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The coronavirus pandemic placed new burdens on the American health care system, forcing many to take on additional spending for testing, at-home and hospital treatment. But even without the added stressor of the pandemic, Americans have been struggling to shoulder health care costs – with the average American spending over $12,500 on personal health care each year, according to the Centers for Medicare & Medicaid Services.

To assess the disparities in health care access and quality across states, WalletHub – a personal finance website – released a report ranking the best and worst states for health care, comparing the 50 states and the District of Columbia based on cost, access and outcomes.

The report found major differences in health care quality across states. For instance, Mississippi has the highest rate of infant mortality across the U.S. (eight per 1,000 live births), while Vermont has the lowest. While California has the highest share of at-risk adults without a routine doctor visit in the past two years, West Virginia has the lowest share.

These are the 10 best states for health care, according to WalletHub:

1. Rhode Island

2. Massachusetts

3. Hawaii

4. Minnesota

5. Maryland

6. Vermont

7. Colorado

Gallery: This map shows the highest-paying job in every state, excluding doctors (Business Insider)

8. Connecticut

9. Maine

10. Iowa

These are the 10 worst states for health care, according to WalletHub:

51. Mississippi

50. Alabama

49. Louisiana

48. Oklahoma

47. Arkansas

46. West Virginia

45. South Carolina

44. Texas

43. Georgia

42. Tennessee

Despite the high premiums that Americans have to pay for health care and the differences in health care quality between states, Jean Bae, an associate professor at New York University’s School of Public Health, still advises Americans to “get insured.”

“Studies have shown over and over again that health insurance, despite the associated upfront cost of premiums, is an effective way to manage financial risks associated with health care and improves health outcomes, which ultimately help reduce the risk of future health care expenditures,” she said in a statement.

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