Best and Worst States for Women’s Healthcare

Updated on August 16th, 2021

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Women face unique health concerns for which care and treatment vary depending on where they live.

Men and women experience similar health problems but some complications affect women far more. Studies show they are more likely to die following a heart attack, show signs of depression and anxiety, and suffer more severe effects from sexually transmitted diseases.

But women can enhance the quality of health for themselves and their loved ones by receiving early prenatal care and regular screenings for breast cancer, cervical cancer, and bone density. 

To determine the best states for women’s health, HealthCareInsider looked at various factors such as the cost of giving birth, mammography rates, physicians per capita, and ovarian cancer and heart disease death rates.

We compared all 50 states and Washington, D.C., to determine how they rank across cost, access, and quality measures.

We conclude by asking our experts to answer critical questions and offer advice on women’s health. 

Please read below for our findings and methodology.

StateRankScoreCostAccessQuality
Massachusetts169.4922.3122.8824.30
Connecticut269.2518.1126.8424.30
Maryland368.5824.6427.9815.96
Rhode Island467.3224.0825.6117.63
Minnesota566.7322.8721.6622.20
California662.7821.6521.0320.10
New Hampshire761.6625.0120.8315.82
Hawaii860.5717.8318.8023.94
Maine960.2618.0120.5521.69
Vermont1059.6817.3622.3020.02
District of Columbia1158.1425.1124.338.71
Washington1257.7721.5618.1418.06
Iowa1356.1517.9221.0417.19
Colorado1455.6916.9919.6219.08
Delaware1555.3920.6324.909.87
New York1655.2116.4321.5117.27
Pennsylvania1754.6819.6919.0915.89
Ohio1854.1821.8419.9312.41
New Jersey1954.0516.5222.8014.73
Illinois2053.7216.8921.3815.45
Michigan2151.5317.6421.6312.26
Wisconsin2251.3012.2320.7118.35
Virginia2350.3512.6921.8415.82
Montana2450.2920.3514.1315.82
Florida2549.4114.6516.8417.92
North Dakota2649.2115.1212.1821.91
Oregon2747.9617.0816.3014.58
Missouri2846.2213.0719.0114.15
North Carolina2945.9510.7320.0515.16
Utah3045.4820.7210.3314.44
Kentucky3145.2418.4816.3810.37
Indiana3244.2615.8715.4812.91
Arizona3342.9814.2812.6716.03
Nebraska3442.7212.2314.2516.25
Georgia3542.4513.5316.9411.97
West Virginia3641.9116.6115.1410.16
Alaska3741.8511.2011.4219.23
Arkansas3840.7016.7112.1711.83
New Mexico3939.0414.6515.109.29
Mississippi4037.9011.8514.0112.04
Wyoming4137.8810.648.5918.65
South Carolina4237.8713.3514.2210.30
Louisiana4337.8712.6916.478.71
South Dakota4437.8412.8812.3312.62
Nevada4537.5716.8910.0110.66
Alabama4634.7812.4113.598.78
Tennessee4734.4812.5114.647.33
Kansas4834.2812.0411.0611.17
Texas4933.089.998.4414.65
Idaho5032.9513.725.2314.00
Oklahoma5125.4810.178.416.89

COST

  • Annual Cost of Care
    Best: Mississippi
    Worst: Washington, D.C.
  • Average Monthly Insurance Premium
    Best: Minnesota
    Worst: Wyoming 
  • Uninsured Rate
    Best: Washington, D.C.
    Worst: Texas
  • Childbirth Medical Expenses
    Best: Washington, D.C.
    Worst: Wisconsin
  • Females Who Reported Not Seeing a Doctor in the Past Year Due to Cost
    Best: Iowa
    Worst: New Jersey
  • Average Medicare Avantage Premium (67 year old female)
    Best: South Carolina
    Worst: North Dakota

ACCESS

  • Percent of Women Age 18-64 with Health Insurance
    Best: Iowa
    Worst: Texas
  • Pregnant Women Medicaid Eligibility Level
    Best: Iowa
    Worst: South Dakota
  • Medicaid Enrollment by Gender
    Best: California
    Worst: Hawaii
  • Abortion Clinics Per Capita
    Best: Maine
    Worst: Kentucky
  • Percent of Women Ages 18-64 Who Report Having a Pap Smear within the Past Three Years
    Best: Connecticut
    Worst: Idaho
  • Mammography Rates (Within the past 2 years, 50-74 years))
    Best: Massachusetts
    Worst: Wyoming
  • Physicians Per Capita
    Best: Washington, D.C.
    Worst: Mississippi
  • Women Receiving Inadequate Prenatal Care
    Best: North Dakota
    Worst: Nevada

QUALITY

  • Breast Cancer Death Rate
    Best: North Dakota
    Worst: South Dakota
  • Adequacy of Prenatal care
    Best: Vermont
    Worst: Colorado
  • Maternal Mortality Rate
  • Best: District of Columbia
    Worst: Louisiana
  • Chlamydia Rate
    Best: West Virginia
    Worst: Washington, D.C.
  • Women Obesity
    Best: Hawaii
    Worst: New Jersey
  • Suicide Rate
    Best: New York
    Worst: Montana
  • Heart Disease Death Rate
    Best: Hawaii
    Worst: Oklahoma
  • Ovarian Cancer Death Rate
    Best: Hawaii
    Worst: Oregon
  • Impaired Fertility
    Best: Alaska
    Worst: Washington, D.C.

Best States for Women’s Healthcare: Countdown

  

Women’s Health Expert Analysis

  • What specifically health-wise should women consider when choosing where to live?
  • What top preventative measures should women consider?
  • What are some health challenges women face?
  • Do women typically pay more for healthcare?
  • What low-cost or free preventive care should women consider?
  • Maternity care can vary by state. What maternity care services should women pay close attention to when considering their health plan or provider?
Deirdre Ragan – Vice President, Insurance and Coverage Solutions, Healthcare.com

Read More

What specifically health-wise should women consider when choosing where to live?

Due to the range of insurance options and the fact that many women are uninsured, healthcare across the U.S. states is not monolithic. States with top healthcare have these factors in common to look for:

o Low rates of adults and children that go without medical care;

o Good maternity care options and utilization amongst Medicaid beneficiaries;

o Low rates of preventable hospital admissions;

o Medicare plan ratings;

o High quality of nursing homes and hospitals;

o Low rate of obesity and smoking;

o Lower rates of suicide and mental illness;

o And lower mortality rate.

What top preventative measures should women consider?

Women should receive a pap smear every three years, as this remains an effective and essential detection for women in screening for cervical cancer. 

Similarly, women are encouraged to get mammograms at least every year between ages 40-54. Although some research shows that mammograms every three years can be just as effective as yearly to detect breast cancer.

While pregnant, women should be getting regular prenatal care and taking prenatal vitamins to have a healthy pregnancy.

Women experiencing menopause are encouraged to get a bone density test every two years for possible early detection of osteoporosis.

What are some health challenges women face?

There is not enough access to quality care. In particular, reproductive health services, especially abortion services, are not available to women due to societal stigma and changing state laws.

Some challenges women face are unique issues such as pregnancy and other conditions related to female organs.

Additionally, women are more likely to die after a heart attack than men; Heart disease is the top killer. Other challenges women face include higher rates of mental illness, Osteoarthritis, and effects from sexually transmitted diseases. 

Do women typically pay more for healthcare? 

Yes. Women are shown not only to pay more but also to utilize more provider services than their men.

What low-cost or free preventive care should women consider?

Medicaid offers pregnant women healthcare, which is the largest single-payer of pregnancy-related services. By federal law, all states provide Medicaid coverage without cost-sharing for pregnancy-related services to pregnant women with incomes up to 133% of the federal poverty level (FPL) and cover them up to 60 days postpartum.

Maternity care can vary by state. What maternity care services should women pay close attention to when considering their health plan or provider?

While most women with private health insurance or insurance through the Affordable Care Act have more uniform services than uninsured women, close to 45% of women qualify for Medicaid, where states have more leeway in the benefits offered.

Uninsured women should not only have unimpeded access to high-quality health care, but in terms of maternity care, the following coverage due to Medicaid can differ in each state:

o Number of appointments;

o Number of ultrasound and other screenings;

o Amount of prenatal vitamins and whether a prescription is needed;

o Providing breastfeeding support;

o Offering of education services;

o Offering drug and alcohol treatment for pregnant women;

o Support of home deliveries.

Methodology

In order to determine the best and worst states for women’s health, HealthCare Insider compared the 50 states and the District of Columbia across three key categories: 1) Cost, 2) Access and 3) Quality.

We evaluated those categories using 24 relevant metrics, which are detailed below. Each metric was graded on a 100-point scale, with a score of 100 representing the best healthcare for women at the most affordable cost.

Lastly, we determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order our sample.

Cost – Total Points: 33.33

  • Annual Cost of Infant Care: Full Weight
  • Average Monthly Insurance Premium: Full Weight
  • Uninsured Rate: Full Weight
  • Childbirth Medical Expenses as Percentage of Income: Full Weight
  • Females Who Report Not Seeing a Doctor in the Past 12 Months Due to Cost: Full Weight
  • States Who Issue a Tampon Tax: Full Weight
  • Average Medicare Advantage Premium for 67 year-old Female: Full Weight

Access – Total Points: 33.33

  • Percent of Women Age 18-64 with Health Insurance: Full Weight
  • Pregnant Women Medicaid Eligibility Level: Full Weight
  • Medicaid Enrollment by Gender: Full Weight
  • Abortion Clinics Per Capita: Full Weight
  • Percentage of Women Ages 18-64 Who Report Having a Pap Smear within the Past Three Years: Full Weight
  • Mammography Rates Within the past Two Years: Full Weight
  • Physicians Per Capita: Full Weight
  • Women Receiving inadequate Prenatal Care: Full Weight

Quality – Total Points: 33.33

  • Total Adequacy of Prenatal Care: Full Weight
  • Breast Cancer Death Rate: Full  Weight
  • Maternal Mortality Rate: Full Weight
  • Chlamydia Rate: Full Weight
  • Women Obesity Rate: Full Weight
  • Suicide Rate: Full Weight
  • Heart Disease Death Rate: Full Weight
  • Ovarian Cancer Death Rate: Full Weight
  • Impaired Fertility Rate: Full Weight

Sources: Data used to create this ranking were collected from the Economic Policy Institute, Kaiser Family Foundation, Center for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), American Cancer Society, American Association of Suicidology, and HealthCare.com research.



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