For years, Gov. Brian Kemp and his predecessor, Nathan Deal, have called press conferences to ballyhoo the state’s No. 1 ranking for business-friendliness according to Area Development magazine.
What you don’t hear Republican leaders talking about, though, is another kind of ranking—perhaps closely related to that great-for-business ranking, but in a bad way. Georgia’s health rankings are dismal even by the United State’s low standards.
Some of the worst rankings are in children’s health. The Annie E. Casey Foundation rates children’s well-being across the nation in its annual “Kids Count.” This year, Georgia ranked 43rd in the nation for children’s health, ahead of only a handful of mainly Southern states with high poverty levels and Republican governments, and far below top states. For what it’s worth, the states with the highest scores, like New York and Massachusetts, tend to vote Democratic, with some exceptions among old-line Northeastern Republican states.
Some Georgia specifics from the 2023 Kids Count:
- Georgia has a child and teen death rate of 36 per 100,000, up from 29 two years earlier and more than twice that of some other states.
- The infant mortality rate is 6.2 per 1,000, compared to 5.4 nationwide.
- Almost 11% of babies born in 2021 had low birth weights, lower than only Louisiana and Mississippi and the highest figure in at least a decade. As with many health statistics, both for children and adults, there are stark racial and ethnic differences. The low birth weight rate for Black Georgia mothers was 15.6%, vs. 7.7% for white mothers.
- The rate of firearms deaths per 100,000 in children aged 1–19 is 7.7 per 100,000 in Georgia. In Massachusetts it’s 1.1, and in New York it’s 1.7. The U.S. average is 5.3.
- Children who received preventive dental care in the previous year: 74% in 2020–21, down from 84% in 2016–17.
- Children without health insurance: 6%—just a little higher than the U.S. average, but a long way behind Massachusetts at 2%. Texas is the worst at 11%.
- Overweight or obese children and teens: 34%, up from 31% in 2018–19 and slightly above the U.S. average.
- Georgia teen deaths per 100,000: 74.5, up from 42.6 in 2012, and part of a national upward trend. The rate of teen deaths by accident, homicide or suicide was 55 in 2021, up from 36 in 2011.
- In 2021, 25% of Black Georgia children ages 1–18 were living in poverty, compared to 10% of white children, according to the Kids Count report.
Georgia also ranks among the nation’s worst states in measures of adult health, beginning with access to health care. As of 2021, Georgia had the third-highest percentage of people without health insurance among U.S. states, according to the U.S. Department of Health and Human Services. Georgia’s uninsured rate of 12.6% was better than only Texas (18%) and Oklahoma (13.8%).
Georgia had one of the highest maternal mortality rates in the nation in 2021. The U.S. rate overall spiked during the COVID-19 pandemic, to 32.9 deaths per 100,000 live births, compared to 23.8 in 2020. Georgia recorded 49 maternal deaths per 100,000, behind only Mississippi (82) and Louisiana (61). Across the nation, the maternal death rate for Black women was 2.5 times that for whites.
According to the USA Facts website, Georgia’s overall death rate per 100,000 people, 998, is higher than all but 11 mostly high-poverty Southern states, and was up 29% since 2019. Like most states, death rates here went up sharply because of COVID-19, the third-leading cause of death in Georgia in 2021 after heart disease and cancer. The death rate for white people, 995 per 100,000, was well below the death rate for Black Georgians, 1093.
Georgia also ranks high in many individual causes of death, according to the World Life Expectancy website, which uses numbers from the Centers for Disease Control and Prevention: thirteenth-highest for COVID, eighth for stroke, sixth for hypertension, fourth for Alzheimer’s, sixth for breast cancer, tenth for prostate cancer, sixth for kidney disease, twelfth for homicide and fourth for HIV/AIDS.
Life expectancy stats are among the most eye-opening. According to the USA Facts website, relying on data from the CDC, the average life expectancy for a Georgian born in 2021 is 75.6 years—lower than 36 states. That’s about the same as the country of Jordan, but better than last-place Mississippi, where the 71.9-year expectancy is about the same as someone born in Libya, according to estimates by the World Bank Group.
As with many other health statistics, life expectancy varies widely among Georgia counties. Oconee County, one of the state’s wealthiest counties, has the third-highest life expectancy for men at 78.9 years, for example. That’s nearly 10 years higher than the 69.7-year life expectancy for a man born in Jefferson County. Oconee was also near the top for women—81.9 years, No. 4. Most Georgia counties with lower life expectancies are rural and in South Georgia, with some exceptions. Bibb (70.5 years) was 152nd of the state’s 159 counties for men, and Richmond (71 years) was 146th. Clarke ranked well—No. 21 for men, 15 for women.
Even the best U.S. life expectancy statistics don’t look good in a global comparison, though. U.S. life expectancy ranked 58th worldwide as of 2021, lower even than much poorer countries such as Albania and Algeria, according to World Bank statistics. The CIA World Factbook ranks the United States even lower, at 72nd among the world’s nations, while the World Health Organization ranking of 40th was better.
The U.S.’s poor health status is in contrast to the nation’s world-leading medical expenditures—about $12,555 per capita, according to Statista, which is nearly 17% of the gross domestic product and twice the average spent by comparable advanced industrial nations with better health outcomes.
Prospects for improving Georgia’s health numbers are uncertain. Only two states spend less money per full-time Medicaid recipient than Georgia, according to KFF (formerly the Kaiser Family Foundation), and only three states spend less than Georgia’s $2,231 per child on Medicaid. Meanwhile, millions of people are losing Medicaid coverage nationwide, including hundreds of thousands in Georgia, as measures that kept people covered during the COVID pandemic expire, though many will regain eligibility.
At the same time, Georgia—one of only 11 states that has not accepted an expanded federal Medicaid program (and federal dollars)—is starting its own limited homegrown Medicaid program. That program makes Georgia the only state in the country, for now, with a work or education requirement for recipients. At best, Georgia’s “Pathway to Coverage” program will cover nearly 140,000 fewer Georgians than full Medicaid expansion, according to the nonpartisan Georgia Budget and Policy Institute.
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