Americans in the western part of the country are struggling to receive timely and adequate medical care.
Utah, Nevada and Arizona rank among the worst for access to healthcare as they struggle with lack of resources, too few qualified doctors and have a large swathe of uninsured residents.
Meanwhile, Americans in the New England area enjoy much more accessible medical services, with Massachusetts, Connecticut and Rhode Island ranking among the best states for healthcare access.
These states have more hospital beds and primary care doctors, as well as fewer uninsured residents.
However, patients in these states still face long wait times for emergency department visits and doctors appointments because of their densely packed populations.
An analysis by Forbes found Utah is the least accessible when it comes to healthcare services
The analysis, performed by Forbes and based on data from KFF, CDC and US Census Bureau, measured 14 metrics.
These included number of doctors, nurse practitioners and physician assistants in the state, percentage of residents without health insurance, number of hospital beds and how many people have delayed care because of costs.
States were then scored on a scale of zero to 100, with zero indicating the state had the highest healthcare accessibility and 100 indicating the state had the least healthcare accessibility.
Utah topped the list with a score of 100 because of its lack of resources, including lower numbers of qualified practitioners.
Additionally, Utah employers cover the second-lowest percentage of employee’s annual health costs and eight percent of residents are insured.
As a result, 11 percent have delayed a doctor’s visit because of high costs.
Utah also has the third-lowest number of primary care doctors per 10,000 residents – 11.3 – and fewest hospital beds per 1,000 residents – 1.7.
It ranked the fourth-lowest for number of nurse practitioners – 3.9 per 10,000 people – and the state has the eighth lowest number of physician assistants – two per 10,000 people.
Nevada follows with a score of 93 out of 100. Its high inaccessibility score is due to the state having the fewest primary care doctors in the country – 10 per 10,000 residents – and having the second-lowest number of advanced practice nurses – one per 10,000 people.
Additionally, 11 percent of its residents are uninsured, placing it sixth in the nation, and 13 percent have delayed medical care because of costs.
With a score of 92.15, Texas rounded out the top three least accessible states.
Total US healthcare spending – that includes what the government as well as insurance companies and individuals pay for – ticked past $4.3 trillion in 2021, nearly a fifth of the country’s annual GDP
The Lone Star State has the highest percentage of people without insurance – nearly 17 percent – and the highest percentage of residents – 16 percent – who delayed a doctor’s visit because of cost.
This delay in or lack of care could be why Texas has 300 more preventable hospital admissions per 100,000 patients than the national average of 2,765, according to US News’ Best States rankings.
To make matters worse, a report from the Center for Healthcare Quality and Payment Reform (CHQPR), found nearly half of the state’s rural hospitals – 75 – are at risk of closure.
Among all 50 states, this is the highest number of rural hospitals at risk and could lead to worse healthcare accessibility.
While western Americans may struggle with medical services, people in northeastern US enjoy plentiful and more affordable healthcare.
Massachusetts, Connecticut and Rhode Island are the top three states for healthcare accessibility.
Home to some of the highest-ranked hospitals, Massachusetts scored a zero on Forbes’ analysis.
Just two percent of residents are uninsured – the least in the country – and the state has the highest primary doctors-to-resident and specialists-to-resident ratio at 23 per 10,000 and 30 per 10,000, respectively.
It also has the fourth-lowest percentage of people delaying care because of costs.
Additionally, its top-notch healthcare system could be a factor behind the state’s nationwide lowest infant mortality rate, second-lowest obesity rate and third-lowest smoking rate, according to a separate US News analysis.
Connecticut was second with an accessibility score of 4.2 out of 100. The state is home to the most physician assistants per 10,000 residents – 7.3 – and has the third-lowest smoking rate.
Rhode Island rounded out the top three with a score of 4.5. It has the fourth-lowest percentage of people uninsured – 4.2 percent – and has the least percentage of residents delaying healthcare – 7.7 percent.
It also places fifth in infant mortality and sixth in overall mortality rate.
The country-wide discrepancy could be due to the geographical differences among states, with the more accessible states having major cities where densely packed-in residents can easily access top hospitals and medical research facilities.
Whereas states that are least accessible often have more rural towns and the population tends to be more spread out, meaning people are further from hospitals, clinics and doctors offices.
In Utah, 12 percent of the population lives in nonmetro areas, compared to just 1.5 percent in Massachusetts.
However, being in a large city can also have its disadvantages. While the care may be accessible, more people are fighting for it.
In a separate analysis earlier this year, Massachusetts was found to have the second longest emergency department wait time, at 214 minutes.
Connecticut was 10th with 186 minutes and Rhode Island was third, with a wait time of 214 minutes.
Additionally, a 2023 analysis found the average wait time for a doctor’s appointment in Boston, Massachusetts, was 34 days, above the average across 15 major cities – which was 26 days.
The AMN Healthcare and Merritt Hawkins analysis blamed the long wait times on a growing population, an increasingly older population that requires more care and doctors leaving the field because of burnout.
In Utah, 12 percent of the population lives in nonmetro areas, compared to just 1.5 percent in Massachusetts
In Utah, rural hospitals are spread far across the state, with some areas not having any health clinics
While some US states fare better than others, overall, the quality and accessibility of healthcare in the US falls short compared to comparable countries.
America spends about double what peer nations spend on healthcare for its residents, however, Americans have shorter lives and are more likely to suffer from chronic diseases or die by suicide.
Compared to other wealthy nations like Japan, Switzerland, France and Australia, Americans die on average three years earlier, with higher odds their deaths could have been prevented with better access to care.
The US also has the highest rates of maternal mortality with 24 new moms dying for every 100,000 babies delivered, nearly two and a half times the average in other wealthy countries and 19 times greater than the best performer on the list, the Netherlands.
