving suicide rates that vary dramatically based on where you live and how much you earn.
But Vital Signs isn’t just about problems—it’s about solutions. Each report combines hard data with actionable recommendations for individuals, healthcare providers, and policymakers. Here’s what the latest data reveals about America’s health challenges and what we can do about them.
The Healthcare System Under Stress
Healthcare Workers in Crisis
America’s healthcare workforce is facing a mental health emergency that threatens the foundation of our medical system. This isn’t about individual weakness—it’s a systemic crisis that COVID-19 intensified but didn’t create.
The numbers tell a stark story. Between 2018 and 2022, healthcare workers reported their mental health was “not good” for an average of 4.5 days per month, up from 3.3 days. Nearly half (46%) reported feeling burned out often or very often in 2022, a dramatic jump from 32% just four years earlier.
The workplace has become increasingly hostile. Reports of harassment from patients and coworkers more than doubled over the same period, climbing from 6.4% to 13.4%. These conditions have consequences: 44% of healthcare workers said they were likely to look for new jobs within the next year.
The feedback loop of failure: This creates a vicious cycle. Harassment and workplace stress fuel burnout and high turnover. Staff departures worsen the very shortages that stress remaining workers. Stressed, understaffed teams are more likely to make medical errors and provide lower-quality care. Poor patient experiences can fuel public frustration and more healthcare worker harassment, completing the destructive cycle.
What needs to happen:
Employers must: Improve staffing levels so workers have adequate time to complete their work. Train supervisors to provide real support and resources. Take zero-tolerance approaches to harassment. Involve workers in decision-making and encourage use of paid leave for recovery.
Government must: Address punitive policies like intrusive mental health questions on licensing applications that deter healthcare workers from seeking care. Continue investing in programs like the Dr. Lorna Breen Health Care Provider Protection Act for mental health and resiliency training.
The public must: Treat healthcare workers with understanding, kindness, and respect. Follow public health guidelines to reduce overall burden on the healthcare system.
Healthcare workers must: Recognize signs of distress in themselves and colleagues. Stay connected with peers and reach out for help—it’s a sign of strength, not weakness. Confidential support is available 24/7 through the 988 Suicide & Crisis Lifeline.
Hospital Infections and Antibiotic Resistance
Modern medical procedures that save lives can also create vulnerabilities. Surgeries, catheters, and other treatments can serve as pathways for dangerous bacteria to enter the body, leading to healthcare-associated infections (HAIs).
The threat is magnified by antibiotic resistance—bacteria evolving to defeat the drugs designed to kill them. Every instance of poor antibiotic prescribing puts patients at risk and fuels development of “superbugs.”
Healthcare-associated infections directly contribute to sepsis cases. A urinary tract infection from a contaminated catheter or pneumonia after surgery can quickly escalate into sepsis—the body’s overwhelming and often fatal response to infection. This means every failure in basic infection control is a direct risk factor for sepsis.
The “protect every patient every time” strategy:
Prevent infections from medical devices: Use invasive devices like catheters only when absolutely necessary and remove them immediately when no longer needed. Maintain strict adherence to sterile techniques and evidence-based safety recommendations.
Prevent bacteria spread within facilities: Rigorous hand hygiene by all staff, patients, and visitors. Use isolation precautions for patients with antibiotic-resistant bacteria. Maintain awareness of HAI outbreaks in the region to coordinate prevention efforts.
Improve antibiotic use: In urgent situations like suspected sepsis, obtain cultures to identify bacteria and start appropriate antibiotics promptly. Use culture results to reassess treatment plans, switching to targeted antibiotics when possible or stopping drugs if infection is ruled out. Every prescription should be the right drug, at the right dose, for the shortest effective duration.
More information on national progress is available in the CDC’s comprehensive HAI progress report.
The Coverage Gap Crisis
Access to health insurance is a critical health determinant, yet millions of Americans lack this fundamental protection. Being uninsured isn’t a benign status—it has direct, dangerous consequences.
Approximately 50 million adults aged 18-64 had been uninsured for at least part of a year, with numbers increasing by 1.1 million annually before major healthcare reforms.
The cascade of consequences:
Delayed and forgone care: The most immediate impact is delaying or avoiding necessary medical care due to cost—particularly dangerous for the 40% of Americans living with chronic conditions.
Worsening chronic conditions: Over 40% of uninsured adults with serious conditions like high blood pressure, asthma, or diabetes had skipped or delayed care because they couldn’t afford it. This allows manageable conditions to progress into severe health crises.
Lack of continuous care: More than half of adults uninsured for over a year reported having no usual source of medical care, missing out on disease management and crucial preventive services.
The economic case for coverage: When uninsured individuals with chronic conditions like hypertension forgo treatment, conditions worsen, potentially culminating in extraordinarily expensive emergencies like strokes or heart attacks. The cost of treating a single acute event can dwarf the cost of many years of affordable medications and preventive check-ups.
Solutions require multiple approaches:
Individuals: Adopt healthy habits like balanced diet and regular exercise. Quit smoking. Take prescribed medicines and explore assistance programs if cost is a barrier. Sign up for health insurance and establish relationships with primary care providers.
Employers: Offer comprehensive wellness programs and affordable health insurance options covering treatment, primary care, and prevention.
Providers and health plans: Integrate preventive care into every patient visit. Support making basic care more convenient through partnerships with community sites like schools, churches, and retail centers.
Government: Federal legislation like the Affordable Care Act has made strides by requiring many insurance plans to cover effective preventive services without co-payments. The CDC estimates greater use of these services could save 100,000 lives annually.
Chronic Conditions and Acute Threats
The Silent Killer: High Blood Pressure
High blood pressure, or hypertension, is called the “silent killer” because it typically has no symptoms until causing severe damage. It’s a primary risk factor for heart disease and stroke—two leading U.S. death causes—contributing to nearly 1,000 deaths daily.
Nearly one in three American adults (approximately 67 million people) has high blood pressure. Of this group, about 36 million don’t have their condition under control (generally defined as below 140/90 mmHg). People with hypertension are four times more likely to die from stroke and three times more likely to die from heart disease than those with normal blood pressure.
The control paradox: Most people with uncontrolled hypertension are already engaged with the healthcare system. They know about their condition, see doctors, and take prescribed medications. This isn’t a problem of public ignorance—it’s a problem of system effectiveness and sustained patient engagement.
The failure occurs in daily life’s “in-between” spaces: inconsistent medication adherence, lifestyle modification challenges, and lack of consistent follow-up. Traditional healthcare models centered on brief, episodic doctor visits are insufficient for managing chronic conditions like hypertension.
The team-based solution:
Patients: Know your numbers and understand what they mean. Take medication exactly as prescribed. Learn to measure blood pressure at home for a complete picture. Adopt healthy, low-sodium diets, get regular physical activity, maintain healthy weight, limit alcohol, and quit smoking.
Healthcare providers: Make blood pressure control a priority at every visit, not just annual physicals. Adopt team-based care approaches where nurses, medical assistants, and pharmacists work together to educate and support patients. Simplify treatment regimens when possible, like once-daily medications.
Health systems: Leverage technology to drive improvement. Use electronic health records and patient registries to identify, track, and proactively follow up with all diagnosed patients. Configure systems to automatically alert doctors to high readings.
More information is available from the CDC Vital Signs homepage.
When Infection Turns Deadly: Sepsis
Sepsis is a medical emergency—the body’s extreme, life-threatening response to existing infections. When infection-fighting processes turn on themselves, they trigger cascades of changes leading to widespread inflammation, tissue damage, organ failure, and death.
Sepsis isn’t a disease itself but rather the catastrophic complication of untreated or undertreated infections. Any infection—bacterial, viral, or fungal—can lead to sepsis.
Common infection sources:
- Lungs: 35% of cases, often starting as pneumonia
- Urinary tract: 25% of cases, from kidney or bladder infections
- Gut/gastrointestinal tract: 11% of cases
- Skin: 11% of cases, often from infected wounds or cellulitis
Sepsis represents cascading failures. Failure to manage chronic conditions like diabetes can lead to non-healing foot ulcers that become infected. Hospital infection control failures can result in catheter-associated urinary tract infections. Failure to get recommended flu or pneumonia vaccines leaves individuals vulnerable to severe lung infections. Failure to recognize worsening infection signs allows escalation.
From this perspective, initiatives improving diabetes care, enhancing hospital safety, and boosting vaccination rates are fundamentally anti-sepsis campaigns.
Key sepsis warning signs:
- Shivering, fever, or feeling very cold
- Extreme pain or discomfort (“worst ever”)
- Clammy, sweaty, pale, or discolored skin
- Confusion, disorientation, or sleepiness
- Shortness of breath
- High heart rate
Four-part prevention strategy:
Prevent initial infections: Diligent chronic illness management like diabetes. Practice good hand hygiene and stay current on vaccinations for influenza and pneumonia.
Educate patients and families: Teach signs that infections are worsening and specific sepsis symptoms. This knowledge empowers immediate medical attention seeking.
Think sepsis, act fast: Healthcare providers must maintain high suspicion for sepsis in any infected patient. Treat as time-sensitive emergency with immediate tests, broad-spectrum antibiotics, and IV fluids.
Reassess and manage continuously: Monitor patient progress closely, using test results to adjust antibiotic therapy. Ensure smooth, well-coordinated care transitions to other settings like rehabilitation facilities.
The CDC provides helpful information and infographics on sepsis at their archived sepsis page.
Dialysis and Health Disparities
For Americans with end-stage kidney disease, life-sustaining dialysis creates dramatically increased vulnerability to dangerous bloodstream infections (BSIs). The treatment requires frequent, direct circulatory system access, creating potential gateways for germs.
During 2017-2020, adults on dialysis were 100 times more likely to contract staph bloodstream infections than adults not on dialysis. This threat affects over 800,000 Americans with end-stage kidney disease, more than half from racial or ethnic minority groups.
Profound disparities: Black and Hispanic dialysis patients experience significantly higher staph BSI rates than White patients. Higher infection rates are also linked to community-level poverty, household crowding, and lower education levels.
These disparities reflect how structural inequities manifest as clinical problems. The highest-risk dialysis access method—central venous catheters—often indicates urgent-start dialysis when kidney disease progresses to failure without proactive planning needed for lower-risk fistulas. Crisis-driven treatment starts are more common in communities facing barriers to consistent primary and specialty care.
Access types and infection risk:
High risk – Central venous catheter: Soft plastic tube inserted into large neck, chest, or groin veins. Useful for short-term or emergency dialysis but carries highest infection risk.
Medium risk – Graft: Surgically implanted synthetic tube connecting artery to vein under skin.
Low risk – Fistula: Gold standard direct surgical connection between artery and vein, typically in arm. Most durable with lowest infection risk.
Prevention strategies:
Patients: Practice frequent hand hygiene. Learn to recognize access site infection signs like redness, pain, swelling, or pus, and report immediately. Ask doctors if lower-risk fistula or graft options are viable for long-term care.
Providers and dialysis facilities: Strict adherence to proven infection prevention protocols including hand hygiene and sterile catheter care techniques. Educate patients on different access type risks and benefits. Work to reduce central venous catheter use by coordinating with vascular surgeons to create fistulas or grafts well in advance.
Public health: Ultimate prevention involves slowing chronic kidney disease progression through broad efforts helping people manage primary drivers: diabetes and high blood pressure. Address social and economic barriers like lack of insurance and transportation contributing to care disparities.
Resources are available from the CDC’s Dialysis Safety page, the National Kidney Foundation, and government sites like govfacts.org.
Community Safety and Environmental Threats
Rising Drowning Deaths
Drowning is swift, silent, and devastating—a leading death cause for America’s youngest citizens. Recent CDC data reveals deeply troubling spikes in drowning fatalities, underscoring urgent need for renewed focus on this entirely preventable crisis.
From 2020 to 2022, an average of more than 4,500 people drowned annually in the United States—approximately 500 additional deaths yearly compared to 2019 baseline.
High-risk groups:
Young children: Drowning is the number one death cause for children ages 1-4. In 2022, drowning deaths in this age group surged 28% compared to 2019.
Older adults: Adults 65 and older have the second-highest drowning rates of any age group.
Racial and ethnic disparities: Black people’s drowning death rates were 28% higher in 2021 than 2019. American Indian and Alaska Native people consistently have the highest drowning rates of any racial or ethnic group.
The swimming lesson gap: More than half of U.S. adults (55%) report never taking swimming lessons. This gap is more pronounced in minority communities: 63% of Black adults and 72% of Hispanic adults never had swimming lessons.
This skill deficit isn’t random but rooted in complex historical and economic factors. Generations of racial segregation at public swimming facilities, combined with high costs and lack of access to pools and lessons in many lower-income communities, created legacies of intergenerational water fear and critical life-saving skill deficits.
| Metric | 2019 (Baseline) | 2020-2022 (Average) | Change |
|---|---|---|---|
| Total Annual Drowning Deaths | ~4,000 | >4,500 | +~500/year |
| Children 1-4 Deaths | Baseline | 2022 Data | +28% |
| Adults 65-74 Deaths | Baseline | 2022 Data | +19% |
| Black People Deaths | Baseline | 2021 Data | +28% |
Multiple layers of protection:
Learn life-saving skills: Basic swimming and water safety training for all individuals, especially children. Community organizations like YMCA and American Red Cross provide these lessons.
Use barriers: Four-sided isolation fences completely separating pools from houses and yards, with self-closing, self-latching gates preventing unsupervised child access.
Wear life jackets: In natural water bodies like lakes, rivers, oceans, children and non-swimmers should always wear U.S. Coast Guard-approved life jackets. Critical during boating activities.
Supervise attentively: Drowning is silent and can happen in under a minute. Children in or near water require constant, undivided adult attention—put away phones and avoid distractions.
Comprehensive community action frameworks are detailed in the U.S. National Water Safety Action Plan.
Suicide: Community Conditions Matter
Suicide is a devastating public health crisis—a leading U.S. death cause. More than 49,000 people died by suicide in 2022, averaging one person every 11 minutes. While individual mental health is critical, groundbreaking CDC research illuminated powerful roles that community-level factors play in protection.
This reframes prevention as public and economic policy issues. Strong inverse correlations between suicide rates and factors like income, insurance coverage, and internet access demonstrate that poverty reduction policies, healthcare access expansion through legislation like the Affordable Care Act, and digital divide closure are powerful suicide prevention policies.
Community protective factors and suicide rate reductions:
| Community Factor | Suicide Rate Reduction | Why It Protects |
|---|---|---|
| Health Insurance Coverage | 26% Lower | Access to mental & physical healthcare; crisis services |
| Broadband Internet Access | 44% Lower | Access to telehealth; job opportunities; social connection |
| Household Income | 13% Lower | Reduced financial strain; ability to meet basic needs |
These characteristics offer protection through clear mechanisms:
Health insurance: Provides affordable access to mental and physical healthcare, including therapy, medication, and critical crisis intervention services.
Internet access: Serves as modern lifeline connecting people to job opportunities, educational resources, and vital telehealth services. Most importantly, helps maintain strong social connections, reducing profound isolation that’s a major suicide risk factor.
Income: Directly alleviates financial strain—a well-documented driver of stress and despair. Stable, sufficient income allows families to meet basic needs for housing, food, and healthcare, providing security foundations that protect against suicide risk.
Comprehensive prevention approach:
Strengthen economic supports: Policies improving household financial security and housing stability are foundational to prevention.
Create protective environments: Reduce access to lethal means like firearms and unsecured prescription medications for at-risk individuals. Foster supportive, healthy cultures in schools and workplaces.
Improve healthcare access: Ensure health insurance plans provide robust mental health coverage. Increase providers in underserved areas, including through telehealth.
Promote healthy connections: Foster community engagement through shared activities and promote healthy peer norms to combat social isolation.
Teach coping skills: Social-emotional learning programs in schools and parenting skill programs improving family relationships build resilience from young ages.
Identify and support at-risk people: Learn suicide warning signs including talking about feeling hopeless or being burdens, withdrawing from others, and increasing substance use. Use “5 Action Steps”: Ask directly about suicide thoughts; Be There for them; Keep Them Safe by reducing lethal means access; Help Them Connect with resources; Follow Up to show continued care.
For immediate, confidential 24/7 support, call or text 988 Suicide & Crisis Lifeline or chat online.
Comprehensive prevention resources are available through the CDC’s Suicide Prevention Resource for Action.
Vector-Borne Disease Surge
Diseases spread by infected mosquito, tick, and flea bites pose growing, significant threats to American health. Reported cases of these vector-borne diseases more than tripled between 2004 and 2016. During the same period, nine new germs spread by these vectors were discovered in or introduced to the U.S. and territories.
Over 640,000 cases of diseases from mosquito, tick, and flea bites were reported from 2004 to 2016. Tick-borne diseases, notably Lyme disease, doubled. Mosquito-borne disease epidemics including Zika, West Nile virus, and Chikungunya outbreaks became more frequent and widespread.
This escalating threat reflects larger global trends. Changing climate can expand geographic ranges and lengthen active seasons for vectors like ticks and mosquitoes. Modern commerce and global travel rapidly transport infected travelers, insects, and germs across the world into newly hospitable areas.
Critical preparedness gap: About 8 in 10 state and local vector control organizations—the nation’s primary defense—report lacking one or more critical prevention and control capacities.
Key U.S. diseases of concern:
Mosquito-borne: West Nile virus, Zika virus, Dengue viruses, Chikungunya virus
Tick-borne: Lyme disease, Anaplasmosis/Ehrlichiosis, Spotted Fever Rickettsiosis (including Rocky Mountain Spotted Fever)
Multi-level protection strategies:
Individuals: Use EPA-registered insect repellents on exposed skin when outdoors in wooded, grassy, or brushy areas. Wear long-sleeved shirts and long pants. Treat clothing, boots, and camping gear with permethrin insecticide or purchase pre-treated items. Control ticks and fleas on household pets to prevent vector introduction into homes.
State and local agencies: Build and sustain robust surveillance programs testing and tracking mosquitoes, ticks, and germs they carry. Use data to drive local control decisions like targeted vector elimination at every life cycle stage. Conduct public education campaigns on personal protection.
Federal government: Coordinate and research efforts. Convene bodies like the Tick-Borne Disease Working Group to improve federal efforts. Invest in research and development of better diagnostic tests, treatments, and vaccines.
More information is available from the CDC’s Division of Vector-Borne Diseases.
Maternal Health Crisis
Mistreatment and Discrimination in Maternity Care
For too many American women, bringing children into the world is marred by disrespect, mistreatment, and discrimination from healthcare systems entrusted with their care. These aren’t poor customer service issues—they’re patient rights violations directly linked to life-threatening complications and significant contributors to the maternal mortality crisis.
The problem is felt most acutely by women of color, who report mistreatment at alarmingly high rates.
The scope of mistreatment: One in five women (20%) reported experiencing some form of mistreatment during maternity care. Most common forms included being ignored or having help requests refused (9.7%), being shouted at or scolded by providers (6.7%), and having physical privacy violated (5.1%).
The self-censorship crisis: A staggering 45% of mothers reported holding back from asking questions or sharing health concerns with providers. Top reasons: feeling embarrassed, not wanting to be seen as “difficult,” or thinking potentially dangerous symptoms were just “normal” pregnancy parts.
This reveals how dismissal of women’s pain has been normalized within healthcare culture. When providers ignore patient concerns, it reinforces self-doubt, making patients even less likely to speak up again. This enforced silence can be deadly—open communication is essential for timely diagnosis of urgent maternal warning signs for conditions like preeclampsia or hemorrhage.
Stark disparities in treatment:
| Group | Percentage Reporting Mistreatment |
|---|---|
| All Mothers | 20.4% |
| White Mothers | 17.8% |
| Black Mothers | 30.0% |
| Hispanic Mothers | 29.3% |
| Multiracial Mothers | 27.3% |
| Asian Mothers | 14.8% |
| Public Insurance | 26.1% |
| No Insurance | 28.1% |
| Private Insurance | 15.9% |
Nearly one in three Black, Hispanic, and multiracial mothers reported mistreatment. Nearly 30% of all mothers reported experiencing discrimination—a figure rising to 40% for Black and multiracial mothers. While age and weight were common discrimination reasons, Black mothers were highly likely to report race or skin color as reasons for poor treatment.
Creating respectful maternity care:
Providers and health systems: Actively listen to patients and take concerns seriously. Invest in training for all staff to recognize and combat unconscious bias and stigma. Implement cultures of respectful, equitable care from top down using tools like patient safety bundles explicitly including respectful care standards. Integrate community-based providers like doulas and midwives into care teams.
Patients and families: Empower yourself with knowledge. Learn urgent maternal warning signs for pregnancy complications. Feel empowered to speak up, ask questions, and voice concerns when something doesn’t feel right. Have friends, partners, or family members present during appointments and delivery for advocacy and support.
Public health: Support programs like ERASE MM (Enhancing Reviews and Surveillance to Eliminate Maternal Mortality) analyzing every maternal death to understand causes and identify prevention opportunities. Public awareness campaigns like the CDC’s “Hear Her” are vital for empowering patients to recognize warning signs and communicate effectively with providers.
For mothers experiencing mental health challenges, the National Maternal Mental Health Hotline provides free, confidential support at 1-833-TLC-MAMA (1-833-852-6262).
The Path Forward
The challenges outlined in these Vital Signs reports might seem overwhelming, but they share common themes that point toward solutions:
Systems matter more than individual choices: Whether it’s healthcare worker burnout, antibiotic resistance, or suicide rates, these problems stem from systemic issues that require systemic solutions. Individual resilience and personal responsibility matter, but they’re not enough to address problems rooted in how we organize and fund healthcare, design communities, and structure economic opportunities.
Prevention is more effective than treatment: Every section of this report shows that preventing problems is more cost-effective and lifesaving than treating them after they occur. Preventing infections is cheaper than treating sepsis. Preventing drowning through swimming lessons and safety measures costs less than emergency response. Preventing suicide through economic supports and community connections saves more lives than crisis intervention alone.
Health equity isn’t optional: The disparities highlighted throughout these reports—from maternal care to dialysis infections to drowning deaths—aren’t accidents. They’re the predictable results of historical and ongoing inequities in access, resources, and treatment. Addressing health disparities isn’t just morally imperative; it’s necessary for protecting everyone’s health.
Data drives effective action: The CDC’s Vital Signs reports work because they combine rigorous data collection with clear, actionable recommendations. Communities, healthcare systems, and individuals who use this data to guide their decisions see better outcomes.
The solutions exist. We know how to prevent healthcare-associated infections, reduce suicide rates, improve maternal care, and address most of the challenges highlighted in these reports. The question isn’t whether we can solve these problems—it’s whether we have the will to implement solutions at the scale and speed necessary to save lives.
Every month, Vital Signs provides updated data on these and other pressing health challenges. By staying informed and taking action based on the best available evidence, individuals, communities, and policymakers can help build a healthier, more equitable future for all Americans.
For the latest Vital Signs reports and detailed information on these and other health topics, visit the CDC Vital Signs website.
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