Module 2 Group Discussion

1. . ( https://www.commonwealthfund.org/ ) Click on Tools and Data Resources, using the dropdown information, find your state on one the various maps and compare the state in which you practice to another state. Select one of the maps to analyze closely. ( Compare Alabama to Texas )
2. Identify the map you analyzed. Describe what part of the map is the most alarming to you or the most reassuring. Why?
3. How does the state where you practice compare to the comparison state? (e.g. How are they similar or Different?)
4. Are there any socioeconomic, political, cultural, and ethical issues surrounding the information gleaned from the interactive map you chose?
5. Respond to at least two of your classmates using the ABC approach when composing your reply:
6. Acknowledge your classmates’ posts.
7. Build upon these posts by providing additional details, statistics, ideas, personal perspectives, or links to interesting, relevant articles.
8. Conclude with a question or new idea to further stimulate the discussion.
9. Use APA format to include in text and reference listing. The discussion post should be at the graduate level and in a prose format (paragraphs and complete sentences).
10. Define acronyms prior to using them alone.

Please use the website from part one as a source

Also, I am a psychiatric RN working as a CoCM in PCMHI at VA Hospital

Respond to posts:

Austin Grube

Feb 9, 2026 4:30 PM

(Edited by Austin Grube on Feb 9, 2026 5:54 PM)

NEW

Childhood Vaccination Rates

Since the COVID-19 pandemic in 2019, childhood vaccination has become a frequent topic of debate in the United States and worldwide. As public controversy surrounding vaccines has increased, vaccination rates have declined. Going into the 20242025 academic year, the Centers for Disease Control and Prevention (CDC, 2025a) reported lower vaccination rates among kindergarten-aged children across all routinely recommended vaccines compared with the previous year. More recently, the CDC adjusted its recommended childhood immunization schedule, reducing coverage from 17 diseases to 10 (U.S. Department of Health and Human Services, 2026). This change has been followed by another rise in vaccine mistrust and hesitancy. To better understand these declining trends, particularly in Idaho, this discussion compares Idahos immunization rates with those of its neighboring state, Utah.

Commonwealth Fund Map Analysis on Childhood Vaccinations

The Commonwealth Fund map showing children who have received all recommended vaccinations highlights a clear downward trend in childhood immunization rates across the United States (The Commonwealth Fund, 2026a). It shows that vaccination coverage has steadily declined since 2018. In that year, 72.8% of children aged 1935 months received all seven key recommended immunizations, compared with 69.5% in 2023.

Idaho and Utah, as neighboring western states, rank similarly in the Commonwealth Funds 2025 state health rankings, with Idaho ranked 19th and Utah ranked 17th (The Commonwealth Fund, 2026b). Despite these similar rankings, meaningful differences exist in childhood immunization coverage between the two states. In 2021, both states were considered top performers, with vaccination rates of 75.9% in Idaho and 78.9% in Utah. By 2023, Utah maintained a relatively high coverage rate of 74.7%, while Idaho dropped to 66.7%, placing it among the lower-performing states. Idaho experienced its largest decline between 2022 and 2023, with a 7.6% decrease, compared with a smaller 3% decline in Utah during the same period.

Socioeconomic, Political, Cultural, and Ethical Considerations

Income level continues to be a major factor influencing childhood vaccination status nationwide. In 2023, 77.9% of children living at or above 300% of the federal poverty level received all recommended vaccines, compared with only 62.3% of children living between 0% and 199% of the federal poverty level (The Commonwealth Fund, 2026a). This gap is concerning, particularly given the availability of the Vaccines for Children (VFC) Program, which provides recommended immunizations at no cost to eligible families who cannot afford them (CDC, 2025b).

Political messaging and media influence have also contributed to declining vaccination rates. Changes to the CDCs immunization schedule may further increase hesitancy, as parents question which vaccines are truly necessary for their children. This concern has been amplified by public criticism from professional organizations such as the American Academy of Pediatrics, which has cautioned that these changes may lead to increased confusion and reduced trust in vaccination recommendations (American Academy of Pediatrics, 2026).

Conclusion

Declining childhood vaccination rates remain an ongoing public health concern in the United States. While some states, including Idaho, have seen significant drops in vaccination coverage in recent years, otherssuch as Utahhave been more successful in maintaining stable immunization rates. Understanding the factors contributing to these differences is essential for developing strategies to rebuild trust and improve vaccination uptake moving forward.

References

Centers for Disease Control and Prevention. (2025a). Vaccination coverage and exemptions among kindergartners (SchoolVaxView). https://www.cdc.gov/schoolvaxview/data/index.html#cdc_data_surveillance_section_2-new-findings-on-vaccination-coverage-and-exemptions-among-kindergartners-2024-2025-school-year

Centers for Disease Control and Prevention. (2025b). About the Vaccines for Children (VFC) Program. https://www.cdc.gov/vaccines-for-children/about/index.html

The American Academy of Pediatrics. (2026, January 5). AAP: CDC plan to remove universal childhood vaccine. AAP News. https://publications.aap.org/aapnews/news/34104/AAP-CDC-plan-to-remove-universal-childhood-vaccine

The Commonwealth Fund. (2026a). Children with all recommended vaccines. https://www.commonwealthfund.org/datacenter/children-all-recommended-vaccines

The Commonwealth Fund. (2026b). Data Center. https://www.commonwealthfund.org/datacenter

U.S. Department of Health and Human Services. (2026, January 5). Fact sheet: CDC childhood immunization recommendations. https://www.hhs.gov/press-room/fact-sheet-cdc-childhood-immunization-recommendations.html

Post 2:

Jamie Hutcheson

Jan 30, 2026 9:03 AM

NEW

Analysis of the Commonwealth Fund State Health System Performance Map

The Commonwealth Fund offers interactive tools for evaluating and comparing health system performance among U.S. states. Drawing on the 2025 State Scorecard on Health System Performance from the Tools and Data Resources section, I examined Alabamas health system performance, where I practice, and compared it to Massachusetts, a state recognized for consistently high performance. The Scorecard assesses states across key domains such as access to care, quality, health outcomes, and equity (Commonwealth Fund, 2025).

Most Alarming and Reassuring Findings

A particularly alarming aspect of the Scorecard map is the pronounced disparity in health system performance among states. Alabama ranks 42nd overall, which reflects lasting challenges including higher uninsured rates, limited access to primary care, and elevated rates of preventable mortality (Commonwealth Fund, n.d.-a). These findings show ongoing barriers to timely and preventive health services.

Conversely, the strong and steady performance of Massachusetts is reassuring. Massachusetts ranks among the top states in health system performance, particularly in access and health outcomes. This suggests that effective policy implementation and sustained investment in health infrastructure can result in improved population health (Commonwealth Fund, 2025).

Comparison of Alabama and Massachusetts

Alabama and Massachusetts show considerable differences in health system outcomes. Alabama demonstrates lower performance in insurance coverage, preventive care utilization, and health outcomes, while Massachusetts achieves higher access to care and better overall health indicators (Commonwealth Fund, 2025). A primary factor playing a role in these disparities is Medicaid expansion under the Affordable Care Act (ACA), a federal law designed to expand health insurance coverage and improve access to care. Massachusetts adopted Medicaid expansion early, whereas Alabama has not, resulting in a larger uninsured population and reduced access to routine care in Alabama.

Socioeconomic, Political, Cultural, and Ethical Considerations

Socioeconomic factors, including income, employment, and insurance availability, influence the disparities observed on the Scorecard map. Political decisions at the state level, particularly regarding Medicaid expansion and public health funding, are central to shaping health system performance. Medicaid is a joint federal and state program that provides health coverage to low-income individuals. From an ethical perspective, the disparities highlighted by the Scorecard raise major concerns about health equity, since limited access to care disproportionately influences vulnerable populations and contributes to preventable adverse health outcomes.

Conclusion

The Commonwealth Funds 2025 State Scorecard shows substantial differences in health system performance between Alabama and Massachusetts. These disparities underscore the influence of policy decisions, socioeconomic conditions, and health system structure on population health, and highlight the need for targeted interventions to improve access and equity in lower-performing states.

References

Commonwealth Fund. (2025). 2025 scorecard on state health system performance. https://www.commonwealthfund.org/publications/scorecard/2025/jun/2025-scorecard-state-health-system-performance

Commonwealth Fund. (n.d.-a). State health data center: Alabama. https://www.commonwealthfund.org/datacenter/alabama