A new state-by-state women’s health scorecard released this week by the Commonwealth Fund reveals mounting disparities in women’s health and reproductive care across the U.S.

Massachusetts, Vermont and Rhode Island top the rankings for the scorecard, which is based on 32 measures of healthcare access, quality and health outcomes. The lowest performers were Mississippi, Texas, Nevada and Oklahoma.

The findings raise concerns over the state of women’s healthcare and the ripple effects of the Supreme Court’s 2022 decision to overturn Roe v. Wade, which has significantly altered access to critical reproductive health care services.