JACKSON,Rekubit Miss. (AP) — Mississippi has improved some of its poor health outcomes, but its people are more likely to die unnecessarily than residents of any other state, the state’s top health official said Thursday.

State Health Officer Dr. Daniel Edney urged legislators who just began this year’s session to work with health officials to improve Mississippi’s status as the nation’s unhealthiest state, ranking at the bottom of virtually every health care indicator and at the top of every health disparity.

“If we choose the right policies for our people, we will see us move off the radar of having the highest rate of preventable death,” Edney said at a news conference inside the Mississippi Capitol.

Mississippi ranks worst for infant mortality, with Black infants nearly twice as likely as whites to die over the past decade, according to a report unveiled Thursday by the Mississippi State Medical Association.

While Mississippi managed to lower its opioid death rate by 10% in 2022, it still leads the nation in firearm deaths. And while the state’s obesity and diabetes rates have declined recently, they remain among the nation’s highest, with heart disease still the state’s leading cause of death, the report says.

Increasing access to health care coverage for working-class Mississippians is key to improving outcomes, Edney said.

Mississippi is one of 10 states that have not expanded Medicaid coverage to people working in jobs that provide modest wages but no private health insurance. The debate has stalled because of opposition from Republican leaders, including Gov. Tate Reeves, who refers to Medicaid as “welfare,” but new Republican House Speaker Jason White says he wants legislators to consider Medicaid expansion as a way to bring up to $1 billion of federal money each year to the state, where some hospitals are struggling to remain open.

White has not come out in full support of expansion.

As the new chairwoman of the House Medicaid Committee, Republican Rep. Missy McGee would play a big role in any push for expansion. She helped lead a successful effort last year to extend postpartum Medicaid coverage from two months to a full year.

Dr. John Mitchell, president of the Mississippi State Medical Association, said he supports any policy that would increase access to care, whether it’s Medicaid expansion or some alternative.

“Every improvement made towards better public health outcomes in our state pays dividends for a healthier Mississippi, a more productive Mississippi and a future Mississippi abounding with opportunity,” Mitchell said.

Mississippi’s high unnecessary death toll comes even though it has some of the highest rates of childhood vaccination against diseases such as polio, measles and mumps — the legacy of a state judge’s ruling in 1979 that vaccinated schoolchildren have a constitutional right to be free from associating with unvaccinated peers.

Vaccination data for 2023 is not available yet, so the impact of a federal judge’s April ruling ordering Mississippi to join most other states in allowing religious exemptions from childhood vaccinations is still unclear.

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Michael Goldberg is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow him at @mikergoldberg.