WASHINGTON — Children who live in the Northeast and Upper Midwest get better health care, on average, than those in the South and Southwest, according to a study by a private foundation released Wednesday.
Iowa had the highest combined score, followed by Vermont, Maine and Massachusetts. Oklahoma ranked last overall, preceded by Florida and Mississippi.
The Commonwealth Fund, a non-profit that specializes in health care policy, ranked all 50 states and Washington, D.C. overall and in five subcategories: health-care access, quality, costs, equity and health outcomes.
Better access to health care and higher insurance coverage rates translate to better quality, the study said. Children from bottom-ranked states were less likely to get vaccines, dental care and regular check-ups, and they had higher infant mortality rates, the study found.
The Commonwealth Fund considered 13 health care indicators such as these in coming up with its subcategory and overall scores. Among the others were infant mortality, developmental delays, preventive care, unmet mental health needs, follow-up after specialty care and referral rates for children with special needs.
Top scorers Iowa and Vermont expanded their insurance coverage for low-income families. They also require that local and regional children's health care systems publicly report data on their quality of care.
Expanded insurance coverage such as Medicaid and the State Children's Health Insurance Program is "critical" to improving the quality of healthcare of every state, the study said.
It found that if all states achieved top-state coverage rates, 4.7 million more children would be insured and 11.8 million more would get their recommended yearly check-ups.
According to the U.S. Census Bureau, 8.7 million children were uninsured in 2006.
Even the top ranking states fell short of recommended standards, however, the study said. Researchers found that 25 percent of children in Massachusetts don't get annual preventive medical and dental care.
"No state was number one in all of our measures," Edward Schor, vice president of the foundation's Child Development and Preventive Care program, said.
There also were exceptions to the regional patterns of healthcare quality. Alabama, a southern state, performed well on both access and quality.
The report, which used the latest available government data for its 13 indicators, is titled "U.S. Variations in Child Health System Performance: A State Scorecard."
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See comparable data on other states. Click on "interactive U.S. map," then click on your state.
Read the Commonwealth Fund study.
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