The Best and Worst States for Women’s Healthcare

A new report prepared by The Commonwealth Fund states that women’s health and reproductive care in the United States is in a “perilous place,” and there are growing disparities in these areas.

They note that more women than ever are dying from preventable causes, and there are large differences in maternal mortality and breast and cervical cancer deaths.

Additionally, women’s life expectancy is at its lowest since the year 2006.

Their state-by-state analysis further draws attention to the fallout from the Supreme Court’s historic decision overturning Roe v. Wade, which made it increasingly more difficult for women to obtain needed reproductive healthcare.

Dobbs v. Jackson Women’s Health Organization has also created a climate where contraception and in vitro fertilization (IVF) are at risk, says the report.

They further discuss the impacts of state-level post-pandemic policies that have left millions of low-income women either without health insurance or with gaps in their coverage.

Additionally, these losses in coverage have left the providers who serve these low-income women in danger of closing their offices.

The 2024 State Scorecard on Women’s Health and Reproductive Care, their first effort to examine women’s healthcare in all 50 states and the District of Columbia, is part of an ongoing series of reports on how well state healthcare systems are fulfilling their missions.

It uses 32 measures to gauge each state’s performance in terms of healthcare access and affordability, health care quality and prevention, and health outcomes.

Where healthcare for women ranks highest and lowest

According to the report, Massachusetts, Vermont, and Rhode Island are some of the best-performing states in terms of healthcare access, quality, and outcomes.

Other top-ten states, ranked from higher to lower, were Connecticut, New Hampshire, Maine, the District of Columbia, Minnesota, Hawaii, and New York.

On the other end of the spectrum, Mississippi, Texas, and Oklahoma ranked the worst on these measures.

Other states among the bottom ten, from lower to higher, were Nevada, Arkansas, Georgia, Alabama, Arizona, Tennessee, and Wyoming.

Among the notable findings of the report is the fact that all-cause mortality for women of reproductive age is highest in southeastern states. At the high end of the spectrum was West Virginia, with an all-cause mortality rate of 203.6 per 100,000. At the low end was Hawaii, with 70.5 per 100,000.

The highest rates of maternal mortality were found in the Mississippi Delta region, which includes Arkansas, Louisiana, Mississippi, and Tennessee. Vermont, California, and Connecticut had the lowest mortality rates.

Another salient finding was that deaths from breast and cervical cancer, which are deemed to be preventable with proper screening and healthcare, were highest in southern states.

The authors of the report noted that northeastern states generally have higher screening rates and the lowest mortality while southern states have lower screening rates and higher mortality rates.

What to do if you live in a state where quality care is less accessible

Nicole Levine, MD, who is a physician focusing on preventive care, nutrition, and lifestyle medicine as well as the founder of Health Strive, said one step you can take is to seek out your local nonprofits and community organizations who provide healthcare.

She also suggests becoming active in lobbying for better healthcare policies.

Additionally, you can make use of telehealth services when care is not available near where you live or travel to other states when necessary healthcare services are denied.

“By taking these steps, the gap in access to high quality healthcare can be closed, she said.

However, she noted that narrowing the gaps between the states and improving women’s health outcomes will involve “more access to comprehensive healthcare and legislation that supports it.”

Rachel Goldberg, a Licensed Perinatal, Infertility, and Eating Disorder Therapist at Rachel Goldberg Therapy, seconded the idea of self-advocacy, making many of the same suggestions as Levine.

“The report also highlights how policy decisions, such as the lack of Medicaid expansion, abortion restrictions, and fertility limitations, directly impact women’s health outcomes,” she added. “This underscores the need for more advocacy and policy changes, which require significant resources and effort.”

Goldberg suggests that increasing awareness through social media, sharing personal stories, and engaging celebrities in the discussion are some grassroots ways to highlight the inequities in women’s health care among the various U.S. states and the District of Columbia.

Takeaway

A new report from The Commonwealth Fund details which states provide the highest and lowest quality healthcare for women.

Massachusetts, Vermont, and Rhode Island are some of the best, while Mississippi, Texas, and Oklahoma rank as the worst.

Some of the important issues identified include higher all-cause mortality in southeastern states and higher rates of preventable cancers like breast and cervical cancer in southern states.

Experts say self-advocacy is an important way women can improve health care for themselves.

However, real progress in narrowing the gaps will require legislation to support it.