Oklahoma has one of the worst health systems in the nation, a system that overall fails to provide access to care and prevent disease among the state’s adults and children, according to a report released Wednesday.

And if Oklahoma were to improve its health system and implement strategies that brought it among the rankings of the best-performing states, thousands of residents could see better health and potentially longer lives, according to The Commonwealth Fund’s report.

The Commonwealth Fund, a New York-based nonprofit health policy group, released its “Scorecard on State Health System Performance, 2014” on Wednesday.

The report assesses states on 42 indicators of health care access, quality, costs and outcomes over the 2007 to 2012 period, which includes the Great Recession and precedes the major coverage expansions of the Affordable Care Act.