State Rankings Presented for Health System Performance

FRIDAY, June 23, 2023 (HealthDay News) -- People living in Massachusetts, Hawaii, and New Hampshire may be among the nation's healthiest, according to a new scorecard that ranks how well the health care system in each U.S. state is working. By contrast, people in Mississippi, West Virginia, and Oklahoma fare the worst when it comes to access to quality care and overall health and well-being.

Released each year by the Commonwealth Fund, a nonprofit group focused on health policy reform, the report card grades all 50 states and Washington, D.C., on 58 measures. They include access to health care, quality of care, cost, health outcomes, and disparities in care. This year's report drew on 2021 data, and it also looked at the state-by-state landscape for women's health, including reproductive health, for the first time.

The report noted there was an unprecedented spike in preventable deaths across the country from 2019 to 2021, largely due to the COVID-19 pandemic. Rates of preventable disease due to COVID-19 were highest in Louisiana, Mississippi, Texas, and New Mexico, surging more than 35 percent. Arizona's rate rose by 45 percent, the largest increase in preventable deaths during this period. Black and American Indian/Alaska Native people experienced some of the highest rates of avoidable death in many states, according to the new report card.

Access to women's and reproductive health care was a mixed bag across states. The report card graded states on 12 measures, including access to prenatal and postpartum care and reproductive cancer screenings and other preventive services, as well as women's overall health outcomes. Overall, women of childbearing age died at increasing rates from preventable causes, including pregnancy and childbirth as well as COVID-19 and substance use during the pandemic. Massachusetts, Rhode Island, and New Hampshire ranked best for reproductive and women's health.

There were pronounced disparities by state in terms of access to prenatal care. In Vermont, 11 percent of women giving birth in 2021 did not receive prenatal care during the first trimester. By contrast, 29 percent of women in Texas and Florida did not have access to such care. Most U.S. women do receive postpartum checkup visits after birth, but there is still room for improvement.

The report also noted there is a mental health care crisis taking place in the United States, with demand for behavioral health services overwhelming supply. Sixty percent of adolescents aged 12 to 17 who had a major depressive episode could not get the treatment they needed, with a high of nearly 80 percent in South Carolina.

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