Oklahoma Ranks Near the Bottom in New Commonwealth Fund Healthcare Report

A troubling new reality check has landed in the form of the Commonwealth Fund’s 2025 State Health System Performance Scorecard. Oklahoma finds itself nearly last, ranking 49th among the 50 states and D.C. for its healthcare system’s overall performance.

Eye-Popping Rankings

The report, reflecting data from 2023, places Oklahoma as one of the poorest-performing states in nearly every health dimension. Access and affordability place the state in 48th position, above only Mississippi, Texas, and Nevada. Within the vital prevention and treatment pillar, Oklahoma ranks 46th.

Storm of Alarming Metrics

Some of the most alarming metrics include:

• Breast cancer mortality: Oklahoma sits dead last, ranked 50th nationally.

• Infant mortality: Ranked 42nd, a glaring concern given its impact on families and communities.

• Medical debt: The state has the highest share of residents with medical debt sent to collections.

• Suicide rate: With around 22 deaths per 100,000, Oklahoma ranks 46th.

• Drug overdose fatalities: The state ranks 25th, with over 32 deaths per 100,000.

Other areas in the bottom five include treatment of premature, preventable deaths. Even maternal mortality remains dangerously high, ranking 48th as of a 2024 Commonwealth Fund women’s health scorecard.

Disparities Across Race and Gender

The Commonwealth Fund notes significant equity gaps in Oklahoma. The state ranks poorly in racial health equity, coming in at 46th. This means that health outcomes and access vary dramatically between racial and ethnic groups. Women’s health, particularly maternal mortality and reproductive care, is among the worst nationwide.

A Mixed Picture?

Not everything is bleak. For seniors, the state shows relatively high primary care spending. This is a silver lining, suggesting that investment in basic care does exist. Yet, this is overshadowed by the weight of poorer outcomes elsewhere.

What’s Behind the Crisis?

Several key contributors to Oklahoma’s low ranking include:

• Limited Medicaid Expansion. Oklahoma was a later adopter of Medicaid expansion, leaving many low-income residents in the coverage gap.

• Rural healthcare deserts. With hospitals struggling financially and clinic shortages, rural areas face striking access challenges.

• Medical debt burdens. With one of the highest rates of debt collections, financial barriers force residents to delay care.

• Policy and systemic inequities. Disadvantaged groups, especially women and racial minorities, suffer disproportionately from inadequate policies and limited provider networks.

The Call to Action

Commonwealth Fund President Dr. Joseph Betancourt emphasizes the urgency of coordinated federal and local efforts. “There is no substitute for being able to get the care you need… policies that make health insurance and health care more affordable and accessible work.”

Policymakers at both state and federal levels have avenues for reform. Expanding Medicaid further, investing in rural clinic infrastructure, implementing debt relief safeguards, and launching targeted efforts to close racial and gender health gaps are all crucial steps.

Why This Should Matter

Ranked below almost every other state in critical areas such as maternal and infant mortality, cancer deaths, preventable deaths, mental health, and affordability, Oklahoma faces a healthcare emergency. The Commonwealth Fund report should serve not as a final verdict but as a wake-up call.

Turning these rankings around will require bold policies and sustained commitment. Without them, families across Oklahoma risk continued harm, from financial distress to life-altering health outcomes. The report makes one thing clear: where you live still determines how healthy you can be.