- From 2019 to 2021, preventable deaths in Louisiana, Mississippi, Texas and New Mexico climbed by more than 35%, and the rates in Arizona increased by 45%, according to nonprofit Commonwealth Fund’s 2023 Scorecard on State Health System Performance released Thursday. The report attributes the increase in deaths mostly to the COVID-19 pandemic.
- The mortality rate for women in their reproductive years (age 15 to 44) rose nearly 40% due to maternal deaths, COVID-19, and substance misuse.
- Massachusetts, Hawaii, New Hampshire, Rhode Island and Vermont had the best overall health system performances while states in the Southeast and South Central regions ranked the lowest. Those included Arkansas, Texas, Oklahoma, West Virginia and Mississippi.
The Commonwealth Fund scorecard provides a more in-depth picture of the health impacts of the pandemic and how it reduced life expectancy, Commonwealth Fund President Joseph Betancourt said.
“We’ve gone backward on life expectancy and avoidable deaths, and women’s health, mental health and substance use disorder ring loudly as critical issues that require urgent attention,” Betancourt said in a statement.
The scorecard rated health systems based on 58 healthcare indicators along with variations in performance attributed to income, race and ethnicity. The preventable deaths among women highlighted a need for better reproductive care and women’s health, according to the report. Access to care was uneven across the U.S. In Vermont, 11% of women that gave birth in 2021 were unable to receive prenatal care in their first trimester, but 29% in Texas and Florida were unable to receive such care. The four states ranking the lowest in reproductive care and women’s health were Alaska, New Mexico, Oklahoma and Texas.
The report recommends extending Medicaid postpartum coverage to 12 months, advancing reproductive care that includes family planning, abortion services and maternity care as well as postpartum and well-woman care.
The report also recommends expanding and diversifying the maternal health workforce.
“Comparing states on how well their health care systems support people of all ages, races, ethnicities and income levels is critical to our understanding of what is and isn’t working in American health care,” Sara R. Collins, study coauthor and Commonwealth Fund Senior Scholar and Vice President for Health Care Coverage and Access, said in a statement. “It’s clear from these findings that people in every state desperately need better access to high-quality, affordable health care — especially women of reproductive age.”
The report also noted high medical debt in the South and that close to one-quarter of West Virginia residents are struggling with medical debt.
Intervening with primary care will be a key way to avoid preventable deaths going forward, according to the report. Challenges around provider burnout and reimbursement must also be addressed, argued Betancourt during a press conference.