States are scored based on equity in U.S. healthcare

Nov. 19, 2021

Both across states and within states, healthcare system performance varies widely by race and ethnicity. Mirroring the nation as a whole, substantial health and healthcare disparities exist between white and Black, Latinx/Hispanic, and AIAN communities in nearly all states.

Even in states that achieve high performance overall, racial and ethnic disparities can be dramatic. For example, Minnesota, which ranked third in the Commonwealth Fund’s most recent State Scorecard on Health System Performance, has some of the largest disparities between white and Black, Latinx/Hispanic, AANHPI, and AIAN communities. Some states, like Mississippi, demonstrate relatively poor performance for all groups.

In the small number of U.S. states where AIAN communities represent a sizeable portion of the nonwhite population — such as South Dakota and Alaska — wide performance gaps are also apparent. While the health system in many states tends to perform better for AANHPI populations, performance is lower in New York and Texas, home to two of the country’s largest AANHPI populations.

The overall health system score for each group within a state represents the aggregate performance across three dimensions: Health Outcomes, Healthcare Access, and Quality and Use of Healthcare Services. Below we describe findings for each of these domains.

Commonwealth Fund release