Where is Health Care The Biggest Part of the Economy?

State health care spending usually gets reported in terms of dollars per capita, leading to maps like this that show Alaska as the highest-spending state and Utah as the lowest:

*Source: https://www.kff.org/other/state-indicator/health-spending-per-capita/*

But states differ greatly in how rich they are and how much they have to spend. I wanted to know the states where health care takes up the largest and smallest share of the economy, so I got the data:

Health Care Spending as Share of State Gross Domestic Product in 2019:

*Source:* *I divided 2019 National Health Expenditure Provider data on total health spending by 2019 Gross State Product data.*

You can see that health spending as a share of GDP looks pretty different from health spending in raw dollars. We’ve gone from a high-spending North and low-spending South to more of a mix. Health spending is now highest in West Virginia, where it makes up more than a fourth of the economy; and lowest in Washington State and Washington D.C., where it makes up less than one ninth of the economy.

The biggest change when considering things this way is in Washington D.C., which has the highest spending in $ terms but the lowest as a share of GDP because it has an enormous GDP per capita. Many other states that spend a lot in $ also fall a lot in the rankings due to high GDP per capita, including Alaska, New York, and Massachusetts. The states that rise the most in this ranking are poor states like Arkansas, Alabama, and Mississippi. Mississippi rises the most, gaining 37 spots in the rankings of highest-spending states when we go from $ per capita to share of GDP.

I share the data here so you can do your own comparisons:

State	Health Spending Per Capita	Health Spending as % ofGDP	Spending Rank	Spending Share of GDP Rank	Change in Rank	GDP Per Capita
AL	$8,741	18.43	41	10	31	47095
AK	$13,226	16.98	2	18	-16	75246
AZ	$8,145	16.24	47	22	25	51467
AR	$8,853	19.47	36	7	29	43921
CA	$9,628	12.30	27	48	-21	80250
CO	$8,286	12.45	45	47	-2	69071
CT	$11,831	14.66	8	34	-26	81710
DE	$12,213	14.62	5	35	-30	80121
DC	$13,934	10.73	1	51	-50	205641
FL	$9,490	18.34	31	11	20	52144
GA	$8,243	14.22	46	39	7	59648
HI	$9,555	14.24	28	38	-10	68443
ID	$7,723	15.99	50	26	24	47386
IL	$9,496	13.14	30	44	-14	70735
IN	$9,927	17.63	20	14	6	57083
IA	$9,193	13.78	33	40	-7	62446
KS	$8,745	14.44	39	36	3	61317
KY	$9,744	19.71	23	5	18	48798
LA	$9,657	17.49	24	15	9	55937
ME	$11,488	22.21	10	2	8	50989
MD	$10,248	13.65	17	42	-25	71445
MA	$12,729	15.07	4	32	-28	87608
MI	$9,532	17.26	29	17	12	54412
MN	$10,510	16.07	16	24	-8	68877
MS	$8,745	20.85	40	3	37	39440
MO	$9,431	17.95	32	12	20	54158
MT	$9,808	19.28	22	8	14	50130
NE	$9,917	15.04	21	33	-12	68026
NV	$8,114	13.66	48	41	7	58557
NH	$11,310	16.92	11	19	-8	65233
NJ	$11,264	15.13	12	31	-19	72335
NM	$8,459	15.55	43	28	15	50753
NY	$12,932	14.32	3	37	-34	92209
NC	$8,619	15.43	42	29	13	57092
ND	$10,653	15.24	15	30	-15	75946
OH	$10,173	17.33	18	16	2	60211
OK	$8,923	16.53	35	21	14	51678
OR	$9,635	16.06	26	25	1	60863
PA	$11,175	17.89	13	13	0	63940
RI	$10,988	18.78	14	9	5	59126
SC	$8,345	16.12	44	23	21	48663
SD	$11,627	19.61	9	6	3	62858
TN	$8,827	16.82	37	20	17	55813
TX	$8,028	12.98	49	45	4	64361
UT	$7,193	12.72	51	46	5	60780
VT	$12,159	19.81	6	4	2	55172
VA	$8,826	13.17	38	43	-5	66038
WA	$8,964	11.10	34	50	-16	81477
WV	$11,951	25.68	7	1	6	44540
WI	$9,652	15.95	25	27	-2	60741
WY	$10,111	11.25	19	49	-30	70688

Note: Because I got much of this data for a different project, I use the provider version of the NHE to calculate health spending a share of GDP, while the dollar per capita column here is the NHE resident data as in the KFF map above; this causes some minor discrepancies. I also use an older version of Gross State Product, for reasons I may explain in an upcoming post. If you are re-doing this analysis yourself, in addition to revisiting these choices you could get the latest 2020 data; I chose 2019 in order to avoid Covid.