This report provides data on health behaviors and experiences of high school students in the United States. Data highlight students' behaviors and experiences in 2023, changes from 2021 to 2023, and 10-year trends. The report focuses on: sexual behavior, substance use, experiences of violence, mental health, suicidal thoughts and behaviors, and other important issues, like social media use. In 2023, female students and LGBTQ+ students experienced more violence, signs of poor mental health, and suicidal thoughts and behaviors than their male and cisgender and heterosexual peers. From 2021 to 2023, there were early signs that adolescent mental health is getting better. There were also concerning increases in students' experiences of violence at school. From 2013 to 2023, 10-year trends were similar to what data showed in 2021. There were decreases in students' use of substances. There were increases in students' experiences of violence, signs of poor mental health, and suicidal thoughts and behaviors. Students' sexual activity decreased, but so did their protective sexual behaviors, like condom use.

Over the past couple of decades, law enforcement use of automated license plate readers (ALPRs; also referred to as LPRs) has increased. These tools are now relatively commonplace in policing. According to the Bureau of Justice Statistics’ 2020 Law Enforcement Management and Administrative Statistics Survey, larger law enforcement offices were more likely to use ALPR technology than smaller offices; nearly 90% of sheriffs’ offices with 500 or more sworn deputies reported using the technology, and of police departments serving over 1 million residents, 100% used ALPRs. ALPRs are camera systems that capture the license plate data of passing vehicles, along with related information. They are generally available in fixed and mobile formats. Fixed ALPR systems are mounted in specific locations, often using existing infrastructure such as light poles, traffic lights, buildings, or bridges. Mobile ALPR systems are frequently mounted on police vehicles or privately contracted vehicles. ALPRs automatically capture images or videos of passing vehicles. An algorithm then detects the license plates within the photo/video and reads the numbers. (ALPR technology can also detect additional, related information, including vehicle type and color, global positioning system [GPS] location data, and date and time.) After they capture and catalog license plate information, ALPR systems can compare these data against various databases, including what are known as hot lists, which contain license plates linked to vehicles of interest. If there is a match to a hot list license plate, the ALPR system can alert a police officer in real time. Law enforcement agencies may use ALPRs for a variety of proactive and reactive policing purposes, including gathering intelligence and evidence, helping identify potential suspects, and facilitating crime scene analysis. There does not appear to be publicly available data on the frequency and extent to which ALPR technology is used for various purpose areas, and there are no data on its use at various phases of the criminal justice system—from generating investigative leads and helping establish probable cause for an arrest or indictment to serving as evidence in courtrooms.

Florida was one of the top 10 states in the U.S. (together with Arizona, California, Illinois, New York, North Carolina, Ohio, Pennsylvania, Texas, and Virginia) with the highest 12-month enrollment in degree-granting institutions for 2019-20. Nationally, in Fiscal Year 2020, 4-year public institutions received 20.0% of their revenues from tuition and fees, 14.3% from operating grants and contracts, 18.5% from legislative appropriations, and 6.3% from non-operating grants and contracts. For 2-year degree granting institutions nationally, 14.4% of revenues are from tuition and fees, 8.6% are from operating grants and contracts, 47.0% are from legislative appropriations, and 19.0% are from non-operating grants and contracts. Instruction was the highest expense for both four-year and two-year institutions at $11,804 and $6,268 respectively. Research and public service expenses were drastically different between these two institutions, while institutional expenses were comparable. In 2019-20, 57% of award recipients at 4-year Title IV degree granting institutions were awarded bachelor’s degrees. The highest number of associate degrees conferred in Title IV post-secondary institutions was Liberal Arts and Sciences, General Studies and Humanities.

Educators, policymakers, and families share concerns about the significant decline in school attendance since the onset of pandemic-induced school closures. According to a 2023 report, the national rate of chronically absent students—those missing 10% or more of school days—nearly doubled from 2018 to 2022, reaching 28%. Although attendance has started to improve in some states, chronic absenteeism remains 75% higher, on average, than pre-pandemic levels. California mirrors this trend, with chronic absenteeism rising to 30% in 2022 before decreasing to 25% in 2023, still well above pre-pandemic levels. When students miss school, they lose opportunities for learning and social interaction as well as access to critical services. Research shows that chronically absent students are more likely to fall behind academically, disengage socially, and drop out of school altogether. Because absenteeism is strongly associated with these important student outcomes, it is crucial that policymakers, educators, and researchers identify effective strategies to alleviate it. Community schools have emerged as a promising approach to mitigate chronic absenteeism, as they are adept at organizing supports for students and families and creating conditions for rich learning and well-being. Support and funding for community schools has increased in recent years at both the federal and state level. California has become a leader in implementation in recent years, supported by an unprecedented $4.1 billion investment through the California Community Schools Partnership Program. The program provides grants that enable school and district partnerships with community agencies and local government to support students’ academic, physical, and mental development.

Last week, the U.S. Department of Education released new data that, for the first time ever, provide college-level counts of the number of high school dual enrollment students, disaggregated by race/ethnicity and gender. According to this information from the Integrated Postsecondary Education Data System (IPEDS), nearly 2.5 million high school students took at least one dual enrollment course from a college or university in the 2022-23 academic year. This is much higher than the previous estimate of 1.5 million using student age (under 18) for fall 2021 enrollment alone, which makes sense given that high school students take dual enrollment courses in the spring. Readers should interpret these new numbers with caution, however, since this is the first-time colleges have reported dual enrollment counts for IPEDS. Nationally, community colleges enrolled the majority of high school dual enrollment students, followed by public four-year and private non-profit four-year colleges. For community colleges, the 1.78 million high school dual enrollment students represented 21% of total enrollments during the 2022-23 year (8.6 million in total). Two hundred forty thousand high school students took dual enrollment at the 10 largest dual enrollment colleges alone, and of these top 10, eight were community colleges. The top five states for dual enrollment by size—California, Texas, New York, Indiana, and Florida—together reported nearly 900,000 dual enrollments, about a third of dual enrollment nationally. California, Texas, and Florida enrolled the largest numbers of Hispanic or Latino dual enrollment students, and Texas, Florida, and Georgia enrolled the largest numbers of Black dual enrollment students.

On January 9, 2024, a major storm system hit Rhode Island, prompting a federal disaster declaration in four counties in the state. Rhode Island was officially classified as a Federal Emergency Management Agency (FEMA) Declared Disaster on March 20, 2024. By mid-April of that year, 882 applications were approved for $4.1 million in FEMA assistance, including housing grants and other storm-related expenses, from transportation to childcare. The U.S. Census Bureau’s Census Business Builder (CBB) provides the economic and demographic details of any area impacted by a disaster, including potential disruption to supply chains in affected areas — a valuable tool during hurricane season. Based on their percentage of national employment, the top two sectors in the Rhode Island disaster region are Educational Services (61) and Finance and Insurance (52). Any impact on these sectors would also affect the products produced and shipped for these sectors. For example, Sector (61) generated over $165 million worth of products, according to the 2017 Economic Census.

The federal Bipartisan Budget Act of 2018 amended the Social Security Act to require the U.S. Centers for Medicare & Medicaid Services (CMS) to collect cost, revenue, utilization, and other information from representative samples of ground ambulance organizations. To meet this requirement, CMS developed the Medicare Ground Ambulance Data Collection System and used a stratified sampling approach to select four representative cohorts of organizations covering nearly all of the over 10,000 organizations that bill Medicare annually. To explore whether ground ambulance organizations have changed over time, including through the COVID-19 pandemic, researchers examined trends in transport volume (i.e., the number of ground ambulance transports paid for by traditional [fee-for-service] Medicare) and the characteristics of organizations billing Medicare for ground ambulance services from 2017 through 2022. This analysis found only slight changes in ground ambulance organizational characteristics from 2017 to 2022, with the exception of a long-term, gradual decline in traditional Medicare transport volume.

This report presents highlights from 2023 final birth data on key demographic and maternal and infant health indicators. The number of births, the general fertility rate (births per 1,000 females ages 15–44), teen birth rates, the distribution of births by trimester prenatal care began, and the distribution of births by gestational age (less than 37 weeks, 37–38 weeks, 39–40 weeks, and 41 or later weeks of gestation) are presented. For all indicators, results for 2023 are compared with those for 2022 and 2021. Key findings include that the number of births in the United States declined 2% from 2022 to 2023. The general fertility rate declined 3% in 2023 to 54.5 births per 1,000 females ages 15–44. Birth rates declined for females ages 15–19 (4%), 15–17 (2%), and 18–19 (5%), from 2022 to 2023. The percentage of mothers receiving prenatal care in the first trimester of pregnancy declined 1% from 2022 to 2023, while the percentage of mothers with no prenatal care increased 5%. The preterm birth rate was essentially unchanged at 10.41% in 2023, but the rate of early-term births rose 2% to 29.84%.

This report presents complete period life tables for each of the 50 states and the District of Columbia by sex based on age-specific death rates in 2021. Among the 50 states and District of Columbia, Hawaii had the highest life expectancy at birth, 79.9 years in 2021, and Mississippi had the lowest, 70.9 years. From 2020 to 2021, life expectancy at birth declined for 39 states (including Florida), increased for 11 states, and remained unchanged for the District of Columbia. In 2021, life expectancy at age 65 ranged from 16.1 years in Mississippi to 20.6 years in Hawaii. Life expectancy at birth was higher for females in all states and the District of Columbia. The difference in life expectancy between females and males ranged from 3.9 years in Utah to 7.6 years in New Mexico. For Florida, life expectancy for 2021 was 76.1 years (73.1 years for males, 79.3 years for females), which ranked 27th among the 50 states and the District of Columbia.

West Virginia entered an institution for mental disease Section 1115 waiver with the U.S. Centers for Medicare & Medicaid Services in 2018, which allowed Medicaid to cover methadone at West Virginia's nine opioid treatment programs (OTPs) for the first time. The research team conducted time trend and geospatial analyses of Medicaid enrollees between 2016 and 2019 to examine medications for opioid use disorder utilization patterns following Medicaid coverage of methadone, focusing on distance to an OTP as a predictor of initiating methadone and conditional on receiving any, longer treatment duration. Following Medicaid coverage of methadone in 2018, patients receiving methadone comprised 9.5% of all Medicaid enrollees with an opioid use disorder (OUD) diagnosis and 10.6% in 2019 (P < 0.01). In 2018, two-thirds of methadone patients either had no prior OUD diagnosis or were not previously enrolled in Medicaid in our observation period. Patients residing within 20 miles of an OTP were more likely to receive methadone (marginal effect [ME]: -0.041, P < 0.001). Similarly, patients residing in metropolitan areas were more likely to receive treatment than those residing in nonmetropolitan areas (ME: -0.019, P < 0.05). Metropolitan patients traveled an average of 15 miles to an OTP; non-metropolitan patients traveled more than twice as far (P < 0.001). We found no significant association between distance and treatment duration. West Virginia Medicaid's new methadone coverage was associated with an influx of new enrollees with OUD, many of whom had no previous OUD diagnosis or prior Medicaid enrollment. Methadone patients frequently traveled far distances for treatment, suggesting that the state needs additional OTPs and innovative methadone delivery models to improve availability.