Iowa  ·  Ledger

Where Iowa ranks

39 measures · each with its source and date · the list of what was held back, and why, is at the bottom · generated 2026-09-07

This page sets Iowa against the other states on health, education, the economy, housing, infrastructure, agriculture and water. A measure appears here only after it was checked against the primary source, and every rank is printed with how many places it was ranked against and which end is the good end. Measures where Iowa does well get the same treatment as the rest, and each rank is counted from the good end, so a 1st is never ambiguous.

Where Iowa ranks lowest

Tap any one to jump to the chart and the source.

  1. 50th Counties that lost hospital-based obstetric care of 50 · worst in the country
  2. 50th Structurally deficient bridges of 50 · worst in the country
  3. 51st State psychiatric beds per capita of 51 · worst in the country
  4. 51st Cancer incidence rate of 52 · near the very bottom
  5. 50th OB-GYNs per 100,000 women of reproductive age of 51 · near the very bottom
  6. 49th Iowans living in a county with no ophthalmologist of 51 · near the very bottom
  7. 48th Real GDP change, first quarter 2026 of 50 · near the very bottom
  8. 43rd Mental health providers per capita of 50 · near the bottom

Where Iowa ranks highest

  1. 3rd Households burdened by housing costs of 51 · among the best
  2. 8th Unemployment rate of 51 · better than most states
  3. 9th Benchmark health plan premium of 51 · better than most states
  4. 13th Children in child care deserts of 51 · in the better half

Agriculture · 3 measures

Family farm bankruptcy filings

Agriculture · as of Filings Jan 1 - Dec 31, 2025; farm counts 2025

Iowa's family farm bankruptcy filings more than doubled in a year.

38th of 50 jurisdictions

Read this carefully. Iowa filings went from 7 in 2024 to 18 in 2025, an increase of 157 percent. The widely quoted 220 percent comes from Farm Bureau prose that contradicts Farm Bureau's own map, which reconciles exactly to U.S. Courts totals.

Show the data as a table
Family farm bankruptcy filings. Chapter 12 filings per 1,000 farms.
ItemValuePeriod or note
Iowa0.21Filings Jan 1 - Dec 31, 2025; farm counts 2025
National0.16Filings Jan 1 - Dec 31, 2025; farm counts 2025
Rank, as the source prints it38 of 5050 jurisdictions
Rank from the good end38 of 501st is best
Median0.12across 50 jurisdictions
Middle half0.04 to 0.2125th to 75th percentile
Full range0 to 0.89lowest to highest

Source: American Farm Bureau Federation Market Intel, 'Farm Bankruptcies Continued to Climb in 2025' (Feb. 2026), state map of U.S. Courts Chapter 12 filings; farm counts from USDA NASS, Farms and Land in Farms 2025 Summary (Feb. 2026). Chapter 12 (family farmer) bankruptcy filings per 1,000 farms, calendar year 2025
https://www.fb.org/market-intel/farm-bankruptcies-continued-to-climb-in-2025

Financially vulnerable Iowa farms

Agriculture · as of 2025-12

The share of mid-size and large Iowa farms in financial trouble has more than doubled in three years.

19% percent of mid- and large-size Iowa farms in the sample

Trend: rising. 7.7% (Dec 2022) to 19% (Dec 2025)

Up from 7.7 percent in December 2022

Read this carefully. The source notes this remains below late-2010s levels.

Show the data as a table
Financially vulnerable Iowa farms. percent of mid- and large-size Iowa farms in the sample.
ItemValuePeriod or note
Iowa19%2025-12
2022-127.7%
2025-1219%

Source: Crespi, J.M., and C.C. Pudenz (Eds.) 2026. 2026 Iowa Agricultural Outlook: The Pressure is Rising. Staff Report 26-SR 125. CARD at Iowa State University, Iowa Farm Bureau Federation, and Iowa Bankers Association.
https://www.iowafarmbureau.com/ArticleFile/file/31e979c6-e8d1-4a2f-ab0a-ea90da4f3de9/2026%20Iowa%20Agricultural%20Outlook.pdf

Iowa net farm income

Agriculture · as of 2022-2024

Iowa farm income fell by more than half in two years.

down 53% percent change, 2022 to 2024

Trend: falling. The report projects an increase in 2025 on government payments and livestock returns, then decreases in 2026 and 2027.

Corn production costs are up 37 percent and soybean costs up 36 percent since 2021.

Read this carefully. The source, which is co-published by Iowa Farm Bureau, states plainly that today's conditions do not yet mirror the severity of the 1980s farm crisis. Farmland equity and lender balance sheets remain healthy.

Show the data as a table
Iowa net farm income. percent change, 2022 to 2024.
ItemValuePeriod or note
Iowadown 53%2022-2024

Source: Crespi, J.M., and C.C. Pudenz (Eds.) 2026. 2026 Iowa Agricultural Outlook: The Pressure is Rising. Staff Report 26-SR 125. CARD at Iowa State University, Iowa Farm Bureau Federation, and Iowa Bankers Association.
https://www.iowafarmbureau.com/ArticleFile/file/31e979c6-e8d1-4a2f-ab0a-ea90da4f3de9/2026%20Iowa%20Agricultural%20Outlook.pdf

Child care · 1 measure

Children in child care deserts

Child care · as of Provider data collected December 2024 through September 2025; child population from 2019-2023 Census estimates

Iowa does well on this one

A smaller share of Iowa children live in a child care desert than nationally.

13th of 51 jurisdictions

Show the data as a table
Children in child care deserts. percent of children in a child care desert.
ItemValuePeriod or note
Iowa36Provider data collected December 2024 through September 2025; child population from 2019-2023 Census estimates
National46Provider data collected December 2024 through September 2025; child population from 2019-2023 Census estimates
Rank, as the source prints it13 of 5151 jurisdictions
Rank from the good end13 of 511st is best
Median48.2across 51 jurisdictions
Middle half36.45 to 55.225th to 75th percentile
Full range5.4 to 96.5lowest to highest

Source: Center for American Progress, W.E. Upjohn Institute for Employment Research, and Stanford University, "America's Licensed Child Care Deserts," April 29, 2026, Table 1 (published chart version 4). Percent of children under age 6 living in a licensed child care desert -- a local area with more than three young children for every licensed child care slot (centers, licensed/registered homes, Head Start, and state pre-K; informal family, friend, and neighbor care excluded)
https://www.americanprogress.org/article/americas-licensed-child-care-deserts/

Economy · 4 measures

Manufacturing jobs, change over the year

Economy · as of June 2026, seasonally adjusted

Iowa lost 4,300 manufacturing jobs in the year to June 2026, a bigger drop than any other sector.

down 4,300 jobs, change from June 2025 to June 2026

Trend: falling. 217,100 in June 2025 to 212,800 in June 2026.

Read this carefully. Of Iowa's eleven supersectors, three grew over this period and manufacturing fell the furthest. Total nonfarm employment fell 9,600, so manufacturing is close to half of the state's job loss. Manufacturing is still Iowa's largest sector by output. This is a payroll figure, not an output figure.

Show the data as a table
Manufacturing jobs, change over the year. jobs, change from June 2025 to June 2026.
ItemValuePeriod or note
Iowadown 4,300June 2026, seasonally adjusted
2025-06217,100
2026-06212,800

Source: U.S. Bureau of Labor Statistics, State and Area Employment, Hours and Earnings. Iowa manufacturing employment, seasonally adjusted, June 2025 and June 2026.
https://www.bls.gov/sae/

Median household income

Economy · as of 2024 (ACS 1-year)

The typical Iowa household earns about six thousand dollars less than the typical American household.

35th of 51 jurisdictions

Show the data as a table
Median household income. dollars per year.
ItemValuePeriod or note
Iowa75,5012024 (ACS 1-year)
National81,6042024 (ACS 1-year)
Rank, as the source prints it35 of 5151 jurisdictions
Rank from the good end35 of 511st is best
Median77,871across 51 jurisdictions
Middle half72,370 to 89,81225th to 75th percentile
Full range59,127 to 109,707lowest to highest

Source: U.S. Census Bureau, American Community Survey 2024 one-year estimates. Median household income in the past 12 months, in 2024 inflation-adjusted dollars, per household
https://data.census.gov/table/ACSDT1Y2024.B19013

Real GDP change, first quarter 2026

Economy · as of 2026-Q1

Iowa's economy went slightly backwards in the first quarter of 2026 while most states grew.

48th of 50 states

The median of the 50 ranked states grew 1.43 percent. The chart and the table below add the District of Columbia, which moves the median to 1.44.

Read this carefully. One quarter, not a trend. BEA's September 30, 2026 release is an annual update that will revise these back years.

Show the data as a table
Real GDP change, first quarter 2026. percent change at an annual rate, 2025:Q4 to 2026:Q1.
ItemValuePeriod or note
Iowa-0.08%2026-Q1
National1.44%2026-Q1
Rank, as the source prints it48 of 5050 states, ranked best to worst
Rank from the good end48 of 501st is best
Median1.44across 51 jurisdictions
Middle half0.85 to 2.3925th to 75th percentile
Full range-1.65 to 4.51lowest to highest

Source: U.S. Bureau of Economic Analysis, SQGDP1, real GDP in chained 2017 dollars, percent change 2025:Q4 to 2026:Q1 at an annual rate. Release of June 25, 2026.
https://www.bea.gov/data/gdp/gdp-state

Unemployment rate

Economy · as of June 2026, seasonally adjusted

Iowa does well on this one

A smaller share of Iowans are out of work than in most states.

8th of 51 jurisdictions

Read this carefully. Alabama and Wyoming share Iowa's 3.2 percent, so Iowa is tied for 8th of 51. A low unemployment rate also says nothing about what the work pays, which is a separate measure on this page.

Show the data as a table
Unemployment rate. percent of the labor force unemployed.
ItemValuePeriod or note
Iowa3.2June 2026, seasonally adjusted
National4.2June 2026, seasonally adjusted
Rank, as the source prints it8 of 5151 jurisdictions
Rank from the good end8 of 511st is best
Median4.1across 51 jurisdictions
Middle half3.35 to 4.6525th to 75th percentile
Full range2 to 6lowest to highest

Source: U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics. Unemployment rate by state, June 2026, seasonally adjusted.
https://www.bls.gov/lau/

Education · 6 measures

Average teacher salary

Education · as of FY 2024-25

An Iowa teacher earns about nine thousand dollars a year less than the national average.

30th of 51 jurisdictions, 50 states and the District of Columbia

Iowa and the national figure

$9,183 below the national average

Read this carefully. Iowa's STARTING teacher salary is $48,139, ranked 24 of 51, essentially at the national average of $48,112. The gap opens over a career, not on day one.

Show the data as a table
Average teacher salary. dollars per year.
ItemValuePeriod or note
Iowa$65,312FY 2024-25
National$74,495FY 2024-25
Rank, as the source prints it30 of 5150 states and the District of Columbia
Rank from the good end30 of 511st is best
FY2024-25$65,312

Source: National Education Association, Educator Pay Data 2026 (FY 2024-25), published April 10, 2026.
https://www.nea.org/resource-library/educator-pay-and-student-spending-how-does-your-state-rank

Best state to be a teacher

Education · as of 2026 edition (released Sep 15, 2025) · composite index

Iowa ranks in the bottom fifth of states as a place to teach.

43rd of 51 jurisdictions

This is a composite index. WalletHub combines about two dozen weighted indicators into a single score. It is an index, not a measurement of any one thing.

Show the data as a table
Best state to be a teacher. composite index score.
ItemValuePeriod or note
Iowa40.62026 edition (released Sep 15, 2025)
Rank, as the source prints it43 of 5151 jurisdictions
Rank from the good end43 of 511st is best
Median45.29across 51 jurisdictions
Middle half41.84 to 50.2825th to 75th percentile
Full range33.21 to 59.97lowest to highest

Source: WalletHub, Best & Worst States for Teachers (2026 edition, published Sep 15, 2025). WalletHub 'Total Score' -- proprietary 0-100 weighted composite of 24 teacher-friendliness metrics across two dimensions (Opportunity & Competition, 70 pts; Academic & Work Environment, 30 pts); higher is better, not a physical quantity
https://wallethub.com/edu/best-and-worst-states-for-teachers/7159

Overall education index

Education · as of 2026 Data Book; education indicators are ACS 2020-24, NAEP 2024 and the 2023-24 school year, indexed to 2019 · composite index

Iowa sits just above the middle of the pack on the combined education index.

27th of 50 jurisdictions

This is a composite index. The Annie E. Casey KIDS COUNT education domain combines four separate indicators into an index rank.

Show the data as a table
Overall education index. composite index value.
ItemValuePeriod or note
Iowa3942026 Data Book; education indicators are ACS 2020-24, NAEP 2024 and the 2023-24 school year, indexed to 2019
National4172026 Data Book; education indicators are ACS 2020-24, NAEP 2024 and the 2023-24 school year, indexed to 2019
Rank, as the source prints it27 of 5050 jurisdictions
Rank from the good end27 of 501st is best
Median403.5across 50 jurisdictions
Middle half326.25 to 468.2525th to 75th percentile
Full range1 to 731lowest to highest

Source: Annie E. Casey Foundation, 2026 KIDS COUNT Data Book (37th edition, June 2026), Appendix A. KIDS COUNT Education domain index score, 0-1,000 scale (higher = better child well-being), min-max rescaled against best/worst 2019 state values on four education indicators
https://assets.aecf.org/m/resourcedoc/Aecf-2026kidscountdatabook.pdf

K-12 spending per pupil

Education · as of FY 2024 (Census F-33, most recent published)

Iowa spends about three thousand dollars less per student than the national figure.

35th of 50 jurisdictions

Show the data as a table
K-12 spending per pupil. dollars per pupil per year.
ItemValuePeriod or note
Iowa14,368.95FY 2024 (Census F-33, most recent published)
National17,619.39FY 2024 (Census F-33, most recent published)
Rank, as the source prints it35 of 5050 jurisdictions
Rank from the good end35 of 501st is best
Median16,050across 50 jurisdictions
Middle half13,710 to 20,72325th to 75th percentile
Full range11,060 to 31,918lowest to highest

Source: U.S. Census Bureau, Annual Survey of School System Finances, FY 2024, Summary Table 8. Current spending per pupil (dollars)
https://www2.census.gov/programs-surveys/school-finances/tables/2024/secondary-education-finance/elsec24_sumtables.xlsx

Per-student spending

Education · as of FY 2024-25

Iowa spends less per student than most states.

37th of 51 jurisdictions, 50 states and the District of Columbia

Show the data as a table
Per-student spending. dollars per student per year.
ItemValuePeriod or note
Iowa$14,353FY 2024-25
Rank, as the source prints it37 of 5150 states and the District of Columbia
Rank from the good end37 of 511st is best

Source: National Education Association, Educator Pay Data 2026 (FY 2024-25), published April 10, 2026.
https://www.nea.org/resource-library/educator-pay-and-student-spending-how-does-your-state-rank

Iowa teacher pay against the national average

Education · as of FY 2024-25

In 2000 an Iowa teacher earned about three percent less than the national average. Today the gap is more than twelve percent. That is the change.

30th of 51 jurisdictions, 50 states and the District of Columbia

Over time

Only the periods shown were verified. The years between them are not estimated and are not drawn.

Trend: falling. The gap widened from 3.1 percent below the national average in FY 2000, to 10.4 percent below in FY 2011, to 12.3 percent below in FY 2024-25.

Iowa $65,312 against a national average of $74,495 in FY 2024-25. In FY 2011 the Legislative Services Agency put Iowa 25th in the nation.

Read this carefully. Three points across twenty five years, not an annual series. The years between are not shown because they were not verified, and this page does not draw lines through data it does not have. Each point comes from a different publication using NEA data.

Show the data as a table
Iowa teacher pay against the national average. percent difference from the national average teacher salary.
ItemValuePeriod or note
Iowa12.3% belowFY 2024-25
Rank, as the source prints it30 of 5150 states and the District of Columbia
Rank from the good end30 of 511st is best
FY20003.1% below
FY201110.4% below
FY202512.3% below

Source: National Education Association, Educator Pay Data 2026 (FY 2024-25), published April 10, 2026.
https://www.nea.org/resource-library/educator-pay-and-student-spending-how-does-your-state-rank

Elder care · 1 measure

Share of nursing homes closed

Elder care · as of Closures 2015 through mid-2026

Iowa has closed a larger share of its nursing homes than most states.

39th of 49 jurisdictions, the 50 states minus Alaska, which had fewer than 25 nursing homes in the 2015 cohort

Show the data as a table
Share of nursing homes closed. percent of nursing homes closed.
ItemValuePeriod or note
Iowa16.4Closures 2015 through mid-2026
National10.6Closures 2015 through mid-2026
Rank, as the source prints it39 of 49the 50 states minus Alaska, which had fewer than 25 nursing homes in the 2015 cohort
Rank from the good end39 of 491st is best
Median10.8across 49 jurisdictions
Middle half6.7 to 14.325th to 75th percentile
Full range2.7 to 32.5lowest to highest

Source: CMS Provider of Services File - Internet Quality Improvement and Evaluation System (iQIES), Q2 2026; 2015 cohort verified against the CMS Provider of Services File - Hospital & Non-Hospital Facilities, December 2015. Percent of a state's Medicare/Medicaid-certified nursing homes that were open at the start of 2015 and have since closed or been terminated (closed cohort: numerator and denominator are both restricted to facilities certified before 2015, so the denominator is cohort members still open plus cohort members terminated 2015-2026; excludes code 07 reclassifications, and excludes facilities first certified after 2014 from both sides)
https://data.cms.gov/sites/default/files/2026-07/a014b55b-f9ec-44bc-ab11-830417f2ecc2/POS_iQIES.DATA.Q2_2026%20-%20Copy.csv

Health · 13 measures

Benchmark health plan premium

Health · as of plan year 2026 (rates effective January 2026; published November 2025)

Iowa does well on this one

Iowa's benchmark marketplace premium is lower than in most states.

9th of 51 jurisdictions

Show the data as a table
Benchmark health plan premium. dollars per month.
ItemValuePeriod or note
Iowa501plan year 2026 (rates effective January 2026; published November 2025)
National625plan year 2026 (rates effective January 2026; published November 2025)
Rank, as the source prints it9 of 5151 jurisdictions
Rank from the good end9 of 511st is best
Median611across 51 jurisdictions
Middle half536.5 to 676.525th to 75th percentile
Full range401 to 1,299lowest to highest

Source: KFF State Health Facts, Marketplace Average Benchmark Premiums, plan year 2026; Iowa and the 29 other states on the federal marketplace platform independently reproduced here from the federal plan and enrollment files. The remaining 21 state-run marketplaces rest on KFF alone. Monthly benchmark premium (the second-lowest-cost silver plan) for a single 40-year-old non-smoker, before any premium tax credit, in dollars per month; county benchmarks weighted by county plan selections
https://www.kff.org/affordable-care-act/state-indicator/marketplace-average-benchmark-premiums/

Cancer incidence rate

Health · as of 2018-2022

Iowans get cancer at a higher rate than almost anywhere in the country, and Iowa's rate is going up while the country's goes down.

51st of 52 jurisdictions, 50 states, the District of Columbia, and Puerto Rico

The source ranks the worst first, where Iowa is 2 of 52.

Iowa and the national figure

Trend: rising. +0.7% per year (95% CI 0.4 to 1.1). The national rate is falling 1.0% per year. Only 3 of 52 jurisdictions are rising: Iowa, West Virginia, Utah.

11.2 percent above the national rate

Read this carefully. Two things a careful reader will ask, answered up front. First, Iowa's rank confidence interval is 2 to 3: Iowa and West Virginia are statistically tied, and Kentucky is first at 519.0. Second, Iowa ranks 2nd on getting cancer but about 23rd on dying of it. A gap that size usually means a state is finding cancers other states miss, so some of Iowa's incidence figure is screening intensity rather than more disease. That does not explain the whole gap, and it does not explain why Iowa's rate is rising while the national rate falls, which is the part nobody has accounted for yet.

Show the data as a table
Cancer incidence rate. age-adjusted cases per 100,000 per year.
ItemValuePeriod or note
Iowa498.8 per 100,0002018-2022
National448.6 per 100,0002018-2022
Rank, as the source prints it2 of 5250 states, the District of Columbia, and Puerto Rico
Rank from the good end51 of 521st is best
2018-2022498.8

Source: NCI State Cancer Profiles, incidence by state, all cancer sites, all stages, 2018-2022. Underlying data: CDC National Program of Cancer Registries and NCI SEER, 2024 submission. Retrieved 2026-07-26.
https://statecancerprofiles.cancer.gov/incidencerates/index.php?stateFIPS=00&areatype=state&cancer=001&race=00&sex=0&age=001&stage=999&year=0&type=incd&sortVariableName=rate&sortOrder=desc&output=1

Dentists per capita

Health · as of 2024 dentist counts over 2024 state population (U.S. Census Bureau estimates); both years matched and verified in-script

Iowa has fewer dentists per person than most states.

41st of 51 jurisdictions

Show the data as a table
Dentists per capita. dentists per 100,000 people.
ItemValuePeriod or note
Iowa47.852024 dentist counts over 2024 state population (U.S. Census Bureau estimates); both years matched and verified in-script
National59.532024 dentist counts over 2024 state population (U.S. Census Bureau estimates); both years matched and verified in-script
Rank, as the source prints it41 of 5151 jurisdictions
Rank from the good end41 of 511st is best
Median53.72across 51 jurisdictions
Middle half48.38 to 64.1625th to 75th percentile
Full range40.22 to 103.24lowest to highest

Source: American Dental Association, Health Policy Institute, 'Supply of Dentists in the U.S.: 2001-2024', Table 3 (analysis of the ADA masterfile). Professionally active dentists (licensed, not retired, working in dentistry -- private practice, dental school faculty, armed forces and other federal service, state and local government, hospital staff, residents) per 100,000 state residents
https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/hpidata_supply_of_dentists_2024.xlsx

Iowans living in a county with no ophthalmologist

Health · as of 2023 physician counts, 2023 population

Thirty-nine percent of Iowans live in a county with no eye physician at all. Nationally it is twelve percent.

49th of 51 jurisdictions

Read this carefully. 79 of Iowa's 99 counties have no ophthalmologist practicing in them, which is 1,250,195 people. Only South Dakota and Wyoming have a larger share. A county line is not a wall, and some of these residents drive to a neighboring county rather than across the state. Counties are counted by people rather than by county, because a state with 254 counties and a state with three cannot be compared any other way.

Show the data as a table
Iowans living in a county with no ophthalmologist. percent of residents in a county with no ophthalmologist.
ItemValuePeriod or note
Iowa39.02023 physician counts, 2023 population
National12.12023 physician counts, 2023 population
Rank, as the source prints it49 of 5151 jurisdictions
Rank from the good end49 of 511st is best
Median15.58across 51 jurisdictions
Middle half5.99 to 27.0425th to 75th percentile
Full range0 to 51.64lowest to highest

Source: HRSA Area Health Resources File, 2024-2025 release. Optometrists from the National Provider Identifier file (2024) and non-federal ophthalmologists (2023), against county population, recomputed across all 3,235 counties.
https://data.hrsa.gov/DataDownload/AHRF/AHRF_2024-2025_CSV.zip

Cancer among Iowa farmers in the Agricultural Health Study

Health · as of 1994-2015

Iowa farmers, who are the most exposed to farm chemicals, got 13 percent fewer cancers than Iowans generally. Whatever is driving Iowa's cancer rate, the simple story does not hold up.

13% fewer cancers than expected versus the Iowa general population

Spouses had 10 percent fewer cancers than expected. Farmers had MORE cases than expected of prostate and lip cancer.

Read this carefully. Quoted from the Iowa Cancer Registry: Iowa farmers in the AHS had 13% fewer cancers overall than expected compared to the general population in Iowa from 1994-2015.

Show the data as a table
Cancer among Iowa farmers in the Agricultural Health Study. versus the Iowa general population.
ItemValuePeriod or note
Iowa13% fewer cancers than expected1994-2015

Source: Iowa Cancer Registry. Cancer in Iowa 2026. University of Iowa College of Public Health, March 2026.
https://shri.public-health.uiowa.edu/wp-content/uploads/2026/03/2026-Cancer-in-Iowa.pdf

Counties that lost hospital-based obstetric care

Health · as of 2010 to 2024

Iowa lost hospital-based obstetric care in a larger share of its counties than any other state.

50th of 50 jurisdictions

Show the data as a table
Counties that lost hospital-based obstetric care. percent of counties that had hospital-based obstetric care in 2010.
ItemValuePeriod or note
Iowa30.82010 to 2024
National16.82010 to 2024
Rank, as the source prints it50 of 5050 jurisdictions
Rank from the good end50 of 501st is best
Median13.7across 50 jurisdictions
Middle half6.9 to 21.0525th to 75th percentile
Full range0 to 30.8lowest to highest

Source: University of Minnesota Rural Health Research Center, 2010-2024 County-Level Hospital-Based Obstetric Care Status (AHA Annual Survey + CMS Provider of Services file). Percent of counties that had hospital-based obstetric care in 2010 and had lost it by 2024
https://rhrc.umn.edu/wp-content/uploads/2026/05/county_OBstat_2010_2024.xlsx

OB-GYNs per 100,000 women of reproductive age

Health · as of Physician counts 2023; population denominator 2023

Iowa has the second fewest OB-GYNs per woman of reproductive age in the country.

50th of 51 jurisdictions

Read this carefully. Iowa was last on the 2021-22 data KFF analyzed. On current 2023 physician counts Iowa is 50th of 51 and Idaho is last, so this page says second fewest rather than last.

Show the data as a table
OB-GYNs per 100,000 women of reproductive age. OB-GYNs per 100,000 women aged 15 to 64.
ItemValuePeriod or note
Iowa27.28Physician counts 2023; population denominator 2023
National39.14Physician counts 2023; population denominator 2023
Rank, as the source prints it50 of 5151 jurisdictions
Rank from the good end50 of 511st is best
Median37.37across 51 jurisdictions
Middle half33.91 to 43.5325th to 75th percentile
Full range25.54 to 66lowest to highest

Source: HRSA Area Health Resources File (AHRF) 2024-2025 county release; OB-GYN counts from the AMA Physician Masterfile, denominator from Census state population estimates (SC-EST vintage 2024) for the same year. Practicing OB-GYNs (non-federal MDs and DOs in patient care, excluding hospital residents) per 100,000 women ages 15-64
https://data.hrsa.gov/DataDownload/AHRF/AHRF_2024-2025_CSV.zip

Ophthalmologists per capita

Health · as of 2023

Iowa has fewer eye physicians per person than most states. They are the ones who treat disease and operate.

37th of 51 jurisdictions

Read this carefully. An ophthalmologist is a physician who treats eye disease and performs surgery. This is not interchangeable with the optometrist count on this page, and the two are never added together here. Iowa is above the national rate on optometrists and below it on ophthalmologists, which is the ordinary rural pattern and is the whole point.

Show the data as a table
Ophthalmologists per capita. non-federal ophthalmologists per 100,000 people.
ItemValuePeriod or note
Iowa4.432023
National5.752023
Rank, as the source prints it37 of 5151 jurisdictions
Rank from the good end37 of 511st is best
Median5.27across 51 jurisdictions
Middle half4.37 to 5.925th to 75th percentile
Full range1.2 to 15.46lowest to highest

Source: HRSA Area Health Resources File, 2024-2025 release. Optometrists from the National Provider Identifier file (2024) and non-federal ophthalmologists (2023), against county population, recomputed across all 3,235 counties.
https://data.hrsa.gov/DataDownload/AHRF/AHRF_2024-2025_CSV.zip

Optometrists per capita

Health · as of 2024

Iowa has more optometrists per person than most states. They handle exams and glasses.

19th of 51 jurisdictions

Read this carefully. An optometrist examines eyes and prescribes glasses and contacts. Iowa is above the national rate here and below it on ophthalmologists, and the two are counted separately on purpose: they do different work, so one does not offset the other. 19th of 51 is a solid result rather than a standout, which is why it does not carry the does-well badge.

Show the data as a table
Optometrists per capita. optometrists per 100,000 people.
ItemValuePeriod or note
Iowa20.742024
National18.332024
Rank, as the source prints it19 of 5151 jurisdictions
Rank from the good end19 of 511st is best
Median19.21across 51 jurisdictions
Middle half16.29 to 21.3825th to 75th percentile
Full range11.65 to 30.1lowest to highest

Source: HRSA Area Health Resources File, 2024-2025 release. Optometrists from the National Provider Identifier file (2024) and non-federal ophthalmologists (2023), against county population, recomputed across all 3,235 counties.
https://data.hrsa.gov/DataDownload/AHRF/AHRF_2024-2025_CSV.zip

Overall state health ranking

Health · as of 2025 edition (36th), published January 2026 · composite index

On a broad measure of overall health, Iowa is ahead of two thirds of the country.

17th of 50 states

This is a composite index. America's Health Rankings combines 99 separate measures into one weighted score. It is an index, not a measurement of any single thing, and a strong overall placing can sit on top of very weak individual measures.

Read this carefully. This is an average, and an average hides the distribution. On the specific access measures on this page Iowa is 50th and 51st: counties that lost hospital-based obstetric care, OB-GYNs per capita, and state psychiatric beds.

Show the data as a table
Overall state health ranking. composite index rank among the 50 states.
ItemValuePeriod or note
Iowa17th2025 edition (36th), published January 2026
Rank, as the source prints it17 of 5050 states
Rank from the good end17 of 501st is best

Source: United Health Foundation, America's Health Rankings 2025 Annual Report (36th edition, published January 2026), overall ranking, Iowa.
https://www.americashealthrankings.org/explore/measures/Overall/IA

Pharmacy access

Health · as of Pharmacy locations April 2022; published March 2024

Iowa does well on this one

Iowa has better pharmacy access than most states.

13th of 51 jurisdictions

Show the data as a table
Pharmacy access. percent of residents without nearby pharmacy access.
ItemValuePeriod or note
Iowa3.35Pharmacy locations April 2022; published March 2024
National4.77Pharmacy locations April 2022; published March 2024
Rank, as the source prints it13 of 5151 jurisdictions
Rank from the good end13 of 511st is best
Median4.62across 51 jurisdictions
Middle half3.39 to 6.1925th to 75th percentile
Full range0.86 to 15.47lowest to highest

Source: Wittenauer R, Shah PD, Bacci JL, Stergachis A. Locations and characteristics of pharmacy deserts in the United States: a geospatial study. Health Affairs Scholar 2024;2(4):qxae035 (Oxford University Press), Supplement Table A2-1. Percent of a state's total resident population living in a pharmacy desert census tract, where a pharmacy desert is a tract that is BOTH low income (20%+ below the federal poverty level, or median household income under 80% of the nearest metro area) AND low access (33%+ of residents beyond 1 mile of a pharmacy if urban, 5 miles if suburban, 10 miles if rural, 0.5 miles if fewer than 100 residents own a car). Denominator is the state's own total population.
https://academic.oup.com/healthaffairsscholar/article/2/4/qxae035/7630415

Projected primary care supply

Health · as of 2030 projection, from the December 2025 release

Iowa is projected to meet a smaller share of its primary care need than most states.

39th of 51 jurisdictions

Show the data as a table
Projected primary care supply. percent of projected primary care demand met.
ItemValuePeriod or note
Iowa72.22030 projection, from the December 2025 release
National86.72030 projection, from the December 2025 release
Rank, as the source prints it39 of 5151 jurisdictions
Rank from the good end39 of 511st is best
Median84.4across 51 jurisdictions
Middle half72.3 to 94.425th to 75th percentile
Full range59.7 to 286.4lowest to highest

Source: U.S. Health Resources and Services Administration, National Center for Health Workforce Analysis, Health Workforce Projections (Health Workforce Simulation Model), December 2025 release covering 2023-2038; full-data spreadsheet behind the Workforce Projections Dashboard. Projected physician supply as a percent of projected physician demand in 2030 (percent adequacy = FTE supply / FTE demand x 100). Below 100% = projected shortage. Covers all physician specialties including psychiatry, as the state-level rows of the HRSA file are constructed
https://data.hrsa.gov/DataDownload/StaticDocuments/Workforce_Projections_FullData.xlsx

Physicians per capita

Health · as of 2024 (AMA Physician Professional Data; U.S. Census Bureau population estimates)

Iowa has fewer doctors per person than all but a handful of states.

43rd of 51 jurisdictions

Show the data as a table
Physicians per capita. active physicians per 100,000 people.
ItemValuePeriod or note
Iowa238.662024 (AMA Physician Professional Data; U.S. Census Bureau population estimates)
National303.542024 (AMA Physician Professional Data; U.S. Census Bureau population estimates)
Rank, as the source prints it43 of 5151 jurisdictions
Rank from the good end43 of 511st is best
Median289.97across 51 jurisdictions
Middle half250.04 to 325.2825th to 75th percentile
Full range203.19 to 866.5lowest to highest

Source: AAMC (Association of American Medical Colleges), U.S. Physician Workforce Data Dashboard, 2025 release, 'Physician Density by Location & Specialty'. Active physicians (MD and DO, all specialties) per 100,000 population
https://www.aamc.org/data-reports/report/us-physician-workforce-data-dashboard

Housing · 2 measures

Households burdened by housing costs

Housing · as of 2024 (ACS 1-year, released September 2025)

Iowa does well on this one

A smaller share of Iowa households is burdened by housing costs than almost anywhere else.

3rd of 51 jurisdictions

Show the data as a table
Households burdened by housing costs. percent of households spending more than 30 percent of income on housing.
ItemValuePeriod or note
Iowa24.42024 (ACS 1-year, released September 2025)
National332024 (ACS 1-year, released September 2025)
Rank, as the source prints it3 of 5151 jurisdictions
Rank from the good end3 of 511st is best
Median28.9across 51 jurisdictions
Middle half27.65 to 34.2525th to 75th percentile
Full range22.1 to 42.4lowest to highest

Source: U.S. Census Bureau, American Community Survey 2024 one-year estimates. Percent of occupied housing units paying 30 percent or more of household income for housing costs, owners and renters combined.
https://www2.census.gov/programs-surveys/acs/summary_file/2024/table-based-SF/data/1YRData/acsdt1y2024-b25106.dat

Effective property tax rate

Housing · as of 2024 (ACS 1-year estimates)

Iowa homeowners pay a higher effective property tax rate than most of the country.

43rd of 51 jurisdictions

Show the data as a table
Effective property tax rate. effective property tax rate, percent of home value.
ItemValuePeriod or note
Iowa1.292024 (ACS 1-year estimates)
National0.892024 (ACS 1-year estimates)
Rank, as the source prints it43 of 5151 jurisdictions
Rank from the good end43 of 511st is best
Median0.75across 51 jurisdictions
Middle half0.55 to 1.1725th to 75th percentile
Full range0.27 to 1.92lowest to highest

Source: U.S. Census Bureau, American Community Survey 2024 one-year estimates. Effective property tax rate on owner-occupied homes: median real estate taxes paid as a percent of median home value.
https://www2.census.gov/programs-surveys/acs/summary_file/2024/table-based-SF/data/1YRData/acsdt1y2024-b25103.dat

Infrastructure · 1 measure

Structurally deficient bridges

Infrastructure · as of 2025

Iowa has more bridges rated structurally deficient than any other state.

50th of 50 states

The source ranks the worst first, where Iowa is 1 of 50.

Read this carefully. Every figure here is from ARTBA's Iowa profile, built on the federal National Bridge Inventory as downloaded on June 24, 2025: 4,423 of Iowa's 23,716 bridges, 18.6 percent, are rated structurally deficient, down from 4,504 in 2021. ARTBA ranks West Virginia second; its profile puts that share at 17.8 percent, 1,307 of 7,345 bridges. Structurally deficient does not mean unsafe or closed. It does mean these bridges are small: they hold 1.3 percent of Iowa's total bridge deck area, and 96 percent of them are on rural local and collector roads.

Show the data as a table
Structurally deficient bridges. percent of bridges rated structurally deficient.
ItemValuePeriod or note
Iowa4,423 of 23,716 bridges (18.6%)2025
Rank, as the source prints it1 of 5050 states
Rank from the good end50 of 501st is best

Source: ARTBA Bridge Report, Iowa profile, 2025 edition, analyzing the FHWA National Bridge Inventory.
https://artbabridgereport.org/state/profile/IA

Mental health · 2 measures

Mental health providers per capita

Mental health · as of Providers 2025; population July 2024

Iowa has far fewer mental health providers per person than the country as a whole.

43rd of 50 jurisdictions, the 50 states and the District of Columbia minus Connecticut, which the source did not update

Show the data as a table
Mental health providers per capita. mental health providers per 100,000 people.
ItemValuePeriod or note
Iowa225.9Providers 2025; population July 2024
National348.3Providers 2025; population July 2024
Rank, as the source prints it43 of 50the 50 states and the District of Columbia minus Connecticut, which the source did not update
Rank from the good end43 of 501st is best
Median350.8across 50 jurisdictions
Middle half262.27 to 432.2825th to 75th percentile
Full range156.4 to 801.9lowest to highest

Source: County Health Rankings & Roadmaps (University of Wisconsin Population Health Institute), Supplemental Data Release, 25 March 2026 -- measure v062, Mental Health Providers, built from the CMS National Provider Identifier downloadable file. Mental health providers per 100,000 residents (higher is better). Providers are all NPI-registered psychiatrists, psychologists, licensed clinical social workers, counselors, marriage and family therapists, providers treating alcohol and other drug abuse, and advanced practice nurses specialising in mental health care. Denominator is total resident population.
https://www.countyhealthrankings.org/sites/default/files/media/document/analytic_supplement_20260325%5B1%5D.csv

State psychiatric beds per capita

Mental health · as of 2023 (TAC survey of state officials, April-August 2023)

Iowa has fewer state psychiatric beds per person than any other state.

51st of 51 jurisdictions

Show the data as a table
State psychiatric beds per capita. state psychiatric beds per 100,000 people.
ItemValuePeriod or note
Iowa22023 (TAC survey of state officials, April-August 2023)
National10.82023 (TAC survey of state officials, April-August 2023)
Rank, as the source prints it51 of 5151 jurisdictions
Rank from the good end51 of 511st is best
Median9.9across 51 jurisdictions
Middle half7.7 to 13.7525th to 75th percentile
Full range2 to 35.7lowest to highest

Source: Treatment Advocacy Center, Prevention Over Punishment: Finding the Right Balance of Civil and Forensic State Psychiatric Hospital Beds (January 2024), Tables 2 and 8. Staffed ('online') adult state psychiatric hospital beds per 100,000 residents; excludes pediatric, geriatric, sex-offender, corrections-run, contracted and non-hospital-level beds
https://www.tac.org/wp-content/uploads/2024/01/Prevention-Over-Punishment-Full-Report.pdf

Population · 2 measures

Graduates produced versus graduates kept

Population · as of Graduates 2010-2018; published September 2022

Iowa's colleges produce far more graduates than Iowa keeps.

42nd of 51 jurisdictions

Read this carefully. This is a net stock comparison, not a retention rate. A retention rate cannot exceed 100 percent; this measure runs from -57.5 to +302.7. Illinois scores 5th best on it while losing its own students, because Chicago imports graduates. Data is frozen at a 2022 LinkedIn snapshot.

Show the data as a table
Graduates produced versus graduates kept. percent difference between graduates produced and graduates living in state.
ItemValuePeriod or note
Iowa-34.2Graduates 2010-2018; published September 2022
Rank, as the source prints it42 of 5151 jurisdictions
Rank from the good end42 of 511st is best
Median-20.5across 51 jurisdictions
Middle half-30.2 to -3.8525th to 75th percentile
Full range-57.5 to 302.7lowest to highest

Source: The Washington Post, Department of Data, "States with the worst brain drain -- and more!" (Sept. 9, 2022), analyzing NBER Working Paper 30088, "Grads on the Go" (Conzelmann et al., May 2022). Percentage difference between college graduates produced in a state (alumni of colleges located there) and college graduates living there; percent, negative = net exporter
https://datawrapper.dwcdn.net/UzMfz/3/dataset.csv

Working-age population, ages 18 to 64

Population · as of Vintage 2025 estimates; July 1 2020 to July 1 2025

Iowa's working-age population shrank slightly, 0.21 percent, while the country's grew 1.57 percent.

34th of 51 jurisdictions

Read this carefully. This counts residents aged 18 to 64, not everyone. Over the same five years Iowa's total population grew 1.48 percent, from 3,191,081 to 3,238,387, and the country's grew 3.08 percent (Census Bureau Vintage 2025 state totals, file NST-EST2025-ALLDATA). So this card says Iowa's working-age share is slipping, not that Iowa is losing people.

Show the data as a table
Working-age population, ages 18 to 64. percent change in population aged 18 to 64.
ItemValuePeriod or note
Iowa-0.21Vintage 2025 estimates; July 1 2020 to July 1 2025
National1.57Vintage 2025 estimates; July 1 2020 to July 1 2025
Rank, as the source prints it34 of 5151 jurisdictions
Rank from the good end34 of 511st is best
Median0.48across 51 jurisdictions
Middle half-1.1 to 3.4325th to 75th percentile
Full range-4.41 to 10.59lowest to highest

Source: U.S. Census Bureau, Population Estimates Program, Vintage 2025. Percent change in resident population aged 18-64, July 1 2020 to July 1 2025; the denominator is the same state's 2020 population aged 18-64 from the same file
https://www2.census.gov/programs-surveys/popest/datasets/2020-2025/state/asrh/sc-est2025-alldata6.csv

Wages · 2 measures

State minimum wage

Wages · as of In effect July 1, 2026

Iowa's minimum wage has been $7.25 since 2009.

32nd of 51 jurisdictions

Read this carefully. This is a twenty-state tie at the federal floor, so the rank is a tie for 32nd rather than a precise position. The median state is at $11.85.

Show the data as a table
State minimum wage. dollars per hour.
ItemValuePeriod or note
Iowa7.25In effect July 1, 2026
National7.25In effect July 1, 2026
Rank, as the source prints it32 of 5151 jurisdictions
Rank from the good end32 of 511st is best
Median11.85across 51 jurisdictions
Middle half7.25 to 1525th to 75th percentile
Full range7.25 to 18.4lowest to highest

Source: U.S. Department of Labor, Wage and Hour Division, Consolidated State Minimum Wage Update Table (effective July 1, 2026). Minimum wage in force for FLSA-covered workers, dollars per hour, standard statewide rate (states with no minimum wage law or a rate below the federal floor are shown at the federal $7.25)
https://www.dol.gov/agencies/whd/mw-consolidated

Wage growth per resident

Wages · as of 2015-2025

Iowa paychecks have grown more slowly than the country's for a decade. This is the measure that does not change answer depending on which year you start from.

43rd of 50 states

Iowa and the national figure

The national rate was 4.53 percent a year over the same decade.

Read this carefully. This replaces personal income growth, which is on this page's held-back list. That measure puts Iowa 48th on a 2022 base but 24th to 32nd on other bases, so it tells you more about the start year than about Iowa. Wages per resident holds at 43rd to 50th in every window tested, which is why it is the one shown.

Show the data as a table
Wage growth per resident. wages and salaries per resident, compound annual growth 2015 to 2025.
ItemValuePeriod or note
Iowa3.56% a year2015-2025
National4.53% a year2015-2025
Rank, as the source prints it43 of 5050 states, ranked fastest growth first
Rank from the good end43 of 501st is best

Source: U.S. Bureau of Economic Analysis, SAINC, wages and salaries per resident by state, compound annual growth 2015 to 2025.
https://www.bea.gov/data/income-saving/personal-income-by-state

Water and environment · 2 measures

Share of assessed river miles impaired

Water and environment · as of Most recent complete reporting cycle per state, 2022-2026

Nearly three quarters of Iowa's assessed river miles are too polluted for their intended use.

30th of 51 jurisdictions

Read this carefully. This is the comparable measure. Raw counts of impaired segments cannot be ranked across states, because states define a segment differently: Pennsylvania files 217,000 assessment units and Delaware 1,060.

Show the data as a table
Share of assessed river miles impaired. percent of assessed river miles impaired.
ItemValuePeriod or note
Iowa72.58Most recent complete reporting cycle per state, 2022-2026
National60.42Most recent complete reporting cycle per state, 2022-2026
Rank, as the source prints it30 of 5151 jurisdictions
Rank from the good end30 of 511st is best
Median69.54across 51 jurisdictions
Middle half41.71 to 82.1825th to 75th percentile
Full range3.99 to 100lowest to highest

Source: U.S. EPA ATTAINS, Clean Water Act section 305(b)/303(d) assessments, retrieved via EPA Expert Query; each state's most recent complete Integrated Report cycle. Percent of assessed river and stream miles rated impaired (overall status Not Supporting) -- impaired miles divided by assessed miles, rivers and streams only
https://owapps.epa.gov/expertquery/attains

Impaired water segments

Water and environment · as of 2026

More than seven hundred stretches of Iowa rivers, lakes and wetlands are too polluted to fully serve their intended uses.

723 impaired water segments (574 category 5 plus 149 category 4)

About 51 percent of assessed river segments were designated impaired.

Read this carefully. This is a count from a DRAFT report, not a national rank. States assess differently, so cross-state comparison of these counts is not valid.

Show the data as a table
Impaired water segments. impaired water segments (574 category 5 plus 149 category 4).
ItemValuePeriod or note
Iowa7232026

Source: Iowa Department of Natural Resources, 2026 draft Integrated Report / 305(b) Assessment Summary, ADBNet.
https://programs.iowadnr.gov/adbnet/Assessments/Summary/2026

Held back, and why

These 15 measures are in the database and not on the page, because they did not meet the standard the page holds itself to. Publishing the list is part of that standard. If one of them later clears, it goes up with the rest.

How to read this page

Every rank is counted from the good end, so 1st always means best. Where a source prints its table the other way round, the card says so and quotes the source's own number beside it.

The pools differ. Some measures rank the 50 states, some add the District of Columbia, and one adds Puerto Rico. Each card names its pool next to the rank, and the count is never reworded as "states" when the source's table holds something that is not a state.

Where the source publishes a full state table, Iowa's rank was recomputed from that table before the measure went up, and the chart draws every row of it. That could not be done for 7 measures, because the source prints a rank and no table: Average teacher salary, Cancer incidence rate, Overall state health ranking, Per-student spending, Structurally deficient bridges, Iowa teacher pay against the national average, Wage growth per resident. Those ranks are quoted as the source prints them.

5 source links refused an automated check with an access error (403). A refusal to a script is not evidence that the page is gone, so those sources stay cited as they are.

Corrections are welcome and are made in public. The about page says how to report one.

Generated 2026-09-07 from the pipeline's own data file, with nothing on this page typed in by hand.