Dramatic Health Inequities Are Pervasive across the United States
A study published by the Commonwealth Fund in late 2021 found that health systems across the United States are failing people of color. According to the study, Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance, Black Americans in nearly every state are more likely than white Americans to die from preventable and treatable conditions exacerbated by lack of timely, high-quality health care.
Even among high-performing states, racial and ethnic health disparities can be dramatic, according to the study. For example, Minnesota’s health care system, which has historically performed well in Commonwealth Fund state scorecard rankings, has some of the largest health disparities between white and nonwhite communities. Maryland, Massachusetts and Connecticut are other traditionally high-scoring states where white residents receive some of the best care in the country, but where quality of care is far worse for many populations of color. Similarly, in states like Mississippi and Oklahoma whose health care systems have historically performed poorly for both white and Black populations, white patients still received markedly better care.
According to the study’s authors, structural racism and generations of disinvestment in communities of color are chief among many factors contributing to pervasive U.S. health inequities. They note that as the COVID-19 pandemic has shown, people in many communities of color are more likely than members of white communities to live in poverty, work in low-paying, high-contact industries, and to reside in high-risk living environments. Many Black, Latinx/Hispanic, and American Indian/Alaska Native (AIAN) populations then face an unequal health system when they need access to care. They are less likely to have health insurance, more likely to face cost-related barriers to care and medical debt, and more likely to receive suboptimal care.
Commenting on the study, one of its co-authors and Commonwealth Fund’s Vice President for Advancing Health Equity, Laurie Zephyrin, MD, said, “The U.S. health care system is not immune from the systemic inequities that plague American society. Our health care is characterized by long-standing disparities in access, quality and outcomes for people of color that were unveiled for many by the COVID-19 pandemic. We can do better, and we can start by tackling systemic racism, ensuring people have the health coverage they need, and resolving racial disparities in care.”
Disparities in Health and Health Care: Key Questions and Answers from the Kaiser Family Foundation
The issue of health care disparities is a complex one, with broad implications that are beyond the purview of this blog to cover in their entirety. Experts at the Kaiser Family Foundation have created an issue brief that provides a good introduction to what health care disparities are, the status of disparities and how COVID-19 has affected them, the broader implications of disparities and current federal efforts to advance health equity.
Several key points of the brief are summarized below, and subscribers can click here to read the full brief.
What are health and health care disparities?
- Health and health care disparities refer to differences in health and health care between groups that stem from broader inequities.
- Health equity generally refers to individuals achieving their highest level of health through the elimination of disparities in health and health care.
- A broad array of factors within and beyond the health care system drive disparities in health and health care.
- Health and health care disparities are often viewed through the lens of race and ethnicity, but they occur across a broad range of dimensions.
What is the status of disparities?
- Prior to the COVID-19 pandemic, people of color and other underserved groups faced longstanding disparities in health, health care and health coverage.
How has the COVID-19 pandemic affected disparities?
- Data consistently show that AIAN, Black, and Hispanic people have experienced disproportionate rates of illness and death due to COVID-19.
- Beyond the direct health impacts of the virus, the pandemic has taken a disproportionate toll on the financial security and mental health and well-being of people of color, low-income people, LGBT people and other underserved groups.
What are the broader implications of disparities?
- Addressing disparities in health and health care is important not only from a social justice and equity standpoint, but also for improving the nation’s overall health and economic prosperity.
Over the coming year, Real World Health Care will explore the issue of racial and ethnic health disparities, bringing you insights from patient support organizations working to address and eliminate these disparities. If you would like to share your organization’s story with our subscribers, please reach out to us via email.