Special Report

25 States With Worst Health Care Systems

20. Illinois
> Uninsured rate: 7.4% — 21st lowest
> Health care spending in 2019: $97 per capita — 6th lowest
> Adults in poor or fair health: 15.9% — 21st lowest
> Hospital beds: 2.5 per 1,000 people — 22nd most
> Employee premium contribution, single coverage: $115 a month — 24th lowest

Illinois’ health care system ranks among the worst in the U.S. largely due to the state’s relatively low spending on health care and hospitals. The state spends $97 per person on health care, the sixth lowest amount per person in the U.S., and $68 per resident on hospitals, the 13th lowest. Both are well below the respective national figures of $205 and $294.

Illinois residents may also have a harder time accessing mental health specialists than people in other states. There are 245.3 mental health providers per 100,000 residents in Illinois, compared to 261.2 per 100,000 in the U.S. as a whole.

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19. Kentucky
> Uninsured rate: 6.4% — 14th lowest
> Health care spending in 2019: $98 per capita — 7th lowest
> Adults in poor or fair health: 21.8% — 4th highest
> Hospital beds: 3.2 per 1,000 people — 10th most
> Employee premium contribution, single coverage: $121 a month — 18th highest

Kentucky’s health care system ranks worse than most other states, in large part because residents may struggle to find access to medical professionals. The state has fewer doctors, dentists, and mental health providers per capita than is typical nationwide.

Even though overall health care spending per capita in Kentucky is one of the lowest among states, at $98, the state’s hospital spending is one of the highest in the nation, at $452 per capita. Only 10 states have higher per capita hospital spending.

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18. North Dakota
> Uninsured rate: 6.9% — 19th lowest
> Health care spending in 2019: $188 per capita — 22nd highest
> Adults in poor or fair health: 13.6% — 8th lowest
> Hospital beds: 4.3 per 1,000 people — 2nd most
> Employee premium contribution, single coverage: $99 a month — 8th lowest

North Dakota ranks among the states with the worst health care system in part due to the state’s low concentration of mental health providers and dentists relative to the population. There are 196.3 mental health providers per 100,000 residents compared to 261.2 per 100,000 across the U.S., and 66.4 dentists per 100,000 residents compared to 71.2 per 100,000 in the country as a whole.

North Dakota is among the states that spends the least on hospitals, at $69 per resident, which is significantly less than the $294 national figure. The state also spends less on health care per resident, at $188, compared to the average health care expenditure per capita of $205 across the U.S.

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17. South Carolina
> Uninsured rate: 10.8% — 11th highest
> Health care spending in 2019: $247 per capita — 13th highest
> Adults in poor or fair health: 17.8% — 20th highest
> Hospital beds: 2.4 per 1,000 people — 25th fewest
> Employee premium contribution, single coverage: $112 a month — 17th lowest

South Carolina’s health care system faces more challenges than many states, including high uninsured rate, low concentration of health professionals relative to the population and a high premature death rate. About 10.8% of adults in the state don’t have health insurance, higher than in all but 10 other states. There are also just 183.0 mental health providers per 100,000 residents, the eighth lowest ratio in the nation and well below the national concentration of 261.2 mental health providers per 100,000 residents.

South Carolina has the ninth highest premature mortality rate in the country, at 410.6 deaths before age 75 per 100,000 residents. Nationwide, the premature death rate is less than 340 per 100,000.

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16. North Carolina
> Uninsured rate: 11.3% — 10th highest
> Health care spending in 2019: $164 per capita — 23rd lowest
> Adults in poor or fair health: 18.0% — 19th highest
> Hospital beds: 2.1 per 1,000 people — 18th fewest
> Employee premium contribution, single coverage: $116 a month — 23rd highest

North Carolina’s health care system ranks worse than most other states, in large part because residents may struggle to find access to medical professionals and because of the state’s relatively low spending on health care and hospitals. The state has fewer doctors, dentists, and mental health providers per capita than is typical nationwide and spends less on health care and hospital per capita than the average across U.S. states.

The state has the 10th highest share of adults without health insurance, at 11.3% compared to the nationwide share of 9.2%. About 18.0% of adults report being in poor or fair health, higher than the 16.5% share across the country as a whole.