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Why Health Equity Matters

Pennsylvania’s health system is among the nation’s best, according to latest scorecard ranking

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Pennsylvania’s health system receives high marks for overall performance compared to all 50 states and the District of Columbia, according to a new Commonwealth Fund analysis.

The Commonwealth Fund’s 2023 Scorecard on State Health System performance is the latest in an annual report that assesses health systems based on 58 healthcare indicators, including access to coverage, insurance costs, service use, disparities, and overall quality.

The organization has also included women’s reproductive health in its recent report. The new criteria evaluates statewide prenatal and postpartum care access, reproductive cancer screenings, preventative services, and mortality rates.

On Thursday, the Commonwealth Fund’s data analysis concluded that Pennsylvania’s health system is “better-than-average” across all measurements, and ranks ninth overall – tied with New York – among states that provide high-quality healthcare.

Pennsylvania ranks behind the top five performers — Massachusetts, Hawaii, New Hampshire, Rhode Island, and Vermont. The bottom five health system performers are Arkansas, Texas, Oklahoma, West Virginia, and Mississippi.

The commonwealth’s health system also placed third among six Mid-Atlantic states which include Delaware, Maryland, New Jersey, New York, and Washington, D.C.

According to the report, Pennsylvania’s health system performs best in reducing 30-day hospital mortality rates, emergency room visits, and preventable hospitalizations. It ranks sixth among states with reduced maternal deaths while pregnant or within 42 days of pregnancy per 100,000 live births.

Since 2020, the report also finds that 77% of women throughout the commonwealth have had up-to-date breast and cervical cancer screenings, which is slightly higher than the U.S. average of 74%.

The analysis shows, however, that Pennsylvania’s health system performs poorly with 30-day hospital readmission rates for individuals ages 65 and older. Pennsylvania also ranks among the worst states in drug overdose deaths since 2021. On average, 43 out of 100,000 per population in the commonwealth have died from a drug-related overdose death. The national average is 32.

New Jersey and Delaware place within the Commonwealth Fund’s top 25 best-performing health systems in the U.S. 25th ranked Delaware saw an average of 54 in 100,000 individuals die of a drug overdose, putting the state at 46 – among the worst drug overdose deaths per 100,000 anywhere in the country.

Delaware also has the highest rate of breast and cervical cancer-related deaths in the country per 100,000 people. Since 2021, the report shows that 25 in every 100,000 female Delaware residents died of breast and cervical cancer-related issues. But Delaware’s health system has also shown improvements since 2020 for women with up-to-date screenings, reaching the national average of 74% of women screened.

New Jersey, ranked 17 in the study, performed most strongly in reducing alcohol and suicide-related deaths. The state currently has the lowest number of alcohol-related deaths, with an average of 8 in 100,000.

The report found that New Jersey has the second-lowest reported suicide deaths — an average of 7 in every 100,000 population. But New Jersey’s health system performed worst of all states concerning hospital 30-day readmission rates of individuals 65 and older.

These indicators are just a fraction of what the Commonwealth Fund cites as a series of “daunting” future challenges for health systems across the country. From 2019 to 2021, every state has experienced a precipitous spike in preventable deaths, while medical debt has also increased. The findings also show that 60% of adolescents ages 12 to 17 with severe mental health needs were unable to get treatment.

Nationally, myriad health care-related disparities have occurred since the COVID-19 pandemic related to women’s health. Women have struggled to get health care, specifically for reproductive care. And since the pandemic, the report found that women of color experienced increased infant mortality rates.

“The maternal death rate for AIAN (Native American and Alaska Natives) women,” the Commonwealth Fund’s report said, “jumped by nearly 70 deaths per 100,000 live births between 2019 and 2021, while the rate for Black women increased by more than 25 deaths per 100,000, putting them well above other racial and ethnic groups.”

The analysis also concluded that high poverty rates, food insecurity, disparities in insurance coverage, and quality of care were to blame.

Support for WHYY’s coverage of health equity issues comes from the Commonwealth Fund.

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