Fractured Futures: New Data Reveals Where Youth Mental Health Is Breaking and How Medicaid Cuts Could Make It Worse
Washington, DC | April 30, 2025 Young people across the U.S. are navigating a mental health system on the brink and in three out of four congressional districts, the odds are growing against them. As Congress debates cuts to Medicaid, new data from Surgo Health’s ThriveAtlas™ reveals where the safety net is failing, why it’s failing, and what policymakers must do to protect it.
Developed by Surgo Health, ThriveAtlas™ is a first-of-its-kind platform that maps the upstream factors shaping youth mental health and wellbeing across the United States. From trauma exposure and economic hardship to provider shortages and social disconnection, ThriveAtlas™ captures the structural and social barriers that too often go unseen.
For the first time, these complex drivers are translated into a district-level view—covering all 435 congressional districts and Washington, D.C.—to reveal where young people are most at risk and why. By turning invisible challenges into visible, actionable insights, ThriveAtlas™ equips policymakers, advocates, and communities with the tools they need to drive meaningful change.
Today, Surgo Health is releasing its first report, Fractured Futures: ThriveAtlas™ Maps the Risk to Youth Mental Health Amid Looming Medicaid Cuts. Built on the ThriveAtlas™ platform and shaped by insights from Surgo Health’s nationally representative survey of 4,500 youth, the report serves as a map of where the youth mental health crisis is most severe, why young people are falling behind, and the policy levers that could help them thrive.
Dr. Sema Sgaier, CEO and Co-Founder of Surgo Health, said, “ For the first time, we can see where youth mental health risk exists, why it persists, and how we can intervene. The inaugural report is proof of that power. It synthesizes data into a district-level roadmap for policymakers ready to act. When we understand the real conditions young people face, we can finally build the systems they deserve.”
Key Findings
3 in 4 congressional districts face high youth mental health risk in at least one of six themes: Provider Shortages, Accessibility Barriers, Socioeconomic Hardship, Limited Wellness Practices, Negative Life Experiences and Limited Support & Belonging.
43% of Southern districts are in "Multi-Burden Districts" facing multiple overlapping challenges with little infrastructure. States like Mississippi (100% of congressional districts), Tennessee (78% of congressional districts), and Alabama (71% of congressional districts) lead this category.
Trigger law states like Arizona and Indiana are positioned to roll back Medicaid expansion despite having some of the least resilient districts to absorb the impact.
Underserved districts (where care is hardest to access) invest the least in Medicaid, averaging just $3,398 per child, compared to $4,292 in Multi-burden districts. This reveals a critical mismatch between risk and investment.
Democratic-led districts are more likely to be Low Burden or face Personal Hardships (with better care access), while Republican-led districts are more likely to be Multi-Burden Districts or Underserved, reflecting critical differences in provider availability, support systems, and negative exposures.
Republican districts are more than 2x as likely to experience provider shortages and face barriers to accessing care.
Democratic-led urban districts are 2.5 times more likely to be at high risk for Socioeconomic Hardship, than Republican-led urban districts, showing that the challenges differ not just in degree, but in type as well.
“You can’t fix what you don’t understand,” said Dr. Sema Sgaier. “This data equips every Member of Congress with a clear, district-level map of need, so we can avoid making one-size-fits-all decisions and start investing in the places that need it most.”
Access ThriveAtlas™ and Fractured Futures: ThriveAtlas™ Maps the Risk to Youth Mental Health Amid Looming Medicaid Cuts here.
About Surgo Health
Surgo Health is a Public Benefit Corporation pioneering data and analytics to transform how the healthcare system understands people. We uncover the unseen drivers of health—people’s beliefs, barriers, and behaviors—and transform that intelligence into scalable products that enable healthcare organizations to drive impact, reduce costs, and advance equity. From improving clinical trial design to optimizing care delivery and public health strategies, our solutions help decision-makers act on what truly shapes health outcomes. By revealing the human side of healthcare, we’re making it more personal, precise, and effective—for everyone.
Contact
Karen Groppe, Interim Director of Communications
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