Minnesota has the nation's best-performing healthcare system, according to a Commonwealth Fund ranking released this week, and Massachusetts, Vermont, and New Hampshire are tied for second. Mississippi ranks last, just as it did on the previous ranking in 2009. Louisiana, Oklahoma, and Arkansas round out the bottom of the list.

For the ranking, the Commonwealth Fund relied on 42 different metrics that gauged everything from insurance coverage to avoidable hospital stays to vaccination rates, at the systemic level; and from obesity rates to how many adults have lost six or more teeth, at the individual level.

Here's the tooth map:

Commonwealth Fund

Almost all states either stagnated or declined in performance since the survey was performed five years ago, and once again, Southern states scored especially poorly across all of the dimensions.

What's more, there were wide mortality differences between black and white residents of several states in the Deep South. "Racial and ethnic minorities in Arkansas, Georgia, Indiana, Mississippi, and North Carolina faced some of widest disparities relative to the national average across all of the indicators assessed in our Equity dimension," the group wrote.

Demographically, Mississippi is already at a disadvantage. A black man in Mississippi has a shorter life expectancy than the average American did in 1960. The state has an obesity rate of 35 percent, one of the highest poverty rates in the country, and just one abortion clinic.