For years, in rankings of health indicators by state, Georgia typically landed in the high 30s to low 40s.

But never at the bottom.

The Peach State, though, has been ranked 50th, ahead of only Oklahoma, in a comparison of states and Washington, D.C., on health care for seniors. It follows a Georgia ranking of 51st last year on overall health care, a ranking largely overshadowed at the time by news of the pandemic.

The recently published ratings by MedicareGuide on senior health care analyzed factors such as prescription drug prices, the number of physicians in relation to a state’s population, and life expectancy to determine which states offered the best health care for people over 65.

MedicareGuide, which is part of the consumer health information website HealthCare.com, compared the states on measurements of cost, quality of care, and access to care.

The cost category includes out-of-pocket medical spending, while the quality measure analyzes mortality rates for heart disease, cancer and stroke, among other factors. Access includes rates of geriatricians, nurse practitioners and home health aides per capita.

“This is depressing but a necessary wake-up call for Georgia policymakers,’’ Kathy Floyd, executive director of the Georgia Council on Aging, said this week. “Unlike the younger population, seniors have Medicare, but that doesn’t automatically translate to good health care.’’

The Georgia Department of Community Health, when asked to comment on the ranking, pointed out that the agency does not administer the Medicare program.

“There is no question that Georgia has work to do as a state where older adult health is concerned,’’ said Lisa Renzi-Hammond of the Institute of Gerontology at the University of Georgia’s College of Public Health. “These rankings are an excellent reminder that we need to roll up our sleeves, dig in and focus on infrastructure to support Georgia’s older adults.’’

But Renzi-Hammond also cited an area where Georgia is doing well: care for Alzheimer’s patients. “We have formed a major statewide collaboration to address Alzheimer’s disease through major public health campaigns focused on community education and prevention, health care provider education, and improving access to diagnosis and post-diagnosis support.’’

“There is absolutely work to be done, particularly around access, but I would not be surprised to see Georgia’s spot on the rankings rise over the next few years,’’ she added.

Some counties left behind

Georgia’s bottom ranking on states’ overall health care last year was compiled by WalletHub, a personal finance website. The WalletHub rankings used the three categories of costs, access and outcomes.

In cost of care, Georgia was average, at 26th. But it was 51st in access to care.

That category includes rates of physicians, dentists, nurse practitioners and physician assistants per population. As of a 2018 report, nine of the state’s 159 counties had no physicians, 76 counties had no ob/gyn, and 60 were without a pediatrician. Another access measure used is the rate of people without any health coverage. Georgia has the third-highest rate of uninsured, at 13.4 percent, trailing only Texas and Oklahoma.

In health outcomes, the state was 47th. The category includes data on infant mortality and maternal mortality, where Georgia has long had problems.

Dr. Harry Heiman, a health policy expert at Georgia State University, said of the WalletHub ranking that “we have known for a long time that Georgia has one of the highest rates in the country for those without health insurance at the same time we have some of the worst health outcomes.’’

“We know Georgia has unacceptably high infant mortality and maternal mortality and high levels of diabetes, stroke, and heart disease,’’ Heiman said. He added that “there are significant inequities for all of these problems, disproportionately affecting low-income, rural, and Black and brown communities in our state.’’

In both rankings, states in the Southeast tended to fall at the bottom. The MedicareGuide rankings had Kentucky, South Carolina, Tennessee, Alabama, North Carolina, Louisiana and Mississippi at 40 and below.