This measure is an aggregate of three measures of improvements in indicators related to 1) access to healthcare and preventive services; 2) maternal and child health; 3) mental and behavioral health. Access to healthcare and preventive services is defined by six indicators, including 1) health insurance; 2) primary care provider; 3) cost as a barrier to healthcare; 4) influenza immunization; 5) routine medical check-up; and 6) routine dental visit. Maternal and child health is defined by four indicators, including 1) first trimester prenatal care; 2) preterm birth; 3) births to adolescents; and 4) infant mortality. Mental and behavioral health is defined by four indicators, including 1) recent poor mental health; 2) adolescent suicide ideation; 3) suicide deaths; and 4) overdose and poisoning deaths. Percentages or rates for each indicator will be reported for each of the six racial and ethnic groups (1) American Indian/Alaska Native; 2) Asian/Asian American; 3) Black/African American; 4) Hispanic/Latino; 5) Native Hawaiian/Pacific Islander; and 6) White) in an appendix. Any improvement in percentages or rates from baseline to June 2024 will be counted as an improvement. The denominator will be 84 (14 indicators, each with percentages or rates for six racial and ethnic groups.) The data sources for these indicators are BRFSS, ESSENCE, birth certificates, and death certificates.

Percent of access to health care and preventive services indicators by race and ethnicity that show an improvement in disparity gap

During the first period of data collection (2020-2021 for all indicators except dental checkups, whose first period is 2018 & 2020), 11.11% of access to health care and preventive services indicators by race and ethnicity showed statistically significant improvements. Native Hawaiian/Pacific Islanders showed improvement in accessing a health care provider and accessing health insurance, and American Indian/Alaska Natives showed improvement in accessing influenza immunizations. There were no statistically significant improvements in accessing routine checkups, routine dental visits, and cost as a barrier to healthcare.

During the second period of data collection (2021-2022 for all indicators except dental checkups, whose first period is 2020 & 2022), 13.89% of access to health care and preventive services indicators by race ethnicity showed statistically significant improvements. Black/African Americans showed an improvement in routine dental checkups and accessing a health care provider. Native Hawaiian/Pacific Islanders maintained their improvement in accessing a health care provider and health insurance. Asians declined in healthcare coverage and maintained that status during the second period of data collection. While showing improvements in the first period of data collection for influenza immunizations, both American Indian/Alaska Natives and Hispanic/Latinos showed declines during the second period of data collection.

During the third period of data collection (2022-2023 for all indicators; dental checkups are not present during this period of data collection), 20% of access to health care and preventive services indicators by race and ethnicity showed statistically significant improvements. American Indian/Alaska Natives and Native Hawaiian/Pacific Islanders showed improvements in access to healthcare coverage. Native Hawaiian/Pacific Islanders and the White population showed improvements in cost as a barrier to healthcare. American Indian/Alaska Natives and Hispanic/Latinos showed improvements in influenza immunizations. While improvements were observed in the second period of data collection, both Black/African Americans and Native Hawaiian/Pacific Islanders showed a decline in accessing a health care provider.

Percent of access to maternal and child health indicators by race and ethnicity that show an improvement in disparity gap

During the first period of data collection (2020-2021 for first trimester prenatal care and pre-term births; 2018-2021 for births to adolescents), 11.11% of maternal and child health indicators by race and ethnicity showed statistically significant improvements. Asians showed improvement in first trimester prenatal care and Hispanic/Latinos showed improvement in pre-term birth outcomes. There were no statistically significant improvements in birth to adolescents.

During the second period of data collection (2021-2022 for first trimester prenatal care and pre-term births; 2019-2022 for births to adolescents), 11.11% of maternal and child health indicators by race and ethnicity showed statistically significant improvements. Asians maintained their improvement in first trimester prenatal care during the second period of data collection. Similarly, Hispanic/Latinos maintained their improvement in pre-term births.

During the third period of data collection (2022-2023 for first trimester prenatal care and pre-term births; 2020-2023 for births to adolescents), 0% of maternal and child health indicators by race and ethnicity showed statistically significant improvements. The two observed improvements during the second period - first trimester prenatal care for Asians and pre-term births for Hispanic/Latinos - both declined during the third period of data collection. No improvements were observed for any groups across the remaining indicators.

Percent of access to mental and behavioral health indicators by race and ethnicity that show an improvement in disparity gap

During the first period of data collection (2020-2021 for recent poor mental health; 2020-2021 for suicide ideation; 2018-2020 for suicide death rates), 11.11% of mental and behavioral health indicators by race and ethnicity showed statistically significant improvements. Native Hawaiian/Pacific Islanders and White Utahns showed improvement in suicide death rates. There were no statistically significant improvements in recent poor mental health days and suicide ideation.

During the second period of data collection (2021-2022 for recent poor mental health; 2021-2022 for suicide ideation; 2019-2021 for suicide death rates), 16.67% of mental and behavioral health indicators by race and ethnicity showed statistically significant improvements. American Indian/Alaska Natives and Hispanic/Latinos showed significant declines in recent mental health. Both Whites and Native Hawaiian/Pacific Islanders maintained their improvements in suicide death rates from the first period of data collection. Native Hawaiian/Pacific Islanders showed an improvement in recent mental health during this period of data collection.

During the third period of data collection (2022-2023 for recent poor mental health; 2022-2023 for suicide ideation; 2020-2022 for suicide death rates), 5.6% of mental and behavioral health indicators by race and ethnicity showed statistically significant improvements. Native Hawaiian/Pacific Islanders’ suicide death rates significantly improved during this period. Conversely, the observed improvement in recent mental health during the previous period of data collection declined, having no significant difference relative to the state average. Similarly, suicide death rates among the White population declined during this period.