South Dakota continues to see some of the nation’s widest racial and ethnic health disparities, according to the Commonwealth Fund’s 2026 State Health Disparities Report, released in late April.
The report, which analyzed health care access, quality and outcomes using data from 2022 to 2024, found that American Indian residents in South Dakota experience among the highest rates of premature death from preventable or treatable causes of any racial or ethnic group in any state.
Researchers found that cost-related barriers to care are worsening. After hitting record lows earlier in the decade, the share of people skipping medical care because of cost is rising again, with the sharpest increases among Hispanic and American Indian and Alaska Native communities. In most states, including South Dakota.
The report also notes that disparities persist even where overall health system performance improves, emphasizing that progress for the general population has not translated into equitable outcomes across racial and ethnic groups. Policy choices, including Medicaid eligibility, insurance coverage gaps and access to preventive and follow-up care, were cited as major drivers of disparities.
Authors warned that recent and proposed federal policy changes affecting Medicaid funding and insurance affordability could further widen health inequities in South Dakota and nationwide in the coming years.
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