Special Report
25 States With Worst Health Care Systems
May 18, 2021 10:00 am
10. Arkansas
> Uninsured rate: 9.1% — 20th highest
> Health care spending in 2019: $58 per capita — the lowest
> Adults in poor or fair health: 23.3% — 2nd highest
> Hospital beds: 3.2 per 1,000 people — 10th most
> Employee premium contribution, single coverage: $104 a month — 10th lowest
Arkansas’ health care system ranks as the 10th worst in the U.S. largely due to the state’s relatively low spending on health care as well as fewer than average numbers of health professionals per capita. Though the state spends a relatively high amount of money per capita on hospitals, Arkansas only spends $58 per person on health care, the lowest per capita figure in the U.S. and compared to the national average of $205.
Arkansas residents may also have a harder time seeing health specialists than people in other states. There are 66.4 primary physicians per 100,000 residents in the state, compared to 75.8 per 100,000 in the U.S. as a whole. The state ranks the lowest in the number of dentists per 100,000 residents, at 47.6 per 100,000 residents in the state compared to 71.2 per 100,000 people nationwide. The child mortality and infant mortality rates in the state are both the fourth highest in the U.S. The share of adults reporting being in poor or fair health, at 23.3%, is the second highest in the country as a whole.
9. Florida
> Uninsured rate: 13.2% — 4th highest
> Health care spending in 2019: $225 per capita — 16th highest
> Adults in poor or fair health: 19.5% — 10th highest
> Hospital beds: 2.6 per 1,000 people — 21st most
> Employee premium contribution, single coverage: $120 a month — 19th highest
Florida ranks among the states with the worst health care system in part due to the state’s high uninsured rate, relatively low spending on hospitals, and low concentration of mental health providers relative to the population. There are 169.0 mental health providers per 100,000 residents, the ninth lowest ratio in the U.S. About 19.5% of adults report being in poor or fair health, the 10th highest share in the country.
The state’s preventable hospitalizations rate of 4,684 per 100,000 people, infant mortality rate of 6.1 per 1,000 births, and premature death rate at 336.7 deaths before the age of 75 per 100,000 residents are all above the respective nationwide figures.
8. Idaho
> Uninsured rate: 10.8% — 12th highest
> Health care spending in 2019: $104 per capita — 10th lowest
> Adults in poor or fair health: 15.1% — 15th lowest
> Hospital beds: 1.9 per 1,000 people — 10th fewest
> Employee premium contribution, single coverage: $73 a month — 2nd lowest
Idaho ranks as one of the states with the worst health care system largely because residents may have more difficulty getting medical care than those in most other states. The state has just 1.9 hospital beds per 1,000 people, lower than in all but a handful of other states.
Idaho has fewer doctors, dentists, mental health providers per capita than the majority of states. The state also has the 12th highest percentage of residents who are uninsured, at 10.8%. Nationwide, just 9.2% of Americans are uninsured.
7. Tennessee
> Uninsured rate: 10.1% — 14th highest
> Health care spending in 2019: $111 per capita — 15th lowest
> Adults in poor or fair health: 21.2% — 7th highest
> Hospital beds: 2.9 per 1,000 people — 15th most
> Employee premium contribution, single coverage: $119 a month — 22nd highest
Tennessee’s 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 as well as fewer than average numbers of health professionals per capita. The state spends $111 per person on health care and $56 per resident on hospitals, both well below the respective nationwide per capita figures of $205 and $294.
Tennessee residents may also have a harder time accessing certain health specialists than people in other states. There are 157.7 mental health providers per 100,000 residents in the state compared to 261.2 per 100,000 in the U.S. as a whole. The state ranks lower in the number of dentists per 100,000 residents with 55.5 dentists per 100,000 residents in the state compared to 71.2 per 100,000 people nationwide. Just over a fifth of Tennessee adults report being in poor or fair health, the seventh highest share in the country.
6. Indiana
> Uninsured rate: 8.7% — 22nd highest
> Health care spending in 2019: $90 per capita — 4th lowest
> Adults in poor or fair health: 18.2% — 17th highest
> Hospital beds: 2.7 per 1,000 people — 19th most
> Employee premium contribution, single coverage: $122 a month — 17th highest
Indiana’s 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 as well as fewer than average health professionals per capita. The state spends $90 per person on health care and $21 per resident on hospitals, both well below the respective national figures of $205 and $294.
Indiana residents may also have a harder time accessing certain health specialists than people in other states. There are 66.8 primary physicians per 100,000 residents in Indiana, compared to 75.8 per 100,000 people in the U.S. as a whole. The state ranked lower in the number of mental health providers per 100,000 residents — 168.3 per 100,000 residents in the state compared to 261.2 per 100,000 people nationwide. Just over a quarter of Indiana adults have unmet mental health needs as of February 2020, the seventh highest share in the country.
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