From access to health care to health-care coverage and health outcomes, women of color in the U.S. have distinctly different experiences than their white female counterparts, according to a new 50-state report card released Tuesday by the Alliance for a Just Society. 

Black women have worse health outcomes than women overall in unique areas, like hypertension and infant mortality. For all 38 states that self-reported data on the topic, black women have an infant morality rate that’s at least 20 percent higher than it is for women overall, according to the report. In seven states, black women post an infant mortality rate double what women overall experience. Diabetes in particular is a problem that has a disproportionate impact on Latinas and Asian women, and Native American women experience higher rates of asthma than women overall do.

Inequities extend to access to care and healthcare coverage. In more than half of U.S. states, black women are uninsured at rates that are at least 10 percent higher than the uninsured rate for women overall, according to the report. In one-third of U.S. states black women are uninsured at rates 20 percent higher than women overall. In 17 states, Latinas are uninsured at rates double the rate uninsured rate of women overall. 

These problems stem from 21 states’ refusal to accept federal funding to expand Medicaid coverage for low-income residents, concludes the Alliance for Justice Society, whose executive director LeeAnn Hall serves on the board of Colorlines’ publisher Race Forward. Those states that refused Medicaid expansion performed especially poorly in AJS’ report card. Boosting Medicaid expansion tops the organization’s policy recommendations. 

“While many states are making critical progress on women’s health thanks to the Affordable Care Act, this report card underscores that we must do more, starting with getting every state to cover low-income women through Medicaid,” Rep. Jan Schakowsky (D-IL) said in a statement, echoing the report card’s findings.

For more, read the Alliance for a Just Society report card here.