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Researchers Find Big State Health And Mortality Variations

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Residents of Mississippi were more than twice as likely to die young from preventable or treatable causes in 2002 than residents of Minnesota were.

Researchers have those statistics and other state health, mortality, health care quality and health care access data in a state “health system performance” report released today by the Commonwealth Fund, New York.

When the researchers looked at 2002 deaths from conditions that can be affected by good medical care, such as diabetes and high blood pressure, they found that the United States as a whole averaged about 103 potentially preventable deaths per 100,000 residents younger than age 75.

Age-adjusted annual preventable premature mortality per 100,000 lives ranged from a low of about 70 in Minnesota up to 150 in Mississippi and 160 in the District of Columbia.

The preventable premature mortality rate for white individuals ranged from 61 in the District of Columbia to 118 in West Virginia, and the rate ranged from 106 in Hawaii to 241 in Arkansas for African-American individuals.

Mortality and other health indicators did not correlate perfectly with indicators of health quality and access, the researchers found.

Hawaii, for example, ranked first in terms of access, an indicator that includes factors such as ownership of health insurance. Hawaii ranked fourth in terms of a “healthy lives” indicator, which includes indicators such as disability rates as well as mortality rates, but it ranked only 20th in terms of preventable premature deaths.

Texas ranked last in terms of access and 46th in terms of quality, but it performed somewhat better in the health quality rankings. It came in 37th on the preventable premature deaths chart and 24th on the healthy lives chart.

But overall analysis of the study findings shows that health insurance, the main component of the health access indicator developed by the authors of the Commonwealth Fund report, plays a critical role in improving the quality of care a person in a particular state receives, the authors of the report say.

“States can do much to improve both affordable access and efficiency in the organization of insurance and delivery of care through their oversight of health insurance markets, purchase of insurance for state employees, and support of public insurance initiatives,” authors write in the report.

Many states with relatively high quality care also have relatively low levels of spending, and health insurance rates are lower in some expensive, high-income states, such as New York, than they are in lower-income states, such as Maine, the researchers note.

“If all states could approach the low levels of mortality from conditions amenable to care achieved by the top state, nearly 90,000 fewer deaths before the age of 75 would occur annually,” the researchers write. “If insurance rates nationwide reached that of the top states, the uninsured population would be halved. Matching the performance of the best states on chronic care would enable close to 4 million more diabetics across the nation to receive basic recommended care and avoid preventable complications, such as renal failure or limb amputation.”

Allison Bell contributed information to this report.