Survey: California Ranks 20th Among States for Health Climate

California ranked 20th in a recent survey of states' health care climates by the Commonwealth Fund, the Sacramento Bee reports.

The survey was conducted to determine a baseline of health-related data prior to implementation of the Affordable Care Act (Craft, Sacramento Bee, 9/19).

Details of the Survey

The report assessed states' health care climates based on 30 indicators, including:

• Access and affordability;
• Prevention;
• Quality of care;
• Potentially avoidable hospital use; and
• Health outcomes (Commonwealth Fund release, 9/18).

It is the first survey to provide state-by-state comparisons of the health care experiences of low- and high-income U.S. residents, according to the Bee.

Researchers defined low-income residents as those earning 200% or less of the federal poverty level, or $47,000 for a family of four. High-income residents were defined as earning 400% or more of the federal poverty level, or $94,000 for a family of four.

Findings

Among low-income California residents, the survey found that:

• 10% lost six or more teeth to decay or disease, compared with 16% of low-income individuals nationwide;
• 31% are considered obese, compared with 34% nationwide; and
• 17% smoke, compared with 27% nationwide.

Among high-income California residents, the report found that:

• 4% experienced such tooth loss, compared with 5% of high-income individuals nationwide;
• 20% are obese, compared with 25% nationwide; and
• 8% smoke, compared with 12% nationwide.

When examining health coverage in California, the report found that:

• 30% of low-income residents had high out-of-pocket health care costs, compared with 2% of high-income state residents;
• 45% of low-income adults and 7% of high-income adults were uninsured; and
• 15% of children in low-income families and 4% of children in high-income families were uninsured, the same as the national average.

In addition, California ranked in the bottom 25% of states for preventive care of elderly individuals.

Reaction

David Blumenthal, president of the Commonwealth Fund, said, "The most striking finding in this report is that those with lower incomes in states that rank well do better than those of higher incomes in the lagging states," adding, "Where you live plays a big part in your health care experience."

Cathy Schoen -- senior vice president at the organization and lead author of the report -- said that California rated highest in the "healthy lives" category, likely because recent immigrants brought healthy habits to the state from their homelands (Sacramento Bee, 9/19).

"Our hope is that state policymakers and health care leaders use these data to target resources to improve access, care, and the health of residents with below-average incomes," Schoen added (Commonwealth Fund release, 9/18).