It’s really nothing to write home about: Overall, California ranks 20th of 50 states in health care climate, according to a study that measures factors ranging from tooth loss to obesity to accessibility of health care.
The Commonwealth Fund’s scorecard provides the first state-by-state, in-depth comparison between the health care experiences of low- and high-income Americans.
The report defines low-wage earners as those making 200 percent of the federal poverty level or less: $47,000 annually for a family of four, or $23,000 per individual. Higher wage earners are defined as making 400 percent of poverty or more, with a baseline of $94,000 for a family of four.
Huge differences also emerged based on where people live.
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“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,” said Dr. David Blumenthal of the Commonwealth Fund. “Where you live plays a big part in your health care experience.”
In Hawaii, for example, the top-ranked state (and also the happiest state, according to other ratings), the experiences of low-income people were reportedly better than those for high earners residing in West Virginia, a state low on the health index.
California had its high points. Fewer people here lose their teeth – counted as six or more – to decay or disease. In California, only 10 percent met that threshold, compared to the 16 percent experiencing tooth loss nationwide. Of Californians in the higher income category, 4 percent lost six or more teeth, compared to the national average for that group of 5 percent.
The state’s obesity rate is lower than the U.S. average as well, the report said. Nationally, 34 percent of the population is considered obese in the sector earning less money; in California, it’s 31 percent. Of the higher-earning category nationwide, 25 percent of Americans are obese, compared to 20 percent here.
More dramatic differences surface when it comes to smoking tobacco. California’s culture and restrictive policies have driven smoking down to 17 percent of the lower-income population, as compared to 27 percent nationwide. Among the higher earners, just 8 percent in California smoke tobacco, vs. 12 percent of all Americans.
When it comes to paying for health care services, 30 percent of lower-income Californians had what the Commonwealth Fund considered high out-of-pocket medical costs relative to their income. But only 2 percent of upper-income people shouldered a similar burden, the report said.
Sharp disparities were also evident in the number of children covered by health insurance. In the lower-income group in California, 15 percent – precisely the national average – were uninsured. High-earning families had only 4 percent of children uninsured, again exactly the national average.
Fewer adults than kids were insured in both income categories, with 45 percent of the lower-earning group going without and 7 percent of the higher-income group remaining uninsured.
California also scored in the bottom quarter of all states for preventive care for older adults.
One notable bright spot: The state was rated tops in a category called “healthy lives.” Commonwealth Fund senior vice president Cathy Schoen explained that was because California is home to so many recent immigrants who brought healthy habits from their homelands.
The point of the survey was to establish a baseline of data just prior to the implementation of the new federal health care law, which opens online insurance marketplaces on Oct. 1, where people can shop for subsidized coverage should they meet the income guidelines.