(NEW YORK) -- Maternal mortality rates in the United States fell in 2022 after at least three years of continuous increases, new federal data shows.

In 2022, 817 women in the U.S. died of maternal causes with a rate of 22.3 maternal deaths per 100,000 live births, according to the report published early Thursday by the Centers for Disease Control and Prevention's National Center for Health Statistics.

This is a drop from the 1,205 women that died in 2021 with a rate of 32.9 maternal deaths per 100,000 live births.

Dr. Jessica Shepherd, a Dallas-based OB-GYN, said she believes one reason for the drop from 2021 to 2022 is that in the later months of the COVID-19 pandemic, people were less nervous to seek medical care and there was more access to health services.

"I do think when you look at 2021, we really were at the height of the pandemic," she told ABC News. "And what we do know that happened during the pandemic is when there was decreased access -- and who was able to go to the doctors -- we didn't have a lot of support during the actual pregnancy and delivery portion because there was less support people that were allowed in the delivery room."

Maternal mortality rates also fell significantly for several racial/ethnic groups in 2022 including Black, white and Hispanic women. However, the 2022 rate for Black women of 49.5 maternal deaths per 100,000 live births was significantly higher than the rate for white women at 19.0 and Hispanic women at 16.9.

Asian women also saw a drop from 2021 to 2022 but the CDC said it was not statistically significant. The rate was also lower than that of Black women at 13.2 maternal deaths per 100,000 live births.

"I think we've recognized for a while that this disparity exists, and I think that for a long time, people thought, 'Oh, it's just access, you know, there isn't good access,' or ''This really reflecting socio-economic status, etc. There's a million different excuses," Dr. Laura Riley, OBGYN-in-chief at NewYork-Presbyterian and Weill Cornell Medicine, told ABC News.

She said the reasons are multi-factorial, but systemic racism in the health care industry, due to lack of representation, may be playing a role.

"Older CDC data suggests that Black women even at the highest socio-economic strata when you compare them to their white counterparts, they still have a higher risk of death," Riley said. "I think we also are recognizing that systemic racism plays a role in some of these adverse events, and it's a question of sort of pulling all of that apart and figuring out how we can provide quality healthcare to everyone."

When broken down by age, rates decreased significantly for every age group between 2021 and 2022. Even with the drop, the rate for women over age 40 was 87.1 maternal deaths per 100,000 live births, about six times the rate for women younger than age 25 at 14.4 per 100,000 live births.

Previous studies have shown that risk factors associated with maternal mortality in older women include smoking during pregnancy, inadequate use of prenatal care, concurrent medical conditions such as hypertension, and previous pregnancy problems.

Riley said it's important for maternal mortality review committees, which convene at the state or local level, to study why women are dying during or after pregnancy, as well as studying women who suffered pregnancy complications.

"We also know that there's [women who have] survived the pregnancy and survived the labor and delivery events but have some long term what we call morbidity associated with birth, long term kind of cardiovascular disease, kidney disease," she said. "And so that's yet another reason that we need to really understand what's happening so that we can make changes in the health care system, in the education system...at community levels, at hospital levels, at individual doctors' levels, so that we can make people healthier and make pregnancy and childbirth super."

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(NEW YORK) -- Retail dairy samples recently tested for the avian flu virus, including cottage cheese and sour cream, did not detect any viable virus that would represent a risk to consumers, the U.S. Food and Drug Administration said Wednesday.

In a joint press briefing with the Centers for Disease Control and Prevention and the U.S. Department of Agriculture, Dr. Donald Prater, acting director of the Center for Food Safety and Applied Nutrition for the FDA, shared updates on ongoing bird flu investigations.

A multi-state outbreak of bird flu in dairy cows was first reported in late March, according to the CDC. The agency said at the time it had "confirmed one human HPAI A(H5N1) infection that had exposure to dairy cattle in Texas that were presumed to be infected with the virus," adding that it was "working with state health departments to continue to monitor workers who may have been in contact with infected or potentially infected birds/animals and test those people who develop symptoms."

Early last week, initial testing results from the national retail milk study, which sampled 96 pasteurized milk products, showed through PCR testing that about 1 in 5 retail milk samples had tested positive for HPAI viral fragments.

This week, the agencies announced they had not detected "any viable virus" in a second group of test samples.

Second round of dairy product testing did not detect any viable bird flu virus, per FDA

"Today we're announcing an additional set of results from our national study of 297 total retail dairy samples. The second group represents an additional 201 samples of pasteurized retail dairy products, including cottage cheese and sour cream in addition to fluid milk," Prater said. "These samples underwent acute qPCR (quantitative polymerase chain reaction) testing, as well as the same egg inoculation test, and we're encouraged that this preliminary testing also did not detect any viable virus."

To further ensure the safety of other milk-derived products for the youngest population, the FDA said it "tested samples of retail powdered infant formula and powdered milk products marketed as toddler formula," all of which came back negative, "indicating no detection of viral fragments or virus."

These additional preliminary results "further affirm the safety of the US commercial milk supply" as well as the efficacy of pasteurization in inactivating HPAI, the agency explained.

The FDA is continuing to test samples of pooled raw milk routed to pasteurization and processing for commercial use in order to help characterize potential virus levels that pasteurization may encounter, which will also be used to inform studies to further validate pasteurization.

The FDA, with the CDC, USDA and local health partners, is continuing surveillance of milk production, processing and pasteurization to manage the emerging disease.

The FDA also reiterated this week that it strongly advises against the consumption of raw milk and recommends that the industry not manufacture or sell raw milk or raw milk products.

FSIS ground beef inspection process amid bird flu in cattle

"We are very confident that the meat supply is safe," a representative from the USDA Food Safety and Inspection Service said Wednesday.

The meat inspection process includes each animal being inspected before slaughter, and all cattle carcasses must pass inspection after slaughter before they go into the food supply.

The FSIS has initiated three separate sampling efforts. The first was a collection of retail ground beef from the affected state, the second tested beef muscle samples from culled dairy cows, and a third study is looking at cooking ground beef at various temperatures.

How the CDC is monitoring H5N1 bird flu, local testing of those exposed

In the course of this investigation, the CDC said Wednesday local public health partners had monitored over 100 people, and if anyone presents with symptoms, the next step is to conduct local testing.

The CDC said it is monitoring flu surveillance data, "especially in areas where H5N1 viruses have been detected in dairy cattle or other animals for any unusual trends in flu-like illness, flu or conjunctivitis," Dr. Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases at the CDC, said in his update Wednesday.

At this time, the CDC said it has found "no indicators of unusual flu activity in people, which includes avian influenza."

While the number of tests conducted on people locally varies day by day, Daskalakis said "it's around 25" currently.

People who have been exposed to infected birds, poultry or other animals are monitored for 10 days after exposure.

"We are looking to grow H5N1 virus stock from the one human case in Texas to use for additional laboratory experiments to learn how the virus reproduces in both human and cows," he said, which will ultimately help the CDC "assess the severity of illness and transmissibility of the virus under different scenarios."

In addition to laboratory testing, the CDC is continuing with outreach and education through public health partner organizations "to ensure preparedness for any potential human infections or exposures."

"CDC is conducting broad outreach to the public to raise awareness about the current situation and and remind everyone that the current risk to the general public health is low," Daskalakis said.

USDA says bird flu outbreak in dairy cows likely stemmed from single spillover event

"We currently have 36 affected hers across nine states," said Dr. Rosemary Sifford, deputy administrator of Veterinary Services and Chief Veterinary Officer for the USDA. "It appears that there was a single spillover event in the Texas panhandle geographic region from wild birds and to dairy cattle. The wild birds are believed to be the initial source of the infection in dairy cattle and then cattle movements spread the virus into other dairy cattle herds and then subsequently into poultry flocks."

Sifford added that of the affected herds, 10% have displayed symptoms, and the "cattle that display symptoms generally returned to near their previous production levels after they recover from the virus, which is taking around two weeks."

Most cows have recovered with palliative treatment with little or no associated mortality, according to the USDA.

The USDA did not provide a specific number of tests conducted on dairy cattle to date, but Sifford said she expects "an increase in the number of tests."

"We're requiring any herds that are moving animals inner state to test up to 30 animals in the lot that they expect to move. Once we reach 30 that's a statistically significant number to be able to determine the status of the lot," she said. 

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(NEW YORK) -- Florida's law banning abortions after six weeks of pregnancy took effect on Wednesday, becoming one of the most restrictive states in the country on abortion access.

Florida's six-week ban replaced the state's previous 15-week abortion ban, prohibiting the procedure before most women know they are pregnant.

In the South, abortion is now either banned or severely restricted in Florida, Mississippi, Alabama, Tennessee, Arkansas and Louisiana.

The closest state to Florida with no gestational limits on abortion is Virginia.

On April 1, the Florida State Supreme Court issued a decision to uphold the state's 15-week abortion ban in response to a legal challenge asking the court to throw out the ban.

The six-week trigger ban signed into law by Gov. Ron DeSantis went into effect Wednesday, 30 days after the court's ruling.

The decision came as part of an ongoing lawsuit filed by the American Civil Liberties Union on behalf of Planned Parenthood, the Center for Reproductive Rights and abortion providers against the state, claiming the ban violates the Florida Constitution.

In a separate decision also released on April 1, the Florida Supreme Court decided to allow a ballot initiative that would enshrine abortion rights in the state's Constitution. The decision will allow voters to determine the future of abortion access in the state in November.

In June 2022, the Supreme Court overturned Roe v. Wade and the constitutional right to abortion that had been the law nationwide for almost 50 years.

Two months before the Supreme Court's landmark decision, Republican lawmakers in Florida passed a law to halt abortion procedures after 15 weeks, which was previously limited to 24 weeks.

Before Wednesday's ban, Florida was a key point of access to women across the southeastern U.S. living in states that have ceased nearly all abortion services after Roe v. Wade was overturned.

Data gathered by the Guttmacher Institute estimates that there were 4,950 more abortions provided in Florida from January to June 2023, compared to the same period in 2020.

Calculating pregnancy is determined from the first day of a woman's last menstrual period, according to the American Pregnancy Association, which shortens the time a woman has to determine pregnancy before six weeks.

In addition, Florida requires patients to complete two in-person doctor visits within 24 hours to receive abortion access.

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(NEW YORK) -- Even though one in five Americans lives with a mental illness, many feel it is not adequately addressed, with a new survey from West Health and Gallup suggesting that three in four Americans believe mental health conditions are not identified and treated in the same way as physical health conditions.

Roughly 60% of Americans give a poor or failing grade to how mental health conditions are treated, according to the survey.

“The magnitude [of the problem] really surprised me,” said Tim Lash, president of West Health. 

He states that the U.S. is not just underperforming -- it is failing on a systemic level and in terms of the number of people with unmet needs.

The survey shows the impact of mental health challenges is significant with 51% of people said they experienced depression, anxiety, or another mental health condition in the past year.

Even more concerning, 22% of them said their mental health was so poor it interfered with normal activities like going to work or taking care of their household.

Stigma remains a significant barrier to care with seven in 10 Americans believing that society views people with mental health conditions negatively, the survey finds.

“It’s very difficult for patients to bring up mental health issues,” says Dr. Vidush Athyal, a family medicine physician at Kaiser Permanente in San Diego.

"The onus should probably be on the physician to really be attuned to picking up signs," said Athyal, emphasizing the importance of healthcare providers proactively incorporating mental health during routine patient visits.

While mental health stigma persists, experts hope increased dialogue will drive change.

"Hopefully, as our society becomes more comfortable talking about mental health, patients will feel more able to bring it up with their doctors," Athyal said. "You really shouldn't be holding too much back from your physician."

He also emphasizes that mental health challenges often manifest as physical symptoms.

“Many of the symptoms we encounter in primary care have an underlying psychosocial component, whether it’s migraines, back pain or palpitations. We think a patient may be having a heart attack, and then we end up running all the tests and everything’s normal. And then somebody finally attempts to dig a little bit deeper,” Athyal said, potentially revealing “a stressful event in the patient’s life that triggered this [response].”

Experts say the survey underscores that mental health shouldn't be an afterthought in American healthcare. Mental health professionals say that mental health is as important as physical health -- the two are inextricably linked.

“There’s a long way to go,” said Lash, “but I see hope. We need societal acceptance of mental health as a core part of overall health, and achieving parity is crucial.”

If you or someone you know is struggling with thoughts of suicide - free, confidential help is available 24 hours a day, seven days a week. Call or text the national lifeline at 988.

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(AUSTIN, Texas) -- Officials in Austin, Texas, are investigating an "outbreak" of deadly drug overdoses spreading across the city.

Austin-Travis County Emergency Medical Services (ATCEMS) and the Austin Police Department (APD) said they received a total of 51 calls for suspected overdoses as of Tuesday afternoon, with four suspected deaths related to the surge, according to local ABC News affiliate KVUE.

APD said overdose patients range in age from 20s to 50s and across racial/ethnic groups, KVUE reported. Those who died from overdoses have not been identified but their ages range from mid-30s to mid-50s.

The surge of calls began around 9:00 a.m. CT Monday morning and were concentrated in the downtown area, Angela Carr, EMS division chief at ATCEMS, said during a Monday evening press conference. Calls later began coming in from around the city, including residences, businesses and in areas accessible to the general public.

Carr said a team was immediately deployed to the area, and Narcan rescue kits were distributed. Narcan is given as a nasal spray and the active ingredient in the medication -- naloxone -- can quickly restore breathing if someone is experiencing an opioid overdose.

ATCEMS said it usually receives two or three overdose calls per day, but the number of calls on Monday equated to a 1,000% increase in call volume, according to Dr. Heidi Abraham, deputy medical director for ATCEMS.

"The trend that we're seeing in this group of overdoses is that it is unusually deadly," she said during the press conference. "We've not experienced overdoses of this volume in several years."

Abraham said the overdose patients reported using several different types of drugs but did not elaborate on the specific drugs.

Christa Steadman, ATCEMS public information officer, said officials suspect the "outbreak" is due to "a new batch in town" likely from the same source or same couple of sources due to the similarities of symptoms among patients.

Officials said they will continue to provide updates as they become available. ATCEMS did not immediately reply to ABC News' request for comment.

It comes as a record number of Americans have died from drug overdoses. In 2022, there were nearly 108,000 drug overdose deaths, according to provisional data from the Centers for Disease Control and Prevention, about 1% higher than the nearly 107,000 overdose deaths recorded in 2021.

In Texas, drug poisoning-related deaths for 2022 sit at 15.4 per 100,000, which is the highest rate since at least 2011, according to provisional data from the Texas Department of State Health Services (TDSHS).

Travis County had the fifth-highest number of provisional drug overdose deaths with 308 in 2022, mostly among white residents.

States have previously said fentanyl, the synthetic opioid 50 to 100 times stronger than morphine, may be driving an increase in overdoses and overdose deaths.

TDSHS says preliminary data shows Travis County had 188 fentanyl poisoning-related deaths, the second-highest number behind Harris County, where Houston is located.

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(ATLANTA) -- Rural Americans are more likely to die early from one of the five leading causes of death than those who live in urban areas, according to new federal data.

Researchers looked at the number of potentially preventable deaths from 2010 through 2022. The report was published Tuesday by the Centers for Disease Control and Prevention.

Rural Americans were more likely to die from heart disease, cancer, unintentional injuries, stroke and chronic lower respiratory disease before age 80 compared to urbanites, researchers said.

"There is a well-described, rural-urban divide in the United States, where rural residents tend to be sicker and poorer and to have worse health outcomes than do their non-rural peers," Dr. Macarena Garcia, a senior health scientist in the CDC's Office of Rural Health, said during a press conference on Monday.

About 20% of the U.S. population lives in rural areas while the remaining 80% live in urban areas, according to data from the U.S. Census Bureau.

Previous research has indicated that rural Americans face numerous health care challenges including long travel distances to special and emergency care and are less likely to have health insurance. Additionally, rural Americans have higher rates of high blood pressure and obesity.

For the report, researchers identified premature deaths as occurring before age 80. The average life expectancy in the U.S. was 79 in 2010. The number of preventable early deaths was calculated by subtracting the number of expected deaths by the number of actual deaths.

Although COVID-19 has been the third- or fourth-leading cause of death since 2020, the CDC said deaths from the virus were "excluded to maintain consistency and facilitate the assessment of trends over time."

Since 2010, an estimated 6.37 million Americans have died prematurely from the five leading causes over the 12-year study period. Researchers found that about 64% of deaths from unintentional injury -- which includes car accidents, falls, accidental shootings, unintentional poisonings, overdose deaths and drownings -- could have been prevented.

The report found 34% of stroke and heart disease deaths were preventable as were 26% of deaths from chronic lower respiratory disease.

Results showed the percentage of preventable deaths were highest in rural counties versus urban ones.

For example, 44% of heart disease deaths among people below age 80 in rural areas were potentially preventable compared with 27% in urban areas. More than half of early deaths from unintentional injury and chronic lower respiratory disease in rural areas were preventable.

For deaths from cancer, less than 20% of deaths were preventable in rural counties.

"We have to remember that screening prevention services as well as treatment services are much more accessible in urban areas," Garcia said. "So that means they are limited in rural areas. Sometimes people have to drive two, three hours to the nearest center that provides specialty care."

She went on, "So that means people go without preventive services. People in rural areas likely have lower rates of screening and certainly have less access to treatment."

When it came to geographic variation, Garcia said the CDC analysis showed consistently that the southeastern U.S. was the region with the highest prevalence of preventable early deaths.

In 2022, for example, the CDC found that when in came to unintentional injuries, between 70% and 100% of early deaths in several southeastern states including South Carolina, Louisiana, Mississippi, Kentucky and Tennessee could have been prevented. By comparison, between 30% and 66% of deaths could have been prevented in the majority of states.

The CDC said it is trying to improve rural health by funding and guiding public health programs in rural communities such as increasing cancer screenings for women and promoting physical education in schools.

"We believe these findings can help guide focused public health interventions at the local and community levels to effectively reduce the risks of premature death," Garcia said during the press briefing. "The findings also suggest a need to better understand potential shifts in social, environmental and structural inequities contributing to disparities in preventable early deaths between rural and urban areas."

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(NEW YORK) -- Weekly COVID-19 hospitalizations have hit their lowest level ever reported since the pandemic began, according to data from the Centers for Disease Control and Prevention.

There were 5,615 COVID hospitalizations in the most recent week data that is available. In comparison, there were over 150,000 weekly admissions at the peak of the Omicron variant circulating in early 2022.

"The significant decline in COVID-19 hospitalizations and deaths to these new lows is encouraging, showing that our public health measures and vaccination efforts have paid off," said Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News medical contributor.

Forecasts of new hospitalizations from the CDC indicate that admissions will likely remain stable for the next four weeks.

"It’s important to continue monitoring for new variants and maintaining protective health behaviors to prevent possible surges," Brownstein added.

The news comes as the requirements for hospitals to report respiratory illness data, like COVID hospital admissions, expire at the end of April. Federal officials plan to use other data sources such as wastewater, laboratory tests and emergency department data to stay informed about the spread of illnesses.

"A key lesson we learned from the COVID-19 pandemic is the importance of having reporting systems in place before an active emergency," a CDC spokesperson said in part of a statement. "These data have a significant and ongoing value for protecting patient health and safety as well as public health," the statement continued.

Data from the CDC shows that about 22.6% of adults as well as 14% of children have received the updated COVID vaccine, which is formulated to better protect against current sub variants. Older adults over the age of 65 were recommended to receive an additional updated COVID vaccine this spring due to their increased risk of severe disease, according to the CDC.

The Food and Drug Administration’s independent panel of advisors is set to meet in mid-March to discuss the recommended strains to be selected in the next formulation of COVID vaccines. As the virus has evolved since the beginning of the pandemic, vaccines have been adjusted to better protect against current strains.

COVID deaths have also been steadily declining this year, reaching new lows. There were an estimated 231 deaths from COVID in the most recent week data that is available, according to the CDC. However, death data are delayed and may be incomplete.

At the height of the pandemic, there were over 25,000 Americans dying weekly from the virus as the Delta variant swept across the country.

"It's crucial that we maintain robust surveillance and data collection to quickly respond to any changes in the virus's behavior," Brownstein said.

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(NEW YORK) -- Federal officials continue to investigate the spread of avian flu, also known as bird flu, in livestock across the country and are now testing the U.S. beef supply to look for the genetic presence of the H5N1 virus.

The virus has been found in at least 34 cattle herds across nine states, according to the U.S. Department of Agriculture. The federal agency said it remains confident that the nation's meat supply is safe.

"There have been no cases of any human being contracting bird flu or H5N1 from meat or milk. So it's completely safe," Dr. Scott Haskell, a professor of food safety at the Institute for Food Laws and Regulations at Michigan State University, told ABC News. "It's not a disease that spreads through eating or drinking."

A spokesperson from the USDA said in a statement: "USDA has a rigorous meat inspection process, where USDA's Food Safety and Inspection Service (FSIS) veterinarians are present at all federal livestock slaughter facilities."

The news from the USDA comes after the Food and Drug Administration noted that fragments of the virus were found in the commercial milk supply. Later tests showed that the widespread practice of pasteurization inactivated the virus.

"This additional testing did not detect any live, infectious virus. These results reaffirm our assessment that the commercial milk supply is safe," the FDA said.

Experts said people should still be careful of consuming raw milk or products made from raw milk.

"Raw milk is unpasteurized and has a plethora of bacteria and viruses in it ... if there is any bird flu in the [raw] milk, it's not going to be denatured or killed. So, you run a minor risk from raw milk," Haskell explained.

The USDA said it will begin work on three separate beef studies: sampling ground beef at retail stores in states where cattle have tested positive; sampling beef muscle from sick dairy cows that have been culled; and conducting experiments that test cooking ground beef to various temperatures.

"Despite our confidence in the safety of the meat supply, the importance of continued and comprehensive investigations remains critical. These studies are crucial for maintaining public trust and ensuring that our food safety measures evolve in response to new information about H5N1," said Dr. John Brownstein, chief innovation officer at Boston Children's Hospital and an ABC News medical contributor.

Only meat that has passed inspection can be sold in grocery stores or restaurants, according to the USDA. The agency has veterinarians that are present at all federal livestock slaughter facilities where animals are inspected before and after slaughter.

Officials continue to recommend safe handling of food to help prevent foodborne illnesses: wash hands and surfaces often, separate raw meats from other foods, cook meat to the right temperature and chill food promptly in a refrigerator. Ground beef should be cooked to 160F and ground poultry to 165F, according to the USDA.

"The USDA's ongoing studies into the safety of beef considering the H5N1 findings in dairy cattle underscore the thoroughness of our food safety protocols," Brownstein added.

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(NEW YORK) -- Rural Americans are more likely to die early from one of the five leading causes of death than those who live in urban areas, according to new federal data.

Researchers looked at the number of potentially preventable deaths from 2010 through 2022. The report was published Tuesday by the Centers for Disease Control and Prevention.

Rural Americans were more likely to die from heart disease, cancer, unintentional injuries, stroke and chronic lower respiratory disease before age 80 compared to urbanites, researchers said.

"There is a well-described, rural-urban divide in the United States, where rural residents tend to be sicker and poorer and to have worse health outcomes than do their non-rural peers," Dr. Macarena Garcia, a senior health scientist in the CDC's Office of Rural Health, said during a press conference on Monday.

About 20% of the U.S. population lives in rural areas while the remaining 80% live in urban areas, according to data from the U.S. Census Bureau.

Previous research has indicated that rural Americans face numerous health care challenges including long travel distances to special and emergency care and are less likely to have health insurance. Additionally, rural Americans have higher rates of high blood pressure and obesity.

For the report, researchers identified premature deaths as occurring before age 80. The average life expectancy in the U.S. was 79 in 2010. The number of preventable early deaths was calculated by subtracting the number of expected deaths by the number of actual deaths.

Although COVID-19 has been the third- or fourth-leading cause of death since 2020, the CDC said deaths from the virus were "excluded to maintain consistency and facilitate the assessment of trends over time."

Since 2010, an estimated 6.37 million Americans have died prematurely from the five leading causes over the 12-year study period. Researchers found that about 64% of deaths from unintentional injury -- which includes car accidents, falls, accidental shootings, unintentional poisonings, overdose deaths and drownings -- could have been prevented.

The report found 34% of stroke and heart disease deaths were preventable as were 26% of deaths from chronic lower respiratory disease.

Results showed the percentage of preventable deaths were highest in rural counties versus urban ones.

For example, 44% of heart disease deaths among people below age 80 in rural areas were potentially preventable compared with 27% in urban areas. More than half of early deaths from unintentional injury and chronic lower respiratory disease in rural areas were preventable.

For deaths from cancer, less than 20% of deaths were preventable in rural counties.

"We have to remember that screening prevention services as well as treatment services are much more accessible in urban areas," Garcia said. "So that means they are limited in rural areas. Sometimes people have to drive two, three hours to the nearest center that provides specialty care."

She went on, "So that means people go without preventive services. People in rural areas likely have lower rates of screening and certainly have less access to treatment."

When it came to geographic variation, Garcia said the CDC analysis showed consistently that the southeastern U.S. was the region with the highest prevalence of preventable early deaths.

In 2022, for example, the CDC found that when in came to unintentional injuries, between 70% and 100% of early deaths in several southeastern states including South Carolina, Louisiana, Mississippi, Kentucky and Tennessee could have been prevented. By comparison, between 30% and 66% of deaths could have been prevented in the majority of states.

The CDC said it is trying to improve rural health by funding and guiding public health programs in rural communities such as increasing cancer screenings for women and promoting physical education in schools.

"We believe these findings can help guide focused public health interventions at the local and community levels to effectively reduce the risks of premature death," Garcia said during the press briefing. "The findings also suggest a need to better understand potential shifts in social, environmental and structural inequities contributing to disparities in preventable early deaths between rural and urban areas."

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(NEW YORK) -- Breast cancer screening guidelines have been finalized by a major task force, bringing the recommended age to 40 for most women of average risk in a report published Tuesday.

The U.S. Preventive Services Task Force, a major task force consisting of expert physicians providing recommendations in the primary care setting for routine medical screenings, behavioral counseling, and preventive medications, is now recommending breast cancer screening with mammograms every other year for women with an average risk of developing breast cancer, starting at age 40. This guidance was previously drafted in May 2023, and nearly one year later, these recommendations have been finalized without major changes.

Previously, the USPSTF guidance said screening should start no later than age 50. The Task Force recommended that women in their 40s talk to their doctor about their individual risk. The age for routine screening was dropped to account for the 2% increase in breast cancer diagnosis rates each year among women in their 40s.

By lowering the screening age, the USPSTF predicts this change has the potential to avert 1.3 cases of death from breast cancer per 1000 women over a lifetime of screening. The recommendations are otherwise consistent with prior 2016 guidelines.

The updated guidelines also addressed ongoing racial disparities in breast cancer diagnosis and survival rates, particularly for Black women. According to the USPSTF, Black women are 40% more likely to die from breast cancer compared to white women. In addition to calling for more research on racial disparities and screening strategies in breast cancer, the USPSTF additionally noted this drop in screening age was included to hopefully address these disparities.

The updated recommendations will not impact insurance coverage, but by law, mammograms should be covered by insurance for all women 40 and older.

The finalized guidelines for routine screening mammograms apply to cisgender women and those assigned female at birth who are between the ages of 40 and 74 with an average risk of developing breast cancer.

The guidance also notes that almost half of all women have dense breasts, which places them at risk for breast cancer.

"In patients with dense breast tissue, addition of MRI may reduce cancer risk and false positive recalls," said Dr. Nancy Chan, Medical Oncologist, NYU Langone Perlmutter Cancer Center, in prepared remarks.

These recommendations do not apply to women with a personal history of breast cancer, those at very high risk for breast cancer following genetic testing, or a history of high-dose radiation therapy to their chest at a young age, or those with a history of breast lesions requiring one or more biopsies. Therefore, considerations should be made to start screening at an even earlier age.

For women aged 75 or older, the USPSTF continues to recommend that they speak to their healthcare providers on whether to continue routine screening, based on their medical history and personal preferences.

"Millions of women over age 75 are in very good health and are expected to live many more years during which their risk of breast cancer remains high. The ACS does not support stopping screening for anyone with a 10+ year life expectancy irrespective of age," said Dr. Karen Knudsen, Chief Executive Officer at the American Cancer Society (ACS), in prepared remarks.

For now, the USPSTF guidance recommends every-other-year screening, rather than annual screening. Some debate still exists about the appropriate rate of screening, with an accompanying JAMA editorial citing ACS that there is enough evidence to recommend annual screening for most women.

"The USPSTF decision today is a critical change concerning women's health and the fight against breast cancer, acknowledging that women in their 40s will benefit from mammography screening, and sending a strong message to referring physicians and women that breast cancer screening should begin earlier than age 50," Knudsen said in prepared remarks.

"Mammography screening is the cornerstone of our strategy to find this potentially deadly disease early, when it's easier to treat successfully," Knudsen continued.

Dr. Jennifer Miao is a cardiology fellow at Yale School of Medicine/Yale New Haven Hospital and a member of the ABC News Medical Unit.

Editor's Note: This story has been updated.

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(NEW YORK) -- About 152 people across 30 counties in West Virginia have been exposed to measles, state health officials said Friday.

Earlier this week, the first confirmed case of measles in the state since 2009 was identified, according to the West Virginia Department of Health (WVDH). The patient was someone who was undervaccinated and had a history of recent international travel, the department said.

State health leaders said that since then, they've learned of dozens of exposed individuals including 128 West Virginia residents and 24 out-of-state contacts from four neighboring states.

Of the people who were exposed, 62% don't have documentation proving they are protected against measles and are considered at risk, according to WVDH.

"The Bureau for Public Health is strongly recommending those exposed individuals with no evidence of immunity against the virus quarantine until May 9 or 10, 2024, depending on their last date of exposure," the department said in a release.

The WVDH did not immediately reply to ABC News' request for comment.

The news about the possible exposure comes amid a rapid increase in the number of measles cases during the first quarter of 2024, in part due to several localized outbreaks, including at a children's hospital and daycare center in Philadelphia, an elementary school in Florida and a migrant center in Chicago.

As of Friday, 128 cases have been reported in 19 states, according to the Centers for Disease Control and Prevention (CDC). More than half of those infected were under 5 years old and 81% are unvaccinated or have unknown vaccination status, the federal health agency said.

Measles is a highly transmissible virus. It's so infectious that a measles patient could infect up to 90% of close contacts who are not immune, either through prior infection or vaccination, according to the CDC.

The CDC currently recommends that everyone receive two doses of the measles, mumps and rubella (MMR) vaccine, with the first dose between ages 12 and 15 months and the second dose between ages 4 and 6.

Why does the US keep experiencing measles outbreaks?

One dose of the measles vaccine is 93% effective at preventing infection if exposed to the virus, and two doses are 97% effective, according to the CDC.

The WVDH said it is working closely with the Monongalia County Health Department, where the positive measles case was identified, to make sure health officials have adequate testing supplies and MMR vaccine availability.

"The Bureau for Public Health recommends the safe and effective MMR vaccination as part of a routine vaccination schedule for all children and adults," the department said in the release. "With summer travel coming up and people going to and coming from countries that have seen sharp upticks in measles cases, the time is now to be sure you and your family members are up-to-date on their MMR vaccine."

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(NEW YORK) -- Public health officials are continuing to monitor as an outbreak of avian flu, also known as bird flu, continues to spread across the country.

The strain, known as H5N1, has sickened several mammals this year, according to the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA).

Several dairy cows have been infected, resulting in milk samples showing inactive remnants of the virus, and one human case has been confirmed.

Health officials say the food supply is safe and the risk to the general public is currently low.

Here's the latest to know on the outbreak:

What is bird flu?

Avian influenza, or bird flu, is an infectious viral disease that primarily spreads among birds and is caused by infection with Influenza A viruses.

These viruses typically spread among wild aquatic birds but can infect domestic poultry and other bird and animal species, according to the CDC.

Although bird flu viruses normally don't infect humans, there have been rare cases of infection. To confirm infection, laboratory testing is required.

Signs and symptoms of infection in humans often include sore throat, cough, fever, runny or stuffy nose, headache, muscle or body aches, fatigue and shortness of breath. Less common symptoms include nausea, vomiting, diarrhea and seizures.

Infections can range from no symptoms or mild illness, such as flu-like symptoms, to more severe illness, such as pneumonia that could require hospitalizations, the CDC says.

How did the outbreak begin?

In early March, the USDA announced a bird flu strain that had sickened millions of birds across the U.S was identified in several mammals this year.

At the time, three states had reported cases of bird flu in mammals in 2024, including striped skunks found in Washington state, a mountain lion in Montana and a raccoon in Kentucky.

A few weeks later, federal and state public health officials said they were investigating an illness among primarily older dairy cows in Kansas, New Mexico and Texas and causing symptoms including decreased lactation and low appetite.

The USDA said in a statement at the time that "there is no concern about the safety of the commercial milk supply or that this circumstance poses a risk to consumer health."

First human case of bird flu

Earlier this month, the CDC said a human case of bird flu was identified in Texas and linked to cattle. The infected individual worked directly with sick cattle and reported eye redness as their only symptom.

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This is the second human case of H5N1 ever reported in the U.S. but the first linked to cattle.

However, there have been no reports and no evidence to indicate there is person-to-person transmission, a CDC Director Dr. Mandy Cohen told ABC News at the time.

The CDC said it considers the health risk assessment to the general public to be low.

Inactive fragments found in milk samples

Earlier this week, reports emerged of bird flu fragments found in samples of pasteurized milk. However, the fragments are inactive remnants of the virus and cannot cause infection as the commercial milk supply undergoes pasteurization.

Federal agencies maintain the U.S. commercial milk supply remains safe because milk is pasteurized and dairy farmers are required to dispose of any milk from sick cows, so it does not enter the supply.

"To date, we have seen nothing that would change our assessment that the commercial milk supply is safe," the FDA said in an update.

The FDA said in its update that fragments of the virus are likely inactivated by the pasteurization process.

"The discovery of bird flu virus fragments in commercial milk is significant, not because it poses a direct threat to public health, but because it indicates a broader exposure among dairy cattle than we previously understood," said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor. "This calls for an expanded surveillance of both the virus's presence and its potential impact on food safety."

He added, "It's crucial to continue rigorous testing to determine if any live virus can survive the process. Understanding the dynamics of this virus in dairy products will help us refine our risk assessments and ensure public health safety."

The FDA said it is collaborating closely with the CDC's food safety group surveillance team to monitor emergency department data and flu testing data for any unusual trends in flu-like illness, flu or conjunctivitis. There is currently no data showing any unusual trends or activity.

ABC News Sony Salzman contributed to this report.

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(NEW YORK) -- The overall number of births in the United States dropped in 2023 as teenage births reached a record low, according to new provisional federal data published early Thursday.

In 2023, there were 3.59 million births recorded, a 2% decline from the 3.66 million recorded in 2022, according to the report from the Centers for Disease Control and Prevention's National Center for Health Statistics.

This follows what has been a general decline since the mid-2010s. Between 2015 and 2020, the number of births fell an average of 2% per year from 2015 to 2020, including a decline of 4% from 2019 to 2020.

Births slightly rose, by 1%, from 2020 to 2021, and the number remained generally steady from 2021 to 2022, according to the report.

By maternal age, provisional birth rates declined for several age groups including teenagers between ages 15 and 19. For this group, the rate in 2023 was 13.2 births per 1,000 females down 3% from the rate of 13.6 per 1,000 in 2022, another record low for that age group.

Aside from an increase in 2006 and 2007, the teen birth rate in the U.S. has been continuously declining since 1991. From 2007 through 2023, rates for younger teens (ages 15-17) and older teens (ages 18-19) declined by 8% and 6% per year, respectively, the report found.

Reasons for the decline in teen pregnancy are not clear but the CDC says evidence suggests it's due to a mix of more teens abstaining from sexual activity, and more sexually active teens using birth control.

Birth rates also declined for women between ages 20 to 29 and ages 30 to 39. For pre-teens and teens between ages 10 and 14 and women aged 40 and older, rates were relatively unchanged from 2022 to 2023.

Additionally, the fertility rate for women between ages 15 and 44 was 54.4 births per 1,000, down 3% from 2022, the report said. Similarly, the fertility rate had been declining from 2014 to 2020, rose from 2020 to 2021, and then began declining again.

"The total fertility rate in 2023 remained below replacement -- the level at which a given generation can exactly replace itself (2,100 births per 1,000 women)," the report read. "The rate has generally been below replacement since 1971 and consistently below replacement since 2007."

When broken down by race/ethnicity, nearly every group saw a decline in the provisional numbers of births with the biggest drop being 5% for American Indian and Alaska Native women. Hispanic women were the only group to see births rise, increasing by 1%, and the number was essentially unchanged for Native Hawaiian or Other Pacific Islander women.

The report also looked at Cesarean delivery rates and found that in 2023, the overall rate increased to 32.4%, from 32.1% in 2022. According to the report, this is the fourth annual consecutive increase after the rate had been in decline since 2009 and the highest rate since 32.7% in 2013.

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(NEW YORK) -- The nearly 30 million kids who eat meals at schools each day in the United States will soon see some changes to the food they are served.

On Wednesday, the U.S. Department of Agriculture announced a series of changes to nutrition standards for school meals, including one that is a historic first.

Here are three things to know about the changes coming to breakfast and lunch meals served at school:

1. Added sugars will now be limited in meals

The biggest change announced by the USDA is that, for the first time, there will be limits on added sugars in school meals.

Currently, schools only have to meet weekly calorie limits, regardless of the added sugars in the foods they serve, according to the USDA.

With this new change, beginning on July 1, 2025, breakfast cereals served at schools will be limited to no more than 6 grams of added sugars per dry ounce; yogurt may have no more than 2 grams of added sugars per ounce; and flavored milk may have no more than 10 grams of added sugars per 8 fluid ounces.

In addition, a second rule, which will take effect on July 1, 2027, requires that added sugars be less than 10% of calories across the week in the school lunch and breakfast programs, according to the USDA.

"USDA heard concerns from parents and teachers about excessive amounts of added sugars in some foods, which factored into this new limit," the agency said in a news release announcing the changes. "Research shows that these added sugars are most commonly found in typical school breakfast items."

According to the Centers for Disease Control and Prevention, children under the age of 2 should not have any added sugars in their diet.

For people age 2 and over, added sugars should constitute less than 10% of their daily calories, according to the CDC. If a child consumes 1,600 calories per day, for example, no more than 160 calories of those should come from added sugars.

Eating too many added sugars -- common in processed foods, desserts, and sugar-sweetened beverages -- is associated with obesity, type 2 diabetes, tooth decay and heart disease, according to to the CDC.

2. Sodium is being gradually reduced in school meals

Beginning on July 1, 2027, school lunches will see a 15% reduction from current limits, while sodium in breakfast meals will see a 10% reduction, according to the USDA.

The USDA said it is allowing current sodium standards to remain for the next three years to give schools, manufacturers, and the general public time to adapt.

"USDA is providing about three years for implementation of the sodium reduction in response to public comments that suggested it takes about three years for manufacturers to reformulate products," the agency said. "Public comments also indicated that children are more likely to accept lower sodium school meals if the meals they consume outside of school are lower in sodium. To that end, other federal agencies are supporting efforts to improve dietary behaviors among the U.S. population."

Eating too much sodium, the majority of which comes from processed foods, can "increase your blood pressure and your risk for heart disease and stroke," according to the CDC.

3. Chocolate milk will still be served, but with limits

The USDA said it will allow schools to continue to sell fat-free and low-fat and flavored and unflavored milk to students.

Beginning on July 1, 2025, however, flavored milk sold at schools will have to meet the new added sugars limits.

Flavored milk offered to K-12 students in school breakfast and lunch must contain no more than 10 grams of added sugars per 8 fluid ounces, according to the USDA, while flavored milk sold a la carte in middle and high schools must have no more than 15 grams of added sugars per 12 fluid ounces.

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(NEW YORK) -- As federal agencies and state partners continue investigating outbreaks of highly pathogenic avian influenza (HPAI) -- more commonly referred to as bird flu -- the U.S. Food and Drug Administration says it discovered fragments of the virus in some samples of milk.

In an update from the FDA, the agency said it tested milk samples by polymerase chain reaction (PCR) and found the presence of fragments of the virus, which is not the same as infectious virus and currently poses no increased risk to human health.

"Based on available information, pasteurization is likely to inactivate the virus, however the process is not expected to remove the presence of viral particles," the FDA said.

"At this point, when you look for something in public health, science and medicine, your chances of finding it go up," ABC News chief medical correspondent Dr. Jennifer Ashton said.

Citing a senior official at the Centers for Disease Control and Prevention, Ashton said, "the overall risk to the general American population is low, particularly from dairy cows, however, 'they are taking this very seriously.'"

What to know about bird flu and safety of milk supply

Importantly, the FDA stated, "we have seen nothing that would change our assessment that the commercial milk supply is safe" and expect new results from multiple studies "in the next few days to weeks."

Concerns were first raised last month when HPAI was detected in dairy cows across multiple states, but the USDA and FDA maintain that the U.S. commercial milk supply remains safe due to "the pasteurization process and the diversion or destruction of milk from sick cows."

"Nearly all (99%) of the commercial milk supply that is produced on dairy farms in the U.S. comes from farms that participate in the Grade 'A' milk program and follow the Pasteurized Milk Ordinance (PMO), which includes controls that help ensure the safety of dairy products," the FDA update continued.

Aside from pasteurized milk, both the FDA and CDC warn against drinking raw milk or products made with it that are typically bought at farms or local stores, due to possible viruses or bacteria that can lead to infection or foodborne illness.

Twenty states explicitly prohibit raw milk sales in some form. And milk that travels across state lines must be pasteurized, according to federal regulations.

HPAI was first detected in 1996 and there have only been two cases of human H5N1 in the U.S. so far. There have been no reports of human-to-human spread in the U.S.

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