Health care isn't far from anyone's thoughts these days, what with the still-raging debate over various provisions of the Affordable Care Act and the current administration continuing to do all it can to hamstring its progress has meant in terms of broader, better coverage for many Americans. With that in mind, the results of the Commonwealth Fund's 2018 Scorecard on State Health System Performance offers some enlightening insights into how the country is doing with regard to the health care available to its citizens. Evaluating data for all 50 states and the District of Columbia, researchers looked not only at health challenges facing the states, but also how they're doing in coping. All were assessed on 43 measures of access to health care, quality of care, efficiency in care delivery, health outcomes, and income-based health care disparities. Researchers found that more indicators improved than worsened—612 compared with 259—with New York improving in the largest number of indicators that are tracked over time: 18 out of 37. Four other states, Arkansas, Louisiana, Oklahoma and West Virginia, each improved in 17 of those 37 indicators. Related: How health issues and life expectancy differ from state to state But improvement notwithstanding, some states did really poorly, and care in particular regions of the country varies greatly. Among the major issues states face are rising death rates, high levels of obesity and gaps in care—as well as a failure to get good value for money spent on health care and disparities in the quality and amount of care both within states and within regions. Southern states, the report finds, "generally rank at the bottom," while care is better for residents of New England, the upper Midwest and several states in the West. An encouraging note is that states that set goals for improvement in specific areas and then worked toward those goals did show improvement—but some states also lost ground rather than gaining it. Interestingly, the top 5 states in the country saw no change in their rankings from the last scorecard. One thing that has changed for the worse is the average life expectancy at birth, which fell for the second year in a row. Says the study, "The combined rate of deaths from suicide, alcohol, and drug use—sometimes referred to as 'deaths of despair'—increased 50 percent from 2005 to 2016." If you're considering relocation, whether for a job or for retirement, and have any serious health issues, you might want to take a look below at the 5 best and 5 worst states, in that order, for health care before you make any drastic moves. You never know; your life could depend on it.