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Compared with other states, Georgia ranks high in the rate of health care uninsurance, maternal mortality, new cases of HIV and gun violence.
The state has a lower incidence of mental illness, but a lower ranking in access to mental health treatment.
Stacey Abrams basically asked us to fact-check her.
The Georgia Democrat running for governor tweeted that Georgia’s residents face a host of problems, and she listed them.
"We’re #48 in mental health, #2 in uninsured. #1 in maternal mortality and new HIV cases, #9 in gun violence," she tweeted May 21, 2022.
When pressed about her grim statistics a couple of days later, Abrams defended her numbers, saying, "Somebody’s going to try to PolitiFact me on this."
We did, and with one exception, her data generally holds up. Some of her numbers are a little off, or different studies found slightly different rankings. We share the data the campaign used and what we found. Due to the complexity of the claim with its many different topics, we won’t issue a rating.
This is the most problematic of her claims. Georgia doesn’t do that badly in some rankings.
Her staff pointed to work by Mental Health America, a group that has been advocating for mental health services for over a century. While the group ranks Georgia 48th in the sub-category of access to care, the state has an overall ranking of 27 out of the 50 states. That’s based on the balance between the prevalence of mental illness and the availability of treatment.
In the group’s ranking process, Georgia benefited from having a relatively low rate of mental illness. It ranked fourth out of 50. Abrams’ campaign said their concern is about how easy it is for Georgians to get treatment.
This is basically correct; Georgia has high rates of uninsurance. Abrams’ relied on the work of the Kaiser Family Foundation, a reliable source of health care data. Using government figures, the foundation found that Texas had the highest rate of people with no health insurance — 17.5% — followed by Oklahoma and Georgia, both with uninsurance rates of 14.5%.
So, Georgia tied for second.
That was for 2020, which was a challenging year for data collection. During the COVID-19 pandemic, fewer people responded to the government’s surveys. But looking at earlier government data didn’t change the picture much.
For 2019, the U.S. Census Bureau found that Georgia ranked third behind Texas and Oklahoma. Either way, Georgia is in the top three states with a large fraction of residents who lack insurance.
Georgia ranks high in maternal mortality, but depending on the definition of maternal mortality and who crunched the numbers, Georgia ranks either first, second or fifth.
The most recent and complete data comes from Jeffrey Howard, a public health professor at the University of Texas San Antonio. Abrams’ campaign didn’t point to his work, but we found it, and it supports her claim.
Howard specializes in sifting through several sources of maternal mortality data. Maternal mortality is generally reported using two time frames — deaths that take place within 42 days of delivery, and those that come within one year of delivery.
Howard uses the longer time frame of up to one year after delivery because he says it’s more helpful in shaping health policy.
"If we don’t include the later deaths, we are ignoring potential problems of access to care, and the quality of care," Howard said.
Howard has data for all 50 states for 2019, and when he runs the numbers, Georgia has the worst maternal mortality rate at 55.43 deaths per 100,000 people.
The most recent government analysis was for 2018, and it reported death rates in both time frames — within 42 days of delivery, and within one year of delivery. For the shorter period, Georgia ranked fifth, not first.
In the longer time frame, Georgia did rank first. But due to data constraints, the longer time frame included only nine states. Louisiana, Alabama and Indiana ranked second, third and fourth, respectively.
For her part, Abrams relied on a 2021 article in the International Journal of Maternal and Child Health, which reported that Georgia "tops the list of all 50 states." We spotted several red flags in the authors’ methodology. Most troubling? They got their key numbers from a non-peer reviewed story written for the general public that relied on data from a non-peer reviewed source.
The campaign got this stat from the Centers for Disease Control and Prevention and it is correct. But it is for 2020, and the CDC warns that numbers gathered during COVID-19 "should be interpreted with caution."
That said, the CDC reported that the rate of new HIV infections in Georgia was 22.1 per 100,000. Louisiana ranked second with a rate of 18.7, per 100,000, and Florida third, with 18.2 new cases per 100,000.
The 2019 pre-pandemic CDC data showed Georgia ranked fourth, behind top ranked Florida, Louisiana and Nevada. So, not the highest rate, but one of the highest in the country.
This is in the ballpark, but precision is difficult. The Abrams campaign relied on a fact-sheet for Georgia from Everytown for Gun Safety, a gun control advocacy group. The group looked at firearm deaths over five years from 2016 to 2020, and firearm injuries for 2017.
"In an average year, 1,693 people die and 4,492 are wounded by guns in Georgia. Georgia has the 9th-highest rate of gun violence in the U.S.," the fact sheet on Georgia said.
The group’s research director Sarah Burd-Sharps told us the ranking is a blend of the two figures (add them together, then divide by the state’s population to get the rate).
Other data sources give a slightly different picture of how Georgia stands relative to other states.
The CDC reported that in 2020, Georgia ranked 15th in firearm-related deaths.
There is no simple source of data on firearm injuries. To fill in the gap, analysts at the RAND Corporation, a nonprofit research group, created a database from several state-level sources that covers the years from 2000 to 2016
In their results, Georgia ranks 10th for firearm hospitalizations.
Neither the CDC count of deaths nor the RAND numbers on injuries rank Georgia at No. 9, but they cover different years, and they don’t suggest Abrams is wildly wrong. Given the way Everytown for Gun Safety derives its rankings, the injury numbers drive the final results. In that regard, Abrams’ number aligns closely with the RAND findings.
Stacey Abrams, tweet- multiple stats, May 21, 2022
NBC News, Abrams says Georgia is 'worst state' to live in, citing health care, incarceration rates, May 23, 2022
Mental Health America, Ranking The States, 2020
Congressional Research Service, U.S. Health Care Coverage and Spending, April 1, 2022
Office of the Assistant Secretary for Planning and Evaluation - U.S. Health and Human Services Department, State, County, and Local Estimates of the Uninsured Population: Prevalence and Key Demographic Features, March 11, 2021
U.S. Census Bureau, Health Insurance Historical Tables, accessed May 24, 2022
U.S. Census Bureau, Health Insurance Coverage, 2019
U.S. National Center for Health Statistics, Maternal Mortality Rates in the United States - 2020, Feb. 23, 2022
Centers for Disease Control and Prevention, Maternal Mortality by State, 2018
International Journal of Maternal and Child Health, Geographic, Health Care Access, Racial Discrimination, and Socioeconomic Determinants of Maternal Mortality in Georgia, United States, Dec. 13, 2021
World Population Review, Maternal Mortality Rate by State, accessed May 24, 2022
Interview, Jeffrey Howard, associate professor of public health, University of Texas San Antonio, May 25, 2022
Centers for Disease Control and Prevention, HIV Statistics Center, accessed May 24, 2022
Centers for Disease Control and Prevention, Diagnoses of HIV Infection in the United States and Dependent Areas 2020, May 24, 2022
Centers for Disease Control and Prevention, Firearm Mortality by State - 2020, March 1, 2022
Johns Hopkins Center for Gun Violence Solutions, A Year in Review: 2020 gun deaths in the U.S., April 28, 2022
RAND, Inpatient Hospitalizations for Firearm Injury, 2021
Email exchange, Sarah Burd-Sharps, senior director for research, Everytown for Gun Safety, May 27, 2022