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2024 State Scorecard on Women’s Health and Reproductive Care

The Commonwealth Fund: Our Scorecard ranks every state’s health care system based on how well it provides high-quality, accessible, and equitable health care. Read the report to see health care rankings by state. Scorecard Highlights:

  • Massachusetts, Vermont, and Rhode Island top the rankings for the 2024 State Scorecard on Women’s Health and Reproductive Care, which is based on 32 measures of health care access, quality, and health outcomes. The lowest performers were Mississippi, Texas, Nevada, and Oklahoma.
  • Deaths from all causes among women of reproductive age — 15 to 44 — were highest in southeastern states. Causes of death include pregnancy and other preventable causes such as substance use, COVID-19, and treatable chronic conditions.
  • The highest maternal death rates were in Tennessee, Mississippi, and Louisiana. Vermont, California, and Connecticut had the lowest rates. Nationally, rates were highest for Black and American Indian and Alaska Native (AIAN) women.
  • Mental health conditions are the most frequently reported cause of preventable pregnancy-related death, including deaths by suicide and overdoses related to substance use disorders. States that screened for postpartum depression at the highest rates also had lowest rates of postpartum depression.
  • Among women of reproductive age (ages 15–44), those in Texas, Georgia, and Oklahoma were uninsured at the highest rates; those in Massachusetts, the District of Columbia, and Vermont had the lowest uninsured rates. Women in states that had not expanded Medicaid eligibility were among those most at risk of lacking coverage.
  • The U.S. Supreme Court decision overturning Roe v. Wade in June 2022 has significantly altered both access to reproductive health care services and how providers are able to treat pregnancy complications in the 21 states that ban or restrict abortion access.

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