Mississippi faces a number of significant challenges, but none is more daunting than trying to reverse the unhealthy lifestyle habits and reduce the preventable illnesses and injuries that compromise the health of the state’s population.
Strengths. Although Mississippi suffered greatly from the devastating effects of Hurricanes Katrina and Rita, Mississippi receives the fifth lowest level of federal disaster preparedness funding ($7.06 per person). Despite this, Mississippi has instituted a number of plans and systems to improve disaster preparedness throughout the state. Mississippi has a written plan for special needs patients and receives emergency and public health physician input into the state planning process. The state also has a real-time notification system in place to notify identified health care providers of an event. While the state lacks any burn unit beds or verified burn centers, Mississippi ranks 12th with respect to its bed surge capacity (856.5 beds per 1 million people) and 9th for the number of ICU beds (358.0 per 1 million).
Regarding the Medical Liability Environment, the average malpractice award in Mississippi is lower than the average across the states ($244,127 versus $285,218), as are average insurance premiums for primary care physicians ($12,065 versus $16,042) and specialists ($63,802 versus $65,489). The state has also enacted a number of medical liability reforms. Mississippi has abolished joint and several liability, provides for case certification by an expert witness, and has instituted a medical liability cap on non-economic damages.
Challenges. Mississippi is ranked among the five poorest performing states for multiple indicators in Public Health and Injury Prevention, including traffic fatalities, fatal occupational injuries, and unintentional deaths from fires and firearms. In addition, the state has low rates of childhood immunization (76.2 versus 80.5 percent nationally) and influenza vaccination among older adults (65.4 versus 69.6 percent nationally). The state also has the second worst infant mortality rate in the nation (11.4 deaths per 1,000 live births), much higher than the national rate (6.9 per 1,000). Mississippi has the highest percentage of adults who are obese (31.4 percent) and the third highest percentage of adults who smoke (25.1 percent).
Mississippi earned a C- in Access to Emergency Care and faces a number of challenges. The state has the second lowest rate of physicians accepting Medicare (1.9 physicians per 100 beneficiaries) and exceptionally high rates of uninsured residents. Nearly 19 percent of children lack insurance compared to 11.7 percent nationwide, while 21.4 percent of adults are uninsured compared to 17.2 percent nationally. Mississippi also faces a severe workforce shortage with regard to emergency physicians, plastic surgeons, orthopedists and hand surgeons, and primary care providers. In addition, less than 60 percent of the population lives within 60 minutes of a Level I or II trauma center, ranking among the bottom ten states for this indicator.
The state’s grade for the Quality and Patient Safety Environment reflects some negative factors such as a low proportion of patients receiving PCI for myocardial infarction within 90 minutes of arrival (49 percent compared to 59 percent across the states). In addition, there are low hospital utilization rates of electronic medical records and computerized practitioner order entry.
Recommendations. Mississippi’s low scores in Public Health and Injury Prevention suggest a critical need for greater focus and investment in this area, particularly regarding the prevention of unintentional injuries and promotion of healthy behaviors and activities (e.g., healthy eating, physical activity, seat belt use, smoking cessation).
While Mississippi has shown some commitment toward improving the Quality and Patient Safety Environment by providing funding for a state EMS medical director position and quality improvement within the EMS system, the state would benefit significantly from further improvement efforts. Quality and patient safety might be improved with the application of system-wide standards to ensure effective response (e.g., regarding application of PCI for myocardial infarction). Mississippi would also benefit from efforts to increase the number of emergency medicine residents in the state, helping to address the state’s low rates of emergency physicians and board-certified emergency physicians.