2024 State Scorecard on Women’s Health and Reproductive Care
The health of women in the United States is in a perilous place. Deaths from preventable causes are on the rise and deep inequities persist, leading to stark racial differences in maternal mortality and deaths from breast and cervical cancers. Despite a small rebound in women’s life expectancy in 2022, it remains at its lowest since 2006. These troubling health trends are occurring while women are experiencing the consequences of state policy choices and judicial decisions that limit their access to the full range of health services and reproductive care.
State Rankings and Health Outcomes
Where a woman lives matters to her health: U.S. states vary widely in access to care, quality of care, and health outcomes for women. 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.
Regarding specific health outcomes, 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.
| Category | Top Performing States | Lowest Performing States |
|---|---|---|
| Overall Rankings | Massachusetts, Vermont, Rhode Island | Mississippi, Texas, Nevada, Oklahoma |
| Maternal Death Rates | Vermont, California, Connecticut | Tennessee, Mississippi, Louisiana |
| Uninsured Rates (Ages 15–44) | Massachusetts, District of Columbia, Vermont | Texas, Georgia, Oklahoma |
Coverage, Access, and Affordability
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. Roughly 55 percent of Medicaid enrollees are working full or part time, and a number aren’t eligible for health insurance through their jobs. Ten states have yet to expand eligibility for Medicaid, leaving nearly 800,000 women uninsured. Women in states that had not expanded Medicaid eligibility were among those most at risk of lacking coverage.
Health Care Quality and Mental Health
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.
Impact of Reproductive Health Restrictions
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. Gaps in women’s health and care could widen further, especially for women of color and those with low incomes who live in states that have restricted access to reproductive health care.