— Wyoming and Natrona County, structural drivers of crisis

When crisis starts young.

Wyoming has the country's highest rate of childhood adversity. It shows up early, and it shapes the years that follow.

#50
Wyoming's ranking on adverse childhood experiences, the worst rate measured in the country [1]
1 in 10
Children in Wyoming have a parent or guardian in jail, the 3rd highest rate in the U.S. [2]
Highest in
the U.S.
Wyoming's rate of children who have witnessed domestic violence at home, about 10% [2]
— Why this is health data

Incarceration, violence in the home, and untreated mental distress don't stay contained to the justice system or the news. Research links a high count of adverse childhood experiences directly to a lifetime of higher chronic disease, worse mental health, substance use, lower life expectancy, and, through Medicaid and emergency rooms, real cost to the whole health care system.

That's why this page counts as health data, not a separate category.

— What ACEs means

Adverse childhood experiences, in plain terms

ACEs are things like a parent's incarceration, witnessing violence at home, or growing up with substance use in the house. Research links a high ACEs count to a much higher lifetime risk of chronic disease, mental health challenges, substance use, and reduced life expectancy. Wyoming's rate is the worst measured in the country.

— Mothers and infants

Maternal and infant health in Natrona County is getting worse.

1 in 3 women in Natrona County receive less than adequate prenatal care. [3] Lack of adequate prenatal care is linked to low birth weight, maternal and infant mortality, premature birth, and postpartum depression, and low birth weight in turn drives lifelong health risks: chronic disease, cognitive delays, behavioral health challenges.

Low birth weight
Share of births, 2019 to 2024
20192024
Natrona County, 9.8% to 9.7% Wyoming, 10.0% to 8.3% U.S., 9.8% to 8.6%
Infant mortality
Deaths per 1,000 births, 2019 to 2024
20192024
Natrona County, 7 to 8 per 1,000 Wyoming, 5 per 1,000, flat U.S., 6 per 1,000, flat

The story in both charts is the same shape. Wyoming and the U.S. improved between 2019 and 2024, Natrona didn't, and on infant mortality, Natrona actually got worse while the state and the country held flat. [4]

— Who's hit hardest

Women receiving less than adequate prenatal care

White
36%
Bi-racial
37%
Hispanic
38%
Indigenous
50%

That's a 14-point gap between White and Indigenous mothers, about 40% higher. [3] In Natrona County, 1 in 2 Indigenous women go without adequate prenatal care. About 1 in 3 Hispanic and biracial mothers giving birth locally are teenagers, ages 15 to 19, an age range with its own higher medical risks. Statewide, 14.6% of women are uninsured, and that rate is worst for single mothers, Hispanic and Indigenous women, and women below 200% of the federal poverty line. [5]

— Access and capacity

Why care is hard to reach

1 hour
Distance
The median drive to a Wyoming hospital with labor and delivery services, a distance that can be life-threatening when complications arise. [6]
No expansion
Medicaid
Many low-income women of reproductive age earn too much for Medicaid and too little for marketplace subsidies. Hospitals also go without federal matching funds and absorb uncompensated care directly. [7]
16 for 97,000
Provider gaps
Since 2022, four Wyoming hospitals have closed their labor and delivery wards, leaving 16 birthing facilities to cover 97,000 square miles. [6]
One clinic
Family planning
Wyoming has one abortion clinic, in Casper. Legal barriers, delays, mandatory testing, and parental consent for minors add strain, and some providers delay standard care or practice in other states. [8]
— Mental health, substance use, and the ACEs cycle

Mental distress is rising faster here than in Wyoming or the nation.

If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day.

Adults reporting frequent mental distress
2019 to 2024 [9]
20192024
Natrona County, 13% to 18%, up 38% U.S., 13% to 16%, up 23% Wyoming, 13% to 15%, up 15%
Nearly 1 in 3
Adults in Wyoming experience intimate partner violence in their lifetime, meaning this kind of trauma is playing out in homes across the state. [10]
Nearly doubled
Non-medical drug use among Wyoming adults, since 2020. [11]
85%
Of the U.S. prison population has an active substance use disorder or is incarcerated for a drug-related crime, the endpoint of a trajectory that often starts with untreated distress. [12]

How it becomes the next generation's problem

Children who grow up surrounded by violence and substance use, both counted as ACEs, are more likely to develop their own mental and behavioral health challenges. Locally, serious juvenile offenses in Natrona County rose 10% between 2023 and 2024. [13] Partner interviews describe this as a loop, not a line: unstable adults raise kids in unstable homes, and without addressing what's driving the adult's distress, every intervention aimed only at the child works in isolation.

— From the statewide survey
60%
of Wyoming moms experienced mental health strain in the last year
63%
of Wyoming women ages 18 to 54 said the same
Wyoming statewide, February 2026 survey, N=545. [14]
— Youth in crisis

The distress is reaching kids earlier.

— Anxiety diagnoses, Wyoming children
17%
2020
→
24%
2025
Roughly 1 in 4 Wyoming children now carries an anxiety diagnosis. [15]
35%
Post-COVID chronic absenteeism in Wyoming, pulling kids out of the one place early intervention could reach them. [16]
Self-harm rising
Reports among youth are climbing even as youth suicide itself has declined, a different outlet for the same distress. [17]
2 to 1
K-8 violence is rising, with boys driving the trend at an estimated 2-to-1 ratio. [15]

Why kids are slipping through

Social media has made bullying constant and harder for adults to detect. School policy in practice means a student flagged as high-risk on a screening tool still gets sent home if a parent insists they're fine, since schools have limited authority to intervene without parental buy-in. Youth substance use treatment runs through a single point of entry, with waits that can stretch for months. And behavioral health services for youth are running at capacity: even providers who want to offer more can't, because insurance reimbursement makes it hard to sustain.

Parents don't always see it coming

Post-COVID institutional distrust means some parents resist school and social service intervention entirely, hearing a flagged risk screener as an accusation rather than a warning. Others don't believe their child could be struggling until it's too late; stigma around mental health keeps some families from even agreeing to a screening at a routine check-up. Without a parent's buy-in, an intervention that's ready to help simply can't reach the kid who needs it.

— A gap in the data itself

Wyoming's own Prevention Needs Assessment, the survey that would normally track youth mental health trends directly, hasn't been collected since 2022, when a new parental-consent requirement took effect for school-administered surveys. The findings above come from partner interviews and national research, not a fresh local survey.

— What local partners are seeing

Interviews with local partners describe a system stretched thin.

Partners said they've been asked to put out public information about substances like Kratom, calling it a sign of how many people cycling through the jail are in the middle of a mental health crisis. Some described domestic violence cases climbing in their own caseloads. Several said that when a parent becomes involved in the justice system, it's often the clearest signal that a child needs behavioral health support, not the other way around.

Paraphrased patterns from community partner interviews, February 2026. Not direct quotes from any one person. [22]

— The math

Why fixing this pays off.

$14
Saved in downstream medical and societal costs for every $1 spent on public health initiatives. [18]
$14.1T
The CDC's national estimate of what health problems linked to adverse childhood experiences cost each year in direct medical spending and lost healthy years of life. [19]
$3 : $1
Returned by mentoring and after-school programs, mostly through reduced crime and higher lifetime earnings, against an average $112,555 a year to incarcerate a single juvenile in the U.S. [20]

Natrona County's specific share of the national figure isn't knowable from that number alone, but the direction holds locally: earlier intervention is the cheaper outcome, for the family and for everyone who shares a tax base or an emergency room with them. Reentry and stabilization programs, the kind that keep someone out of the cycle after a crisis rather than just responding to the next one, return $1.47 to $5.27 for every dollar, after accounting for both reduced crime and lower long-run incarceration costs. [21]

None of this is the whole story, and none of it is fixed.

The Trust is taking a hard look at what it would take to change these numbers, more on that soon.

Natrona Collective Health Trust

Sources

Numbers are cited inline above with bracketed numbers. This list gives the full source behind each one.

  1. America's Health Rankings, adverse childhood experiences measure, Wyoming
  2. America's Health Rankings, children with an incarcerated parent and children who witnessed domestic violence, Wyoming
  3. Kids Count Data Center, Annie E. Casey Foundation, prenatal care access
  4. Kids Count (birth weight) and County Health Rankings, Robert Wood Johnson Foundation (infant mortality)
  5. America's Health Rankings, uninsured women in Wyoming
  6. Wyoming Women's Action Network, distance to care and hospital labor and delivery closures
  7. KFF, Medicaid Postpartum Coverage Tracker
  8. Center for Reproductive Rights and Kaiser Family Foundation, Wyoming abortion access
  9. County Health Rankings, Robert Wood Johnson Foundation, mental distress trend
  10. Wyoming Department of Health, intimate partner violence data
  11. America's Health Rankings, substance use trend
  12. American Addiction Centers, prison population and substance use disorder
  13. Cowboy State Daily, youth violence and juvenile offense data
  14. New Bridge Strategy Wyoming Statewide Survey, Feb. 2026, statewide sample, supporting evidence only
  15. America's Health Rankings, youth anxiety and K-8 violence trends
  16. Education Recovery, chronic absenteeism data
  17. Journal of Adolescent Psychiatric Nursing, 2025, youth self-harm trend
  18. Families USA and Pew Research, 2025, public health return on investment
  19. Christopher Peterson, Missy V. Aslam, Phyllis H. Niolon, et al., "Economic Burden of Health Conditions Associated With Adverse Childhood Experiences Among US Adults," JAMA Network Open (2023), as cited by the CDC
  20. Susan Manheimer and Joshua Spaulding, "After School: The Prime Time for Juvenile Crime," Police Chief Magazine, citing Elena Holodny, Business Insider (2016), and William O. Brown et al., The Costs and Benefits of After School Programs (The Rose Institute, 2002)
  21. Council of Economic Advisers, Returns on Investments in Recidivism-Reducing Programs, Executive Office of the President (2018)
  22. Natrona Collective Health Trust strategic planning Workshop 1 pre-read, community partner interviews, February 2026, internal document, no public link