Health care reform may be coming to the whole country, but our health care system is still very local. That's the conclusion of a new scorecard from the Commonwealth Fund that looks at health and health care in regions around the country.
The report split up the country into small "hospital referral regions," and tracked a wide array of health measures and evaluations of system performances.
They varied widely. More than 95 percent of residents have health insurance in some parts of Massachusetts, while more than half go without in some parts of Texas. Big disparities also exist in the health of populations and the percentages who receive substandard health care, like preventable hospital readmissions or bedsores in nursing homes.
The report also highlighted how one good measure tends to lead to another. So many of the communities with the highest ratings for health care access also scored high in their use of preventive health services, ability to avoid unnecessary care, and basic public-health indicators -- such as obesity and the percentage of residents who smoke. The reverse was true for the worst-performing places; they tended to be bad across all four groups of measurements. That said, health indicators did not track perfectly with incomes. Some poorer communities scored better than their higher-earning peers.
The highest-performing communities tended to be in the North -- New England, the upper Midwest and parts of the West. Many of the worst-performing regions were in the South.