Study ranks Alabama 6th-worst in health care

Aug. 07--According to the most recent available estimates by the Centers for Medicare and Medicaid Services, Alabamians spend more than $35 billion each year on personal health care. This figure is one of many factors considered in its current ranking by personal finance website WalletHub as the sixth-worst state to receive health care.

"As many experts will tell you, your zip code is a better predictor of your health than your genetic code," said Arthur M. Mora, clinical associate professor at the Tulane University School of Public Health.

To that end, WalletHub compared all 50 states and the District of Columbia across several measures before compiling their list. The measures were broken down into three main categories: cost, access and outcomes.

In terms of cost, things such as the cost of a medical visit, average monthly insurance premium and the percentage of population with high out-of-pocket medical spending were considered. Alabama ranked eighth-worst, or 44th place, on WalletHub's list for cost.

Amol S. Navathe, assistant professor of medical ethics and health policy at the University of Pennsylvania, said one of the most important steps Americans can take in minimizing health-related expenditures is investing in basic, preventative care. However, in a state that also ranks eighth-worst for access, this can prove difficult.

According to WalletHub, Alabama has the third-fewest dentists per capita and is the fourth-worst state for nurses. It ranked slightly below average in its medical environment for doctors but was ranked overall as the 11th best place for doctors to practice.

When assessing access to health care, study conductors looked at the quality of the state or district's public hospital system; number of hospital beds, urgent-care centers and retail clinics per capita; how many medical professionals were in an area; how long it took to receive emergency care; rate of Medicare or Medicaid acceptance; and how many adults or children had insurance or a personal doctor.

Alabama's low access ranking may be one reason why it ranked equally low in outcomes. Again in 44th place, Alabama performed better than state neighbors Tennessee (48th place) and Mississippi (51st or worst), but Alabama proved to have the highest infant mortality rate and was the fifth-highest of all states in its rate of heart disease.

WalletHub included these factors in its assessment of outcomes, as well as life expectancy, cancer rate, diabetes rate, how often patients visited doctors and more.

"Mortality rates, indicators of effective prenatal care, monitoring and reporting the percentage of the population with health insurance, readmission rates for hospitals, infection rates in intensive care units, the percentage of patients with chronic conditions receiving appropriate followup care and recommended screenings and so many others are all extremely important" in evaluating state healthcare systems, Mora said.

When it comes to combatting those issues, he said, strategies that address the social determinants of health, such as poverty, education or institutional racism, will have a greater impact than medical care. Because of this, he argued, assessing at a state level is insufficient, as it doesn't include the fact that health issues can vary widely even within the same community and it ignores the extremely poor outcomes he feels should be the biggest concern.

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