Georgia ranks 50th in the nation on the amount of dollars spent on tobacco use prevention.
/PRNewswire/ -- The states are collecting record amounts of revenue from the 1998 tobacco settlement and tobacco taxes, but have cut funding for programs to reduce tobacco use by more than 15 percent in the past year, according to a report released today by a coalition of public health organizations.
With the nation's adult smoking rate stalled after decades of decline, the report warns that continued progress is at risk unless states significantly increase funding for programs to prevent kids from smoking and help smokers quit. The report also calls on Congress to ensure that health care reform legislation includes adequate funding for disease prevention initiatives, including tobacco prevention and cessation, and mandates coverage in Medicaid and other health insurance programs for smoking cessation medication and counseling.
The report, titled "A Broken Promise to Our Children: The 1998 State Tobacco Settlement 11 Years Later," was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association and Robert Wood Johnson Foundation. These organizations have issued annual reports assessing whether the states have kept their promise to use funds from the state tobacco settlements - estimated to total $246 billion over the first 25 years - to fight tobacco use. The states also collect billions more each year from tobacco taxes.
Key findings of this year's report include:
-- The states this year (Fiscal Year 2010) will collect $25.1 billion in
revenue from the tobacco settlement and tobacco taxes, but are
spending just 2.3 percent of it - $567.5 million - on tobacco
prevention and cessation programs (the states also receive $62 million
in federal grants for tobacco prevention, for total funding of $629.5
million). With more states expected to increase tobacco taxes in the
coming year, that revenue figure is certain to increase.
-- In the past year, states have cut funding for tobacco prevention by
$103.4 million, or 15.4 percent. Including cuts approved just last
week, New York made the largest cut - $25.2 million, or 31 percent -
despite having a successful program that has reduced smoking to well
below national rates. Other states with large cuts include Colorado,
Maryland, Pennsylvania and Washington.
-- Only one state - North Dakota - currently funds a tobacco prevention
program at the level recommended by the U.S. Centers for Disease
Control and Prevention (CDC). Only nine other states fund tobacco
prevention at even half the CDC-recommended level, while 31 states and
DC provide less than a quarter of the recommended funding.
-- Tobacco companies spend $20 to market tobacco products for every one
dollar the states spend to fight tobacco use. According to the latest
data from the Federal Trade Commission, tobacco companies spend $12.8
billion a year on marketing.
The report comes as recent surveys have found that smoking declines in the United States have slowed and even stalled. The CDC in November reported that the adult smoking rate in 2008 was 20.6 percent - essentially unchanged since 2004 when 20.9 percent smoked. While smoking among high school students has declined by 45 percent from a high of 36.4 percent in 1997, 20 percent of high schoolers still smoke and declines have slowed in recent years.
"To continue reducing tobacco use, elected officials at all levels must resist complacency and redouble efforts to implement proven strategies," said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. "Despite their current budget challenges, the states lack excuses for failing to do more. They are collecting record amounts of tobacco money, more of which should be used to fight the tobacco problem. And there is overwhelming evidence that tobacco prevention programs not only reduce smoking and save lives, they also save money by reducing tobacco-related health care costs. Those states that make short-sighted decisions to cut tobacco prevention will pay a steep price in lives and dollars."
"The inadequate funding of tobacco prevention and cessation programs is a powerful example of misplaced priorities in our nation's health care system," said Risa Lavizzo-Mourey, M.D., M.B.A., President and CEO of the Robert Wood Johnson Foundation. "We spend too much on treating people after they get sick and too little on keeping them healthy in the first place. Investing more in proven tobacco prevention programs and policies, like smoke-free restaurants and workplaces, will help people lead healthier lives and reduce health care costs."
"There is absolutely no question that the devastating toll and financial burden of tobacco use is a huge drain on our nation's economy and contributor to spiraling health care costs," said Nancy Brown, CEO of the American Heart Association. "It's a travesty that only a small fraction of tobacco settlement funds is actually being used to support tobacco prevention programs in states. If we allow this to continue, how can we expect to ever realize the true potential of settlement dollars to save lives and improve the physical and economic health of this country."
"Fully funded tobacco prevention and cessation programs stop addiction before it starts and improve the health of our nation's communities," said John R. Seffrin, Ph.D., chief executive officer of the American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society. "States must do better at funding programs that help reduce tobacco use and protect the health of children, 3,500 of whom try their first cigarette every day."
"As more states are turning to tobacco taxes to help during these difficult economic times, states need to spend a portion of the revenue on tobacco prevention and control programs - especially those programs to help smokers quit," said Charles D. Connor, American Lung Association President and CEO. "Increasing tobacco taxes is a proven and effective way to reduce the number of adults and youth who smoke, but as they make tobacco products more expensive states also have a responsibility to ensure that the nearly 46 million smokers in this country have the help they need to quit."
The report cites conclusive evidence that tobacco prevention and cessation programs work to reduce smoking, save lives and save money. Maine, which has long had one of the best-funded programs, has reduced smoking by 71 percent among middle school students and by 64 percent among high school students since 1997. Washington state, before cutting its program by 42 percent this year, reduced adult smoking by 30 percent and youth smoking by 50. An August 2008 study found that California's tobacco control program, the nation's longest-running, saved $86 billion in health care costs in its first 15 years, compared to $1.8 billion spent on the program, for a return on investment of nearly 50:1.
Tobacco use is the leading preventable cause of death in the U.S., killing more than 400,000 people and costing $96 billion in health care bills each year. Every day, another 1,000 kids become regular smokers - one-third of them will die prematurely as a result.
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Showing posts with label states. Show all posts
Showing posts with label states. Show all posts
Wednesday, December 09, 2009
Thursday, October 15, 2009
Most States Fail to Adequately Protect the Legal Rights of Abused Children, New Study Finds
/PRNewswire/ -- Most U.S. states do not adequately protect the rights of abused and neglected children, leaving our most vulnerable citizens exposed to the vagaries of the juvenile court system without adequate legal representation, according to a state-by-state study conducted by two national child advocacy organizations.
The peer-reviewed study -- A Child's Right to Counsel: A National Report Card on Legal Representation for Abused and Neglected Children -- was released today on Capitol Hill by First Star and the Children's Advocacy Institute at the University of San Diego School of Law (CAI). To view the full report, visit www.firststar.org, or www.caichildlaw.org.
"The federal government reported that nearly 800,000 children were abused or neglected in 2007," said Amy Harfeld, Executive Director of First Star. "In the current economic recession, these children are suffering more than ever - reports of child abuse have skyrocketed while resources to help them have been placed in jeopardy. Most of these children will go through court proceedings that will determine their lives and futures. Yet while the state and the allegedly abusive or neglectful parent stand in court with attorneys by their sides, the children often stand alone and silent. They are herded through the system without a strong voice to advocate on their behalf. This is a troubling double-standard."
The report graded each state and the District of Columbia based on how well they protect the legal rights of abused and neglected children in dependency court. Twenty-nine states earned C's or lower:
-- Two states earned A+'s: Connecticut and Massachusetts
-- 9 states earned A's: Iowa, Louisiana, Maryland, Mississippi, New
Mexico, New York, Oklahoma, Vermont, and West Virginia
-- 11 states earned B's: California, Kansas, New Jersey, North Carolina,
Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, and
Wyoming
-- 14 states earned C's: Alabama, Alaska, Arkansas, Colorado, Michigan,
Minnesota, Montana, Nebraska, Nevada, South Carolina, Utah, Virginia,
Washington DC, and Wisconsin
-- 8 states earned D's: Arizona, Georgia, Illinois, Kentucky, Missouri,
New Hampshire, South Dakota, and Washington
-- 7 states earned F's: Delaware, Florida, Hawaii, Idaho, Indiana, Maine,
and North Dakota
"The level of legal protection these children receive should not vary depending on what state they call home," said Robert C. Fellmeth, CAI Executive Director. "The stakes in these cases are high for all involved, but especially for the child. Yet, in many states, not only have they been betrayed and mistreated by their own parents, they have also been abandoned by the very system that is supposed to protect their rights and their lives."
The study is the second of its kind. The first report, issued in April 2007, prompted 17 states to adopt new legislation in the right to counsel arena. In addition, advocates in many states have proposed legislative reforms, filed litigation, or launched other efforts to ensure children's rights are protected. States with improved laws include: Alabama, Arkansas, California, Connecticut, Iowa, Louisiana, Massachusetts, New Hampshire, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Vermont and Wyoming.
In addition, the federal government recently announced a five-year, $5 million grant to research the benefits of providing counsel to children in these proceedings. Up to now, research has been scarce.
"The tide is turning," said Peter Samuelson, co-founder and Chairman of First Star. "Many jurisdictions are moving beyond the old legal paradigm that treated children as chattel, and are recognizing that their opinions are valuable in court proceedings that determine their futures. But there is still a long way to go before we create uniform, nationwide legal protections for these vulnerable children."
To build on this momentum, First Star and CAI recommend:
-- An amendment to the federal Child Abuse Prevention and Treatment Act
(CAPTA) that would require all abused and neglected foster children
receive quality client-directed representation in dependency
proceedings;
-- Passage by the American Bar Association of a Model Act that would
serve as a prototype for states to establish uniform standards for
representing children in dependency cases;
-- Implementation of a loan forgiveness program for child advocate
attorneys, since compensation is prohibitively low;
-- Adoption of caseload limits of 100 clients so attorneys can focus
enough attention on each case;
-- Support to ensure that abused and neglected children receive quality
representation in all court proceedings that determine their futures.
State grades were based on a rigorous examination of state law by leading national child welfare experts, who established guiding principles and developed a 100-point grading system. Criteria included: whether state law mandates that attorneys be appointed for children in dependency proceedings; whether these attorneys represent the children in a client-directed manner; whether this representation continues throughout the case, including appeal; whether states have specialized education or training of a child's counsel; whether the child is given the legal status of a party to the proceedings; and whether rules pertaining to confidentiality and immunity from liability apply to attorneys representing these children. Extra credit was given if states have mandatory caseload limits for children's counsel. Officials and/or advocates from each state participated in the process and provided valuable feedback.
"We hope this Report Card will become a tool to increase public awareness of this issue, a rallying cry for advocates and lawmakers in poorly performing states, and a source of pride for states that have enacted strong laws," said Elisa Weichel, CAI's Administrative Director & Staff Attorney. "Tremendous progress has been made in the last two years; it is our aim to build on that momentum."
-----
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The peer-reviewed study -- A Child's Right to Counsel: A National Report Card on Legal Representation for Abused and Neglected Children -- was released today on Capitol Hill by First Star and the Children's Advocacy Institute at the University of San Diego School of Law (CAI). To view the full report, visit www.firststar.org, or www.caichildlaw.org.
"The federal government reported that nearly 800,000 children were abused or neglected in 2007," said Amy Harfeld, Executive Director of First Star. "In the current economic recession, these children are suffering more than ever - reports of child abuse have skyrocketed while resources to help them have been placed in jeopardy. Most of these children will go through court proceedings that will determine their lives and futures. Yet while the state and the allegedly abusive or neglectful parent stand in court with attorneys by their sides, the children often stand alone and silent. They are herded through the system without a strong voice to advocate on their behalf. This is a troubling double-standard."
The report graded each state and the District of Columbia based on how well they protect the legal rights of abused and neglected children in dependency court. Twenty-nine states earned C's or lower:
-- Two states earned A+'s: Connecticut and Massachusetts
-- 9 states earned A's: Iowa, Louisiana, Maryland, Mississippi, New
Mexico, New York, Oklahoma, Vermont, and West Virginia
-- 11 states earned B's: California, Kansas, New Jersey, North Carolina,
Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, and
Wyoming
-- 14 states earned C's: Alabama, Alaska, Arkansas, Colorado, Michigan,
Minnesota, Montana, Nebraska, Nevada, South Carolina, Utah, Virginia,
Washington DC, and Wisconsin
-- 8 states earned D's: Arizona, Georgia, Illinois, Kentucky, Missouri,
New Hampshire, South Dakota, and Washington
-- 7 states earned F's: Delaware, Florida, Hawaii, Idaho, Indiana, Maine,
and North Dakota
"The level of legal protection these children receive should not vary depending on what state they call home," said Robert C. Fellmeth, CAI Executive Director. "The stakes in these cases are high for all involved, but especially for the child. Yet, in many states, not only have they been betrayed and mistreated by their own parents, they have also been abandoned by the very system that is supposed to protect their rights and their lives."
The study is the second of its kind. The first report, issued in April 2007, prompted 17 states to adopt new legislation in the right to counsel arena. In addition, advocates in many states have proposed legislative reforms, filed litigation, or launched other efforts to ensure children's rights are protected. States with improved laws include: Alabama, Arkansas, California, Connecticut, Iowa, Louisiana, Massachusetts, New Hampshire, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Vermont and Wyoming.
In addition, the federal government recently announced a five-year, $5 million grant to research the benefits of providing counsel to children in these proceedings. Up to now, research has been scarce.
"The tide is turning," said Peter Samuelson, co-founder and Chairman of First Star. "Many jurisdictions are moving beyond the old legal paradigm that treated children as chattel, and are recognizing that their opinions are valuable in court proceedings that determine their futures. But there is still a long way to go before we create uniform, nationwide legal protections for these vulnerable children."
To build on this momentum, First Star and CAI recommend:
-- An amendment to the federal Child Abuse Prevention and Treatment Act
(CAPTA) that would require all abused and neglected foster children
receive quality client-directed representation in dependency
proceedings;
-- Passage by the American Bar Association of a Model Act that would
serve as a prototype for states to establish uniform standards for
representing children in dependency cases;
-- Implementation of a loan forgiveness program for child advocate
attorneys, since compensation is prohibitively low;
-- Adoption of caseload limits of 100 clients so attorneys can focus
enough attention on each case;
-- Support to ensure that abused and neglected children receive quality
representation in all court proceedings that determine their futures.
State grades were based on a rigorous examination of state law by leading national child welfare experts, who established guiding principles and developed a 100-point grading system. Criteria included: whether state law mandates that attorneys be appointed for children in dependency proceedings; whether these attorneys represent the children in a client-directed manner; whether this representation continues throughout the case, including appeal; whether states have specialized education or training of a child's counsel; whether the child is given the legal status of a party to the proceedings; and whether rules pertaining to confidentiality and immunity from liability apply to attorneys representing these children. Extra credit was given if states have mandatory caseload limits for children's counsel. Officials and/or advocates from each state participated in the process and provided valuable feedback.
"We hope this Report Card will become a tool to increase public awareness of this issue, a rallying cry for advocates and lawmakers in poorly performing states, and a source of pride for states that have enacted strong laws," said Elisa Weichel, CAI's Administrative Director & Staff Attorney. "Tremendous progress has been made in the last two years; it is our aim to build on that momentum."
-----
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Tuesday, March 10, 2009
Midwestern and Southern States Receive Least Federal Funding for Disease Prevention
TT Note: Looking at the states' rankings based on the amount of federal dollars, that is, your and mine tax dollars, there appears to be an unequal distribution. Wonder if the new and improved tax revenues by the new administration will allow for those states who receive less federal help have lower taxes than those who dip mightily? Oops, sorry. Guess the caffeine isn't making my brain work too well. Of course not. We will all have to dig deep for the money.
/PRNewswire/ -- Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) today released a new report that found Midwestern and Southern states received less funding from the federal government than Northeastern and Western states did in fiscal year (FY) 2008 for disease prevention programs, which can amount to millions of dollars in differences. The Shortchanging America's Health: A State-By-State Look at How Federal Public Health Dollars are Spent also examines how the economic downturn could lead to serious cuts to disease prevention and emergency preparedness programs at the state level.
The report found that states receive $17.60 per person on average from the U.S. Centers for Disease Control and Prevention (CDC) to spend on public health. Midwestern states received an average of $17.69 per person and Southern states received $18.43 per person, while Northeastern states received $22.49 and Western states received $23.94 per person from the CDC.
"Even in better economic times, the country's investment in keeping the public healthy and safe is a tiny fraction of what we spend on treating people after they've become sick. Our priorities are upside down. And now in tough times, this balance could get worse, but we shouldn't forget that cutting public health programs to try to solve short-term budget problems will result in long-term negative financial and health consequences," said Jeff Levi, PhD, Executive Director of TFAH. "Public health programs help keep disease rates down, which in turn keeps health care costs down. It's going to be hard to get the economy healthy again if our workers and our health care system are both sick."
Alaska received the most funding from CDC of any state at $52.78 per person in FY 2008, while Indiana received the least at $12.74 - a $40 difference. Approximately 75 percent of CDC's budget is distributed through grants or cooperative agreements to states and communities to support programs to prevent diseases and prepare for health disasters.
Public health programs are supported through a combination of federal, state, and local resources. State funding is expected to drop significantly as state governments face severe budget crises. According to the Center on Budget and Policy Priorities (CBPP), at least 46 states are facing shortfalls to their 2009 and/or 2010 budgets. CBPP estimates that combined budget gaps for states in the remainder of 2009, 2010, and 2011 could total more than $350 billion.
Some health programs at-risk for cuts include:
-- Cancer, diabetes, obesity, and other chronic disease prevention;
-- HIV/AIDS, MRSA, TB, and other infectious disease prevention;
-- Food and water safety;
-- Environmental health improvement; and
-- Bioterrorism and health emergency preparedness.
In addition, more than 11,000 state and local public health jobs have already been cut, and another 10,000 may be cut, according to surveys conducted by state and local health departments.
The American Recovery and Reinvestment Act provided an additional $1 billion for public health programs for next year, which will help provide additional support in many communities.
"The financial crisis makes it more important than ever for the country to make prevention a top priority," said Risa Lavizzo-Mourey, M.D., M.B.A president and CEO of the Robert Wood Johnson Foundation. "Even in these troubled times, prevention is an investment we can count on to deliver a big payoff - sparing millions of people from developing preventable diseases while saving billions in health care costs."
The full report includes state-by-state pages of key health statistics and funding information and is available on TFAH's Web site at www.healthyamericans.org. The report was supported by a grant from RWJF.
Rankings of CDC Funds for States (Based on Fiscal Year 2008)
1=Most funds; 50=Least funds. Funds are listed on a per person basis.
The national average CDC funding is $17.60 per person.
1. Alaska ($52.78); 2. Vermont ($35.15); 3. Wyoming ($32.43); 4. Rhode Island ($32.09); 5. New Mexico ($30.94); 6. South Dakota ($29.12); 7. North Dakota ($27.45); 8. Hawaii ($25.55); 9. Delaware ($24.98); 10. Montana ($24.33); 11. Maine ($23.53); 12. Maryland ($22.92); 13. West Virginia ($21.78); 14. New York ($21.39); 15. Washington ($21.34); 16. Louisiana ($21.25); 17. New Hampshire ($21.07); 18. Idaho ($20.97); 19. Massachusetts ($20.85); 20. Nebraska ($20.54); 21. Mississippi ($20.04); 22. Nevada ($19.67); 23. Arkansas ($19.19); 24. Oklahoma ($19.10); 25. North Carolina ($19.00); 26. South Carolina ($18.69); 27. Georgia ($18.68); 28. Connecticut ($18.63); 29. Colorado ($17.92); 30. Arizona ($17.30); 31. Texas ($17.16); 32. Alabama ($16.95); 33. Illinois ($16.66); 34. Iowa ($16.37); 35. Oregon ($16.33); 36. California ($15.94); 37. Michigan ($15.76); 38. New Jersey ($15.75); 39. Utah ($15.73); 40. Minnesota ($15.66); 41. Kansas ($15.14); 41. Missouri ($15.14); 43. Wisconsin ($14.97); 44. Tennessee ($14.96); 45. Pennsylvania ($13.99); 46. Kentucky ($13.94); 47. Florida ($13.29); 48. Virginia ($12.88); 49. Ohio ($12.76); 50. Indiana ($12.74).
*Regions are based on the U.S. Census Bureau definitions. Midwestern states include: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. Northeastern states include: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. Western states include: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. Southern states include: Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. Washington, D.C. was not included in the analysis.
-----
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/PRNewswire/ -- Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) today released a new report that found Midwestern and Southern states received less funding from the federal government than Northeastern and Western states did in fiscal year (FY) 2008 for disease prevention programs, which can amount to millions of dollars in differences. The Shortchanging America's Health: A State-By-State Look at How Federal Public Health Dollars are Spent also examines how the economic downturn could lead to serious cuts to disease prevention and emergency preparedness programs at the state level.
The report found that states receive $17.60 per person on average from the U.S. Centers for Disease Control and Prevention (CDC) to spend on public health. Midwestern states received an average of $17.69 per person and Southern states received $18.43 per person, while Northeastern states received $22.49 and Western states received $23.94 per person from the CDC.
"Even in better economic times, the country's investment in keeping the public healthy and safe is a tiny fraction of what we spend on treating people after they've become sick. Our priorities are upside down. And now in tough times, this balance could get worse, but we shouldn't forget that cutting public health programs to try to solve short-term budget problems will result in long-term negative financial and health consequences," said Jeff Levi, PhD, Executive Director of TFAH. "Public health programs help keep disease rates down, which in turn keeps health care costs down. It's going to be hard to get the economy healthy again if our workers and our health care system are both sick."
Alaska received the most funding from CDC of any state at $52.78 per person in FY 2008, while Indiana received the least at $12.74 - a $40 difference. Approximately 75 percent of CDC's budget is distributed through grants or cooperative agreements to states and communities to support programs to prevent diseases and prepare for health disasters.
Public health programs are supported through a combination of federal, state, and local resources. State funding is expected to drop significantly as state governments face severe budget crises. According to the Center on Budget and Policy Priorities (CBPP), at least 46 states are facing shortfalls to their 2009 and/or 2010 budgets. CBPP estimates that combined budget gaps for states in the remainder of 2009, 2010, and 2011 could total more than $350 billion.
Some health programs at-risk for cuts include:
-- Cancer, diabetes, obesity, and other chronic disease prevention;
-- HIV/AIDS, MRSA, TB, and other infectious disease prevention;
-- Food and water safety;
-- Environmental health improvement; and
-- Bioterrorism and health emergency preparedness.
In addition, more than 11,000 state and local public health jobs have already been cut, and another 10,000 may be cut, according to surveys conducted by state and local health departments.
The American Recovery and Reinvestment Act provided an additional $1 billion for public health programs for next year, which will help provide additional support in many communities.
"The financial crisis makes it more important than ever for the country to make prevention a top priority," said Risa Lavizzo-Mourey, M.D., M.B.A president and CEO of the Robert Wood Johnson Foundation. "Even in these troubled times, prevention is an investment we can count on to deliver a big payoff - sparing millions of people from developing preventable diseases while saving billions in health care costs."
The full report includes state-by-state pages of key health statistics and funding information and is available on TFAH's Web site at www.healthyamericans.org. The report was supported by a grant from RWJF.
Rankings of CDC Funds for States (Based on Fiscal Year 2008)
1=Most funds; 50=Least funds. Funds are listed on a per person basis.
The national average CDC funding is $17.60 per person.
1. Alaska ($52.78); 2. Vermont ($35.15); 3. Wyoming ($32.43); 4. Rhode Island ($32.09); 5. New Mexico ($30.94); 6. South Dakota ($29.12); 7. North Dakota ($27.45); 8. Hawaii ($25.55); 9. Delaware ($24.98); 10. Montana ($24.33); 11. Maine ($23.53); 12. Maryland ($22.92); 13. West Virginia ($21.78); 14. New York ($21.39); 15. Washington ($21.34); 16. Louisiana ($21.25); 17. New Hampshire ($21.07); 18. Idaho ($20.97); 19. Massachusetts ($20.85); 20. Nebraska ($20.54); 21. Mississippi ($20.04); 22. Nevada ($19.67); 23. Arkansas ($19.19); 24. Oklahoma ($19.10); 25. North Carolina ($19.00); 26. South Carolina ($18.69); 27. Georgia ($18.68); 28. Connecticut ($18.63); 29. Colorado ($17.92); 30. Arizona ($17.30); 31. Texas ($17.16); 32. Alabama ($16.95); 33. Illinois ($16.66); 34. Iowa ($16.37); 35. Oregon ($16.33); 36. California ($15.94); 37. Michigan ($15.76); 38. New Jersey ($15.75); 39. Utah ($15.73); 40. Minnesota ($15.66); 41. Kansas ($15.14); 41. Missouri ($15.14); 43. Wisconsin ($14.97); 44. Tennessee ($14.96); 45. Pennsylvania ($13.99); 46. Kentucky ($13.94); 47. Florida ($13.29); 48. Virginia ($12.88); 49. Ohio ($12.76); 50. Indiana ($12.74).
*Regions are based on the U.S. Census Bureau definitions. Midwestern states include: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. Northeastern states include: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. Western states include: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. Southern states include: Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. Washington, D.C. was not included in the analysis.
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