Top 10 Performing States

1. Massachusetts
2. Rhode Island
3. Hawaii
4. District of Columbia
5. Connecticut
6. Vermont
7. New Hampshire
8. Pennsylvania
9. New York
10. California

Top Takeaways

In general, the 5 top performing states fall into the top 10 states across all indicators. All top five states have Democratic governors and have expanded Medicaid coverage.

• Exceptions are Vermont on Psychiatrist Access and New Hampshire on insurance coverage. For the first, the state still has below average Distance to Goal and below average inequity.
• All of the top 5 states are relatively small in terms of both population size and geography, which may make it easier for them to provide adequate access to primary and mental health care.

Generally, top performing states are closest to HOPE goals with low distance to goals and lower levels of inequity.

• All of the 5 top performing states have below low inequity and low distance to goal for access to primary care.
• Hawaii, Massachusetts, and New Hampshire all meet HOPE goals across all race/ethnic groups for access to primary care and access to psychiatric care indicators.

Although top performers have lower inequity across indicators, exceptions still exist.

• Across Massachusetts and New Hampshire, American Indian/Alaskan Native, Hispanic and Multiracial residents are falling behind their counterparts in other race / ethnic groups in being able to afford health care.
• For access to psychiatric care and insurance coverage, Vermont and New Hampshire, respectively, have above average inequity with American Indian/Alaskan Native populations lagging. Specifically, in Vermont, only 68% of American Indians/Alaskan Native adults have access to psychiatric care, compared to 93% of Black and 94% of Asians/Pacific Islander adults; while in New Hampshire, 76% of American Indian/Alaska Native adults have insurance coverage compared to 91% of White adults.

Bottom 10 Performing States

1. Oklahoma
2. South Dakota
3. Mississippi
4. North Carolina
5. North Dakota
6. Georgia
7. Idaho
8. Tennessee
9. Utah
10. Wyoming

Top Takeaways

Bottom performing states are located in multiple regions and tend to be the bottom performing states across all indicators within the Access to Health Care domain.

• All of the bottom six states are largely rural with geographically dispersed populations. All also have Republican governors except North Carolina.
• Four out of the six bottom states have not expanded Medicaid coverage (South Dakota, Oklahoma, Mississippi, and North Carolina).

Hispanic and American Indians/Alaskan Native populations are performing the worst across most of the bottom five states across indicators. Although White populations are generally the better performing groups across states and indicators, exceptions to this include White populations performing worse in both Utah and Mississippi in primary care access than other groups.