A new "scorecard" lists "shockingly wide variations" among the states when it comes to the health of their residents, says the president of the Commonwealth Fund, which compared such factors as access to care, insurance coverage and avoidable hospital admissions.
"The differences we see among the states translate to real lives and real dollars," Karen Davis said Wednesday at a news conference.
"Where you live matters for how long you live and how healthy you live," said study co-author Cathy Schoen, senior vice president of the Commonwealth Fund.
Overall, Vermont ranked No. 1 and Mississippi came in last, the same position it held when the Commonwealth Fund compiled its first scorecard in 2007. Hawaii, which was second this year, ranked first, ahead of Vermont, in 2007. The same 13 states made up the top quarter in both 2007 and 2009, although their specific rankings shifted. And 10 of the 13 states in the lowest quarter in 2009 also ranked at the bottom in 2007.
Schoen noted that the 2009 scorecard is based on data collected "on the eve of the recession," so "the worst is yet to come."
In some measures of health status, the top state's performance was double or triple that of the bottom state's, the Commonwealth Fund found.
The gap was especially wide in the percentage of adults ages 18 to 64 who lacked health insurance. In Massachusetts, which has a universal health insurance program, only 7.2% of its residents that age were uninsured. In Texas, nearly a third, or 31.5%, were.
Improving the performance of all states to the levels achieved by the best states could save thousands of lives and billions of dollars, according to the "Commonwealth Fund State Scorecard on Health System Performance."
Some examples:
*At least $5 billion a year could be saved in preventable hospitalizations and readmissions for chronically ill or frail nursing home patients.
*Each year, nearly 78,000 fewer adults and children would die prematurely.
*About 29 million more Americans would be insured.
"On a positive note, there were gains in children's coverage as a result of national reforms, and improvement in some measures of hospital and nursing home care following federal efforts to publicly report quality data," the scorecard said.
"When we take action at a national level ... we succeed," Davis said. "States cannot go it alone. Health reform is needed on a national level."
For detailed, state-by-state information, visit www.commonwealthfund.org.
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