When it comes to health care, not all states are created equal. 

This truth is clearly demonstrated in WalletHub’s 2017’s Best & Worst States for Health Care, which compares the 50 states and the District of Columbia across three key dimensions: cost, accessibility and outcome.

WalletHub’s analysts evaluated those dimensions using 35 relevant metrics, with varying weights. For example, to evaluate cost, the analysts measured average monthly insurance premium and share of out-of-pocket spending, among other metrics; for access, metrics included factors like hospital beds per capita, average emergency room wait time, and physicians per capita; and for outcomes, factors included infant mortality rate, share of patients readmitted to hospitals, and life expectancy.

Each metric was graded on a 100-point scale, with a score of 100 representing the best health care at the most reasonable cost. The analysts then determined the weighted average of each state and D.C. across all metrics to calculate their total score, and used the resulting scores to derive their rankings. 

Read on for the top five: 

1. Hawaii

Hawaii topped the list, with a total score of 67.36. The state ranked No. 1 for outcomes, No. 3 for cost, but No. 42 for access. When ranked best or worst for key metrics, the Aloha State ranked No. 4 for highest percentages of insured adults aged 18 to 64; No. 4 for highest percentage of insured children; No. 1 for lowest heart disease rate; but No. 51 for the lowest physician Medicare-acceptance rates. 

 

2. Iowa

Iowa, with a total score of 66.62, ranked No. 2 for cost, No. 13 for outcomes and No. 19 for access. When it came to other key metrics, the Hawkeye State ranked No. 1 for most hospital beds per capita; and No. 2 for lowest infant mortality rate. 

3. Minnesota

Minnesota came in third, with a total score of 66.62, ranking No. 5 for cost, No. 8 for outcomes, and No. 11 for access. The North Star State ranked No. 3 for highest physician Medicare-acceptance rates; No. 5 for highest percentage of insured adults; No. 2 for lowest heart disease rate.; and No. 3 for lowest percentage of adults with no dental visit in the past year. 

4. New Hampshire

New Hampshire, with a total score of 65.54, ranked No. 4 for access, No. 7 for outcomes and No. 16 for cost. The Granite State ranked No. 2 for highest physician Medicare-acceptance rates; No. 1 for lowest infant mortality rate; but No. 50 for lowest percentage of medical residents retained. 

5. District of Columbia

The District of Columbia, with a total score of 65.47, ranked No. 1 for cost, No. 6 for access, but No. 37 for outcomes. D.C. was tied for No. 4 for lowest average monthly insurance premium; No. 2 for most hospital beds per capita; No. 1 for most physicians per capita; No. 5 for most dentists per capita; No. 2 for highest number of insured adults; tied for No. 2 for highest number of insured children; but No 49 for highest infant mortality rate; No. 50 for lowest physician Medicare-acceptance rates; and No. 51 for lowest percentage of medical residents retained. 

And now, for the five worse states for health care.  

47. North Carolina

North Carolina, with a total score of 44.45, ranked No. 50 for cost, No. 44 for access and No. 36 for outcomes. Broken down by key metrics, the Tar Heel State ranked No. 47 for highest average monthly insurance premium. 

48. Arkansas

Arkansas, with a total score of 42.82, ranked No. 42 for cost, No.  34 for access and No. 49 for outcomes. Arkansas ranked No. 48 for the highest percentage of adults with no dental visits in the past year — but the Natural State ranked No. 4 for most hospital beds for per capita. 

49. Alaska

Alaska, with a total score of 40.64, ranked No. 51 for cost, No. 38 for access and No. 33 for outcomes. Best and Worst states broken down by key metrics, Alaska ranked No. 50 for lowest percentage of insured children; tied for No. 50 for highest average monthly insurance premium — but the Last Frontier was tied for No. 2 for highest percentage of medical residents retained. 

50. Mississippi

Mississippi, with a total score of 40.54, ranked No. 43 for cost, No. 31 for access and No. 51 for outcomes. Broken down by key metrics, the Magnolia State ranked No. 48 for fewest physicians per capita; No. 51 for highest infant mortality rate; No. 49 for highest heart disease rate; No. 49 for the highest percentage of adults with no dental visit in the past year  — but the state tied for No. 4 for the fewest percentage of at-risk adults with no routine doctor visit in the past two years. 

51. Louisiana

Louisiana, with a total score of 38.95, ranked No. 49 for cost, No. 35 for access and No. 50 for outcomes. Broken down by key metrics, the Bayou State ranked No. 50 for fewest dentists per capita; No. 49 for highest cancer rate; and No. 47 for highest heart disease rate.