Special Report
25 States With Worst Health Care Systems
May 18, 2021 10:00 am
5. Nevada
> Uninsured rate: 11.4% — 8th highest
> Health care spending in 2019: $93 per capita — 5th lowest
> Adults in poor or fair health: 19.1% — 12th highest
> Hospital beds: 2.1 per 1,000 people — 18th fewest
> Employee premium contribution, single coverage: $105 a month — 11th lowest
Nevada ranks among the states with the worst health care system in part due to low government spending on health care and hospitals as well as one of the highest uninsured rates in the U.S. Though the number of mental health providers and dentists per capita in Nevada are slightly lower than the national figure, the concentration of primary care doctors is significantly lower. There are 58.4 doctors per 100,000 state residents, the third lowest rate in the country, and compared to 75.8 doctors per 100,000 people nationwide.
Nevada’s premature death rate, child mortality rate, and share of adults in poor or fair health are all above the U.S. averages. The share of adults with unmet mental health needs is the third highest, at 28.6%.
4. Mississippi
> Uninsured rate: 13.0% — 5th highest
> Health care spending in 2019: $133 per capita — 19th lowest
> Adults in poor or fair health: 22.1% — 3rd highest
> Hospital beds: 4.0 per 1,000 people — 3rd most
> Employee premium contribution, single coverage: $109 a month — 13th lowest
Mississippi ranks as the state with the fourth worst health care system in the U.S. for several reasons. One is the high uninsured rate — 13.0% of adult residents don’t have health insurance, the fifth highest share in the country. Another reason is the relatively limited access to health professionals compared to most other states. There are just 52.9 primary care doctors per 100,000 residents in the state, fewer than in any other state. Mississippi also has one of the lowest concentrations of dentists and mental health providers per 100,000 residents in the U.S.
Maybe partially as a result, Mississippi has the highest infant mortality rate, the highest child mortality rate, the second highest rate of residents dying before the age of 75 per 100,000 people, and the third highest share of adults reporting poor or fair health.
3. Arizona
> Uninsured rate: 11.3% — 9th highest
> Health care spending in 2019: $81 per capita — 3rd lowest
> Adults in poor or fair health: 18.6% — 14th highest
> Hospital beds: 1.9 per 1,000 people — 10th fewest
> Employee premium contribution, single coverage: $127 a month — 12th highest
Arizona’s health care system faces more challenges that most other states â 11.3% of adults in the state don’t have health insurance, the ninth highest share in the U.S. About 9.2% of people under 19 are uninsured as well, the fourth highest share and well above the nationwide figure of 5.7%.
About 18.6% of adult residents report being in fair or poor health, higher than the national share of 16.5%. People in Arizona are also more likely to lack access to health care. There are just 65.7 doctors per 100,000 residents, the ninth lowest concentration in the nation, and well below the national ratio of 75.8 doctors per 100,000 residents.
2. Georgia
> Uninsured rate: 13.4% — 3rd highest
> Health care spending in 2019: $119 per capita — 18th lowest
> Adults in poor or fair health: 18.4% — 15th highest
> Hospital beds: 2.4 per 1,000 people — 25th fewest
> Employee premium contribution, single coverage: $108 a month — 12th lowest
The uninsured rate in Georgia is the third highest in the nation, with 13.4% of adult residents lacking health insurance. In addition, Georgia ranks among the states with the fewest number of health professionals per capita at 52.1 dentists per 100,000 residents (fifth lowest), 145 mental health providers per 100,000 residents (fifth lowest), and 66 primary care doctors per 100,000 residents (10th lowest).
Lack of insurance and limited access to different health specialists may explain Georgia’s high rate of adults reporting poor or fair health at 18.4% compared to the U.S. average of 16.5%. The preventable hospitalizations rate of 4,835 per 100,000 people and the infant mortality rate of 7.3 per 1,000 are among the highest in the country.
1. Texas
> Uninsured rate: 18.4% — the highest
> Health care spending in 2019: $109 per capita — 13th lowest
> Adults in poor or fair health: 18.7% — 13th highest
> Hospital beds: 2.3 per 1,000 people — 22nd fewest
> Employee premium contribution, single coverage: $113 a month — 19th lowest
Texas ranks as the state with the worst health care system. This is in large part due to the high rate of residents of all ages lacking health insurance and the limited access to certain types of health care. The uninsured rate, at 18.4%, is double the national figure and higher than that of any other state. The shares of people under 19 and under 6 years old lacking health insurance are also the highest in Texas. The state also has among the fewest mental health providers and primary care doctors per capita.
About 18.7% of adult residents in Texas report being in poor or fair health, the 13th highest share in the U.S. Additionally, Texas has a significantly higher rate of preventable hospitalizations at 4,793 per 100,000 people, the 13th highest in the U.S. This measure reflects how efficiently outpatient services are used as well as the overall quality of health care in a state.
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