Nevada ranks close to dead last in women’s health and reproductive care across all U.S. states and the District of Columbia, a new report shows.

The report by the Commonwealth Fund, a foundation working to improve the quality and access of the United States health-care system, is part of a series examining state health system performance and used 32 criteria to evaluate each state based on health care access, affordability, quality of care and health outcomes for women in the U.S. This is the first time the group has created a scorecard for women’s health and reproductive care.

Dr. Joseph Betancourt, president of the Commonwealth Fund, said in a press release that “looking across states and comparing their health care systems is an important way of telling us what is and isn’t working in American health care.” 

Nevada, which ranked last in the Western region and 48th overall, is ranked 39th in health care and reproductive outcomes, 49th in coverage, access and affordability and 51st, or last, in health care quality and prevention.

According to the report, Nevada health care providers ranked better on their performance with women between the ages of 18-64 who have never had an HIV or AIDS test or who reported poor mental health. Nevada health care workers also ranked better on maternal mortality per 100,000 live births. 

Nevada performed worse with women ages 18-44 who have not had a routine checkup in the past two years or who went without medical care because of the cost. Nevada also performed worst on women with up-to-date cancer screenings. 

Betancourt said “the scorecard’s findings are deeply concerning and underscore the urgent need for federal and state policies to expand women’s access to affordable, timely reproductive care and other essential health services, regardless of who they are, what they earn, or where they live.”

Additional Nevada rankings from the report include:

Health outcomes 

• 14th in maternal deaths while pregnant or within 42 days of termination of pregnancy per 100,000 live births. (This is out of 43 states as statistics were not available from several states.)

• 30th in infant mortality per 1,000 live births.

• 43rd in breast and cervical cancer deaths per 100,000 females. 

• 30th in all-cause mortality per 100,000 women ages 15-44. 

• 37th in reported live births where the baby was born prior to 37 weeks of pregnancy. 

• 44th in the rate of women ages 15-44 with syphilis per 100,000 females.

• 44th in the rate of infants born with congenital syphilis per 100,000 live births. 

• 49th in the percentage of women ages 18-64 who reported being in fair or poor health. 

• 11th in women ages 18-64 who reported having 14 or more poor mental health days in the past month.

Coverage, access and affordability

• 45th in the percentage of women ages 19-64 without health insurance coverage.

• 50th in the percentage of women ages 18-44 who reported a time in the past 12 months when they needed to see a doctor but could not because of cost.

• 48th in the percentage of women ages 18-44 who did not have one or more people who they think of as their personal health care provider.

• 25th in the share of in-hospital births in the state with a self-pay insurance payment source. 

• 47th in the rate of maternity care providers per 100,000 women ages 15-44. Maternity care providers include medical doctors, osteopathic medicine doctors, certified nurses and midwives practicing in obstetrics and gynecology. 

• 20th in the number of abortion clinics per 100,000 females ages 15-44. 

Health care quality and prevention

• 34th in the rate of singleton, cesarean deliveries who have reached 37 completed weeks or more of gestation and are not breech to women having a first birth per 100 women.

• 50th in the percentage of women ages 18-44 who reported not visiting a doctor for a routine checkup in the past two years. 

• 33rd in the percentage of live births where prenatal care did not begin during the first to third month of pregnancy, among birth records that specified a time period for when prenatal care began.

• 46th in the percentage of women ages 50-74 with a mammogram in the past two years.

• 40th in the percentage of women ages 21-65 with a Pap smear in the past three years. 

• 51st in the percentage of women ages 45-74 who received a sigmoidoscopy or a colonoscopy in the past 10 years or a fecal occult blood test in the past two years. 

• 47th in the percentage of women 65 and older who ever received a pneumonia vaccine. 

• 8th in the percentage of women ages 18-64 who have ever had an HIV or AIDS test.

All data is from 2020, 2021, 2022 or 2023.