Study: Racial inequities pervasive in U.S. health system
Even states that are generally considered high-performers in terms of overall health could see wide disparities.
The United States continues to have stark disparities in access and quality of health care based on race, according to a new report from the Commonwealth Fund. The group’s “State Scorecard on Health System Performance” found racial and ethnic inequities are pervasive in all states, but can vary significantly from state to state.
“Black, Latinx/Hispanic, and American Indian/Alaska Native (AIAN) populations are less likely to have health insurance, more likely to face cost-related barriers to getting care, and more likely to incur medical debt,” the report said. “It is also less common for individuals from these groups to have a usual source of care or to regularly receive preventive services like vaccinations.”
This study, like others, finds that systemic racism in our society has created barriers for people of color, in this case regarding health outcomes. “Decades of policy choices made by federal, state, and local leaders have led to structural economic suppression, unequal educational access, and residential segregation, all of which have contributed in their own ways to worse health outcomes for many people of color,” the report said. “The failure to ensure all Americans have reliable health coverage has paved the way to inequitable access to health care.”
A long list of unequal outcomes
The data showed that in every area of health, there are racial and ethnic inequities in outcomes. The Commonwealth report found:
- State uninsured rates are generally higher and more variable for Black, Latinx/Hispanic, and AIAN adults compared to Asian American, Native Hawaiian, and Pacific Islander (AANHPI) and white adults.
- White people are less likely than other population groups to face cost-related barriers to health care in most states.
- In most states, Black people and AIAN people are more likely than white people to die early in life from conditions that are treatable with timely access to high-quality health care.
- Black women are more likely than white women to be diagnosed with breast cancer at later stages and to die, even though breast cancer is often considered treatable when detected early.
- Black Medicare beneficiaries are more likely than white beneficiaries to be admitted to a hospital or to seek care in an emergency department for conditions typically manageable through good primary care.
- Black, AIAN, and Latinx/Hispanic adults are less likely than AANHPI and white adults to receive an annual flu shot.
Disparities among all states, made worse by the pandemic
One of the notable findings of the report is that even states that are generally considered high-performers in terms of overall health could see wide disparities in the rankings for some racial and ethnic groups. Minnesota, for example, ranks No. #7 in overall health care system scores for whites, but ranks 13th for overall health with Blacks and 30th in overall health for its Latinx/Hisainic population.
Regional differences were also seen. The study found higher preventable mortality rates for both Black and white residents in many southeastern states compared to other parts of the country, while preventable mortality rates among AIAN people tended to be higher in the upper Midwest and northern Plains states.
At a press conference presenting the report, Commonwealth Fund President David Blumenthal, M.D., said that the COVID-19 pandemic has widened the gap in outcomes for different racial and ethnic groups in the U.S.
“There’s little doubt that the pandemic has exacerbated these inequities and other weaknesses in our health care system,” he said. “Structural racism and generations of disinvestment in communities of color are chief among the many factors contributing to these pervasive issues.
“If we want to get this pandemic under control and mitigate longstanding injustices in our health care system and beyond, we need to dismantle the racist policies and practices that have led us here and create a truly equitable health system.” Blumenthal said.
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