INDIANAPOLIS (WISH) — Health care costs and health care outcomes were a big reason why Indiana scored so poorly on an inaugural study conducted by Forbes Advisor.

Indiana also had the ninth-lowest number of physician assistants and the fifth-lowest number of registered nurse anesthetists.

Forbes Advisor touts itself as a global platform dedicated to helping consumers make the best financial choices for their lives. Zoi Galarraga, senior digital public relations manager for Forbes Advisor, told News 8, “There is a shortage of both nurse practitioners and critical care nurses.”

Since some Hoosiers can’t afford health insurance or can’t fully take advantage of it, they’re not as healthy as they should be.

Galarraga said, “Indiana stands out as the state with the sixth-highest rate of chronic respiratory diseases deaths, the eighth-highest of diabetes deaths, the eighth-highest rate of kidney disease deaths, and the 10th-highest infant mortality rate.”

Forbes Advisor got its data from the Kaiser Family Foundation, the U.S. Centers for Disease Control and Prevention, and the federal Centers for Medicare & Medicaid Services.

Galarraga said, “We do see a correlation between the percentage of residents who choose not to see a doctor in the past year because of costs, and out-of-pocket spending, and health care outcomes tend to be worse in states where residents are not getting the preventative care that they need.”

Galarraga said consumers should compare and contrast health care plans before selecting one. Employers can invest in healthier employees by covering a larger portion of worker premiums.

“Hopefully residents will then feel empowered to see the doctor when they need to and then as a result healthcare outcomes should improve.”

In the study, Georgia ranked as the worst state for health care, and Minnesota placed as the best state for health care.