Georgia ranks among unhealthiest states in the nation

The state of Georgia’s health improved slightly over the past year, though it remains among the most unhealthy states in the nation, a new study shows.

The Peach State slipped from 45 to 46 in a ranking of 50 states and Washington, D.C., released by the nonprofit Commonwealth Fund on Wednesday. The group’s 2015 scorecard examines the state of health system performance in five key areas, including the accessibility and affordability of care, during 2013 and 2014.

Georgia was followed by such Deep South states as Alabama, Louisiana, Arkansas and Mississippi, as well as the South Central state of Oklahoma. Mississippi was last. Louisiana and Oklahoma improved on the greatest number of indicators, the scorecard reported.

As did most states, Georgia improved in most measures, even though it lost ground in the ranking. The state improved in the number of adults and children who have insurance, and it improved in the number of children current on their vaccinations.

The percentage of uninsured Georgians aged 19-64 fell from 26 percent to 22 percent, for example. And, the number of Georgians aged 19-64 without insurance who are at 200 percent of the federal poverty level fell from 46 percent to 40 percent.

Still, that’s not something to brag about, said Sara Collins, a vice president for the Commonwealth Fund, based in New York City.

“That’s one of the highest rates across the country,” Collins said.

She compared that to Kentucky, which expanded Medicaid under the Affordable Care Act. Its rate of uninsured in that group fell 18 percentage points, from 38 percent to 20 percent. In Georgia, Gov. Nathan Deal and conservative state lawmakers have rejected Medicaid expansion, saying the state can’t afford to grow a program that is already too costly and inefficient.

“Georgia has major health issues that continue to go unaddressed, and many of the programs it has aren’t working” said Bill Custer, a health care policy expert at Georgia State University.

Even though some of Georgia’s low health scores in general have to do with obesity, smoking and other things that are related to “personal behavior,” Custer said, people who smoke and who are obese still need tools and support to make behavioral changes.

Among those poor who are 18 and older in Georgia, the number of people who said they did not get needed care because of cost in 2014 actually rose — from 35 percent in 2013 to 38 percent in 2014.

In Kentucky, Collins said, the percentage of poor saying they did not get needed care dropped from 34 percent in 2013 to 27 percent in 2014.

Collins said that many factors affect those numbers, but that “clearly, on the access indicators” that states that had expanded Medicaid “had higher grades.”

“There’s just a very large disparity between those states that did and those that did not,” said Collins.

A spokeswoman for the governor said she had not seen the report and could not comment on it. “Regardless, Gov. Deal remains opposed to Medicaid expansion because Georgia can’t afford the program,” said Jen Talaber. “However, with more flexibility from the federal government, Georgia could provide more and greater coverage to vulnerable populations through innovative solutions.”

While the scorecard was the first since Obamacare was in place, “it may take years to see the resulting changes,” the scorecard stated.

Also, Dr. David Blumenthal, president of the Commonwealth Fund, said it is hard to prove that implementation of Obamacare was responsible for improvements across the board. On most of the 42 indicators, more states improved rather than worsened, the report said.

“It’s always hard to prove causation,” Blumenthal said on a conference call Tuesday. “But it’s an unusual finding.”

Other Southern states fared poorly in the report too, but Florida, West Virginia and North Carolina ranked in the 30s rather than the 40s. South Carolina tied Kentucky for number 40.

The top-ranked states were Minnesota, Vermont, Hawaii, and Massachusetts.

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