August 12, 2022

In national health care rankings, North Carolina is chronically ill

Graphics: Commonwealth Fund

The Commonwealth Fund, a nonprofit that promotes high-quality health systems, publishes a scorecard each year that ranks states on 56 benchmarks, such as healthcare access, health disparities, and quality.  The nonprofit added seven benchmarks related to COVID-19 to this year’s scorecard, including “excess deaths.” 

Overall, North Carolina ranked 34th of 51. (The District of Columbia is included in the rankings with the 50 states.) North Carolina ranked better than most states in the Southeast, but lagged behind neighboring Virginia, which came in 20thHawaii was No. 1 and Mississippi was 51st.

Most of the state with the highest number of uninsured adults have not expanded Medicaid. North Carolina is among those non-expansion states, and 15.7% of adults were uninsured in 2020, placing the state near the bottom.

North Carolina was one of 16 states where more than 80% of hospital ICU beds were occupied for more than 150 days between Aug. 1, 2020, and March 31, 2022. The state ranked 41st in days of high ICU stress, with 251.  

Between Feb. 1, 2020, and April 23, 2022, North Carolina had 344.7 excess deaths per 100,000 people, according to the report, lower than the national average. Excess deaths resulted from COVID-19, heart disease, cancer, stroke and other causes, which pushed the number of deaths beyond estimates based on historical patterns. Hawaii had the lowest rate of excess deaths at 110.3 per 100,000 people, and Mississippi had the highest rate, at 595.8 per 100,000.

The Commonwealth Fund used CDC data to determine the rankings.

Here’s where North Carolina ranked on specific measures: 

10 in adults with appropriate cancer screenings 

13 — in prevention and treatment, and 1st among southeastern states 20 — in maternal deaths while pregnant or within 42 days after pregnancy 

22 — in avoidable hospital use and cost, and 3rd in the Southeast

27 in children who are uninsured 

28 in adults 18 and older without a usual source of care 29 — in adults without a dental visit in the last year 

29 — in racial and ethnic equity, and 5th in the Southeast

34 — in healthy lives, which includes factors such as state public health funding, premature death, smoking and obesity, and tooth loss, 4th in the Southeast

34 in adults with mental illness reporting an unmet need 

34 — nationwide in premature deaths from treatable causes

37 — in healthcare access and affordability, and 6th of 12 southeastern states

38 in children who did not receive needed mental health care  

39 in adults who went without care in the past year because of cost 

44 — in income disparities, and 5th among southeastern states. This measure compares health markers — such as children without medical and dental preventative care visits, adults who report fair to poor health, and adults who smoke — against family income. 

44 in number of adults 19-64 who are uninsured

46 in residents with medical debt