Mass. health care ranks No. 1 in new report

Massachusetts has the best overall health care system in the country, according to an annual ranking released Thursday by The Commonwealth Fund, a New York City-based foundation that conducts independent research on health care issues.

The report assessed how well each state’s health care system performed on 58 measures including health care access, quality, costs, health disparities, reproductive care, women’s health, and health outcomes. Massachusetts, Hawaii, New Hampshire, Rhode Island, and Vermont were the top performers. The lowest-performing states were Arkansas, Texas, Oklahoma, West Virginia, and Mississippi.

Nationally, the report found that during the first two years of the pandemic there was a dramatic increase in preventable deaths not only from the COVID19 virus but from drug overdoses, the use of firearms, and the inability to get timely care for treatable chronic conditions. The report also found that the maternal mortality rate nearly doubled between 2018 and 2021.

Increases in the numbers of preventable and maternal deaths varied by race and ethnicity and disproportionately impacted Black, American Indian, and Alaska Native populations.

Although Massachusetts also experienced rising mortality rates, it fared better than other states. Preventable deaths in Massachusetts rose by around 13 percent from 2019 to 2021 compared with Mississippi, which saw an increase of more than 35 percent. Likewise, the rate of all cause mortality among women of reproductive age rose from 70.2 to 81.1 per 100,000 females, compared with the lowest performing state, West Virginia, which saw its rate increase from 174.8 to 238.6.

Carlene Pavlos, executive director of Massachusetts Public Health Association, said it’s not a surprise to see Massachusetts at the top of the list considering the combination of a strong department of public health at the state level, social safety nets, and high rates of insurance coverage, among other factors.

Andrew Stokes, an assistant professor of global health at Boston University, said the state’s robust health care system is reflected by the state’s quick and effective response to the COVID19 pandemic.

“Massachusetts’ response to COVID was one of the most effective state responses in the nation,” Stokes said. “By summer of 2020, the state had implemented a number of policies and non pharmaceutical interventions that were effective in reducing morbidity and mortality ... and managed to close gaps in vaccination in a way that is not seen in many other states.”

However, Massachusetts’ top ranking doesn’t mean the state’s health care system isn’t flawed, said Pavlos.

“When you look across the state, we may see that we do very well compared to other states, but it’s masking the fact that there are pockets of health inequities,” Pavlos said. “The problem is that when we look at that single metric, and generalize it across Massachusetts, it masks the reality of the lived experience of many that live in the Commonwealth.”

Stokes said the findings from the Commonwealth report align with other research that has found health inequities among communities of color, noting a Boston Public Health Commission report that highlighted stark disparities in life expectancy among city neighborhoods.

Although Massachusetts tops the list for providing the best reproductive care and women’s health, the report argues that state leaders must confront issues that put women’s health at risk, explaining how the prolonged pandemic, inequities in care delivery, and the existing maternal mortality crisis have driven up avoidable deaths for women. For low-income women and women of color, the stakes are even higher.