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A new Commonwealth Fund report ranked West Virginia at 41st for doing a good job with helping the state's low income residents, many who are considered the working poor.
"Health Care in the Two Americas," found giant gaps between the lowest and highest performing states.
The Commonwealth Fund supports independent research on health policy, looking at 30 different indicators in four categories.
West Virginia ranked 20th in providing preventive care screenings and treatment for low-income residents, 28th in health-care access and affordability, and 46th in potentially avoidable hospital.
West Virginia was 50th in promoting healthy lifestyles, adult obesity, smoking, lack of exercise, and those reporting poor to fair health or mental health status.
The report said 32 percent of West Virginia adults, one-fourth of state second graders and about 28 percent of fifth graders are obese.
It ranked West Virginia at the bottom for the number of hospital admissions.
While polls indicate most people believe that low income people have healthcare benefits, it said one-third of West Virginia's low-income population was uninsured, although that could partially be remedied by controversial Obamacare.
"We found repeated evidence that we are often two Americas, divided by income and geography when it comes to opportunities to lead long and healthy lives," said Cathy Schoen, a Commonwealth Fund senior vice president.
"These are more than numbers. We are talking about people's lives, health, and well-being," she said.
Nine of the bottom 10 states were in the South.
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