Researchers at the Institute for Women’s Policy Research recently crunched nearly two decades worth of national data to gauge female wellness across the country -- and uncovered a roster of disturbing health trends.

While certain indicators have generally improved in recent years -- national mortality rates from heart disease and breast cancer have dipped, for example -- several others show a need for prompt attention, said Cynthia Hess, study director at IWPR.

“Health isn't something that exists in a vacuum,” said Hess, who used data from the CDC's Behavioral Risk Factor Surveillance System Survey. “It’s connected to economic security, access to affordable health care, housing quality, access to healthy food and racism.”

To reverse the alarming trends, policymakers must address what may be driving maladies in roughly half the population, she said. One compelling reason: Health spending is projected to be 19.3 percent of GDP by 2023, up from 17.2 percent in 2012, according to CMS. Here are the top six highlighted in a massive new report, published Wednesday.

1. Chlamydia is on the rise in every state, especially North Dakota and Massachusetts.

 The incidence of chlamydia among American women of all ages surged 37 percent between 2002 and 2013, from 455 to 623 per 100,000.  Men also saw a major increase (but the male rate remains lower): 60 to 263 per 100,000.


Courtesy of the Institute of Women's Policy Research

Every state saw an increase in cases of the sexually transmitted infection, which, if left untreated, can trigger pelvic inflammatory disease and infertility.

But the increases varied drastically, the report points out: North Dakota had the largest at 118 percent  (257 to 559 per 100,000), followed by Massachusetts (249 to 559 per 100,000) and Arkansas (425 to 755 per 100,000). Rates didn’t budge much in Georgia, Connecticut, Hawaii, Colorado and Mississippi.

Women in Washington, D.C., meanwhile, are the most likely to have Chlamydia, the findings show, and those in New Hampshire are the least.

 Most people who carry the infection show no symptoms, according to the CDC. More reported cases, however, may not actually signify worsening sexual health, Hess said: “It’s possible tests are getting better and more sensitive, and more people are becoming aware they have it.”

2. Mental health is declining across the country.

More women reported feeling distressed in all states but four. The median number of days per month women nationwide reported experiencing poor mental health -- anxiety, depression, stress -- increased from 3.8 to 4.2 between 2000 and 2013, or about 11 percent.

Only women in the District, New Mexico, Virginia and Wisconsin reported fewer mentally rough days. The Midwest appears to be faring particularly badly:


Courtesy of the Institute for Women's Policy Research

3.  More American women are committing suicide.

The suicide mortality rate among U.S. women grew 35 percent between 2001 and 2013, from 4 to 5.4 per 100,000. Every state saw an increase over this period. It's hard to say why, Hess said, but previous research suggests times of economic hardship -- the recession, for example -- increases a population's risk of depression.

The suicide mortality rate of Washington, D.C.,  which had the lowest rate in 2001, more than doubled between 2001 and 2013, from 1.3 per to 3.1 per 100,000. (The District, however, still holds the lowest rate.)

Montana, which ranked 42nd in 2001, also saw a large increase, from 5.7 to 10.8 per 100,000 -- more than double the national average. Other states with tragic upswings: South Dakota (3.6 to 6.2 per 100,000), Iowa (3.1 to 5.3 per 100,000), and Vermont (3.7 to 6.3 per 100,000).

Rates varied by ethnicity. White women and Native American women are most likely to commit suicide:


Courtesy of the Institute for Women's Policy Research.

 4. A black woman is nearly thirty times more likely to have AIDs than an Asian woman.

 Incidence rates of AIDS for black women -- 28 per 100,000 --  are nearly six times higher than the rate for all women, the report found. That’s about thirty times higher than among Asian women (.9 per 100,000)  and roughly twenty times higher than white women’s rate (1.2 per 100,000).

Black women are also most likely to get tested for HIV. Sixty percent have been tested compared with only 30 percent of Asian and white women.

5. Fewer than half of American women get regular exercise.

Only 48.2 percent of U.S. women hit the gym -- or yoga studio, or hiking trail -- with any regularity, the study found. Women in Colorado and Vermont are the most active, with 59 percent of women reporting at least 150 minutes of exercise per week. At the bottom at Mississippi (33.1 percent), Tennessee (34.7 percent) and Arkansas (38.1 percent).

Between 2000 and 2013, the average number of days each month women reported their activities were limited by the state of their mental or physical health increased from 3.5 to 4.6, or about 31 percent. Nebraska and Kentucky experienced small improvements here. All other states saw a decline.

Obesity is also growing concern for U.S. women: Nearly six in ten women are overweight, or have a body mass index of 25 or greater, the report said.

6. More women report having diabetes, particularly black and Native American women.

Diabetes drives up risk of stroke, heart disease and blindness. Ten percent of U.S. women and 10.4 percent of men report they have diabetes, according to the CDC.

Between 2001 and 2013, the median percentage of women across the country who have ever been told they have diabetes rose from 6.5 percent to 9.7 percent -- a 49 percent surge, the IWPR report found. Arizona saw the largest rise: 4.9 percent in 2001 to 10.0 percent in 2013, a 104 percent increase. Montana had the smallest: 6.2 percent to 7.0 percent, a 13 percent increase.

Black women are the most likely to report they have diabetes, followed by Native American women:


Courtesy of the Institute for Women's Policy Research