Southeastern States Fare Poorly on the Commonwealth Fund’s Latest Healthcare Scorecard

In the Commonwealth Fund’s yearly Healthcare Scorecard rating the performance of state healthcare systems, the South performed the poorest across most categories.

Highlights of the Commonwealth Fund Healthcare Scorecard

• Among 58 indicators – including access to healthcare, price, quality, and health outcomes – declining general health, decreasing availability of reproductive care and differences across states stood out.
• During the first two years of the COVID-19 epidemic, mortality caused by pregnancy, overdoses of drugs, firearms, and some curable chronic diseases increased considerably. 
• There was a record increase in insurance coverage during the epidemic; however,  COVID-era plans are starting to expire.
• On all seven measures of health system performance, Massachusetts came out on top. 
• Hawaii, New Hampshire, Rhode Island, and Vermont rounded up the top five. 
• Mississippi, Texas, West Virginia, Arkansas, and Oklahoma made the bottom five.

COVID-19 fatalities contributed to a rise in overall avoidable mortality, reducing life expectancy in the country. The decline in life expectancy was especially severe for African-Americans.

Effective public health interventions and primary care, according to the research, can significantly reduce the number of deaths before 75. Premature deaths were associated with fundamental health and socioeconomic variables, state pandemic reactions, and vaccination rates. Also of grave concern was the frightening increase in deaths attributed to firearms, which has risen by 23% since 2019.

Although all states reported significant increases in preventable deaths, the research highlighted the extraordinary 35% rise in Arizona, Texas, Louisiana, Mississippi, and New Mexico. According to the research conducted by The Commonwealth Fund, people of color, including African Americans and Native Americans, have the highest mortality rates from curable and avoidable illnesses.

There was an increase from around 50 fatalities per 100,000 live births in American Indian and Alaska Native communities in 2020 to about 120 deaths per 100,000 in 2021. There was a rise of almost 25 fatalities per 100,000 Black mothers.

Laurie Zephyrin, Ph.D., Commonwealth Fund VP of health equity, remarked: “Ultimately, we see states with the worst outcomes are also implementing and considering further restrictions on reproductive care. This really raises concerns about inequity in access and inequity in health outcomes.”

There are a total of 12 new indicators for assessing maternal and childbirth outcomes as well as accessibility to reproductive care in this year’s scorecard. The representatives of the Commonwealth Fund reaffirmed a point made many times in the report: the supplied data predates the 2022 Supreme Court Dobbs judgment.

Death rates varied widely by state, from 9.6 per 100,000 California births to more than 40 in Alabama, Arkansas, Louisiana, Mississippi, and Tennessee.

Care that tackles socioeconomic variables of health, including race, and the training of a diverse, thorough, community-based maternal wellness staff should be invested in, according to the report’s authors.

Drug overdoses, alcohol, and suicide accounted for almost 200,000 fatalities in 2021, 50,000 more than the 2019 peak level pre-Covid.

 

The Commonwealth Fund expressed concern about the general availability of healthcare due to impending changes to Medicaid. 13 of the 18 states with the largest uninsured rates weren’t expansion states for Medicaid, according to the research.