A health care scorecard released Wednesday that evaluated all 50 states and the District of Columbia ranked Oklahoma 49th overall. Only Arkansas (50th) and Mississippi (51st) fared worse.

The Scorecard on State Health System Performance was issued by The Commonwealth Fund and evaluated the states on 42 measures of health care access, quality, costs and outcomes over the 2007-12 period. Those five years encompassed the Great Recession and preceded the major coverage expansions of the Affordable Care Act.

The scorecard showed that “on a significant majority of measures, the story is mostly one of stagnation or decline,” The Commonwealth Fund lamented. “In most parts of the country, performance worsened on nearly as many measures as it improved.”

Oklahoma worsened on eight indicators but improved on a dozen others. South Carolina was better on 13 indicators and worse on 13 others. Alabama improved on seven indicators but worsened on 16.

Oklahoma ranked among the top five states on none of the indicators, and among the worst states in 25 indicators.

The analysis reported that:

• 21% of American adults aged 19-64 had no health insurance in 2011-12. In Oklahoma that ratio was 25%. (The U.S. Department of Health and Human Services reported Thursday that more than 69,000 Oklahomans signed up for health insurance plans under the Affordable Care Act between Oct. 1 and the March 31 deadline. Approximately 29% of the enrollees were aged 18-34 and approximately 56% are women, records reflect.)

• Among U.S. children (newborns through age 18) who were uninsured, the national rate was 10%; in Oklahoma it was 8%.

• In 2012, research found, 17% of U.S. adults went without any health care because they couldn’t afford it. The comparable figure in Oklahoma was 18%.

• Nationally, the 50-state median number of at-risk adults in 2012 who had not had a routine visit to any doctor in the preceding two years was 14%. Among Oklahomans it was 20% -- one of every five – ranking us 46th in the country.

• Nationwide, the number of adults in 2012 who had not been to a dentist was 15%. In Oklahoma, it was 18%.

• The number of U.S. children in 2011-12 who had a medical and dental preventive care visit within the past year was 68%. In Oklahoma, it was 62%.

• The number of U.S. children aged 19 to 35 months who had all of their recommended vaccinations in 2012 was 68%. In Oklahoma the number was 61%, ranking the Sooner State 48th in the nation.

• Nationally, the infant mortality rate in 2009 was 6.4 deaths per 1,000 live births. The Oklahoma rate was 7.9/1,000, ranking the Sooner State 44th in the country.

• The number of adults in the U.S. with a poor health-related quality of life in 2012 was calculated to be 27%. In Oklahoma, it was 31%.

• The number of American adults who smoked in 2012 was estimated at 19%. In Oklahoma, it was 23%.

• The number of American adults deemed to be obese in 2012 was 28%. In Oklahoma, it was 33% -- which was the sixth worst rate in the nation.

• An estimated 31% of U.S. children in 2011-12 were believed to be overweight or obese. In Oklahoma, that ratio was 34% -- slightly more than one of every three.

• Breast-cancer deaths per 100,000 American females in 2010 was gauged at 22.1. In this state the number was 24.9 – ranking Oklahoma 49th in the nation.

• Colorectal cancer deaths in the U.S. in 2010 were reported to be 15.8 per 100,000 population. The ratio in Oklahoma was 16.5 per 100,000.

• Nationally, suicide deaths in 2010 were reported to be 12.1 per 100,000 population. The Oklahoma rate was 16.5 per 100,000.

The Commonwealth Fund said its health care indicators were drawn from publicly available data sources, including government-sponsored surveys, registries, publicly reported quality indicators, vital statistics, mortality data, and administrative databases.

The Commonwealth Fund is a New York-based non-profit organization that was established in 1918. Its mission is to “promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children and elderly adults.” The Fund supports independent research on health care issues and making grants to improve health care practice and policy.