The Commonwealth Fund has released its 2024 State Scorecard on Women’s Health and Reproductive Care and the findings are extremely concerning, showing mounting disparities, a rise in preventable deaths, and more.
Unfortunately, these findings are not a surprise, as the United States persistently has the highest rate of maternal deaths of any high-income nation.
This is the Commonwealth Fund’s first comprehensive analysis of women’s health care in all 50 states and the District of Columbia. The report evaluated and scored each state, using 32 measures, on health care access, affordability, quality of care, and health outcomes for women in the U.S.
“Looking across states and comparing their health care systems is an important way of telling us what is and isn’t working in American health care,” said Sarah R. Collins, study lead author and Commonwealth Fund senior scholar and vice president for health care coverage and access, in a statement. “The scorecard’s findings are deeply concerning and underscore the urgent need for federal and state policies to expand women’s access to affordable, timely reproductive care and other essential health services, regardless of who they are, what they earn, or where they live.”
Key report findings include:
- The top ranked states for health system performance for women overall are Massachusetts, Vermont, Rhode Island, Connecticut, and New Hampshire. The lowest ranked include Mississippi, Texas, Nevada, Oklahoma, and Arkansas.
- All-cause mortality among women of reproductive age (15-44) is highest in southeastern states, which researchers attributed to inadequate access to health care before, during, and after pregnancy, combined with social determinants of health.
- Maternal mortality rates nearly doubled between 2018 and 2022, with rates highest among Black and American Indian and Alaska Native women.
- The highest rates of maternal mortality are in Arkansas, Louisiana, Mississippi, and Tennessee.
- The most frequent cause of pregnancy-related death during or after pregnancy are suicide, overdoses, and other deaths attributable to underlying mental health conditions.
- States that screened for postpartum depression at the highest rates also had the lowest rates of postpartum depression. Southeastern states, including Mississippi, Arkansas, and Alabama, had lower rates of depression screening for women who recently gave birth and higher rates of self-reported postpartum depression. Vermont, Massachusetts, and Minnesota had higher-than-average rates of screening and lower-than-average rates of self-reported postpartum depression.
- Uninsured rates among women were highest in Texas, Georgia, and Oklahoma, whereas rates were lowest in Massachusetts, the District of Columbia, and Vermont. Women in states that had not expanded Medicaid eligibility were among those most at risk of lacking coverage.
The researchers also underscored the deep impact of the U.S. Supreme Court’s decision to overturn Roe v. Wade in June 2022 has had, significantly altering both access to reproductive health care services and how providers are able to treat pregnancy complications in the 21 states that ban or restrict abortion access.
They concluded the report calling on Congress and state policymakers for urgent action “to ensure women have timely access to complete health and reproductive care, regardless of who they are, what they earn, or where they live.”