A new report from the Commonwealth Fund reveals large and widespread racial and ethnic disparities in health and healthcare across the United States. The report examined 25 measures of health care performance for Black, white, Hispanic, American Indian/Alaska Native, and Asian American/Pacific Islander populations in each state.
Using a scoring method, the Commonwealth Fund assessed each state’s healthcare system performance for different racial and ethnic groups. The study’s findings provide insight into disparities and serve as a starting point for addressing healthcare inequalities.
“Profound racial and ethnic disparities in health, well-being, and life expectancy have long been the norm in the United States,” the report states. It found that these disparities are “especially stark” for Black and American Indian/Alaska Native people.
The research looked at premature deaths from preventable causes, finding “Black people are more likely than Asian American, Native Hawaiian, and Pacific Islander, Hispanic, and white people to die early from avoidable causes.”
Lack of health insurance contributes greatly to the disparities. The report notes that “Hispanic people have the highest uninsured rates and cost-related problems in getting care” across states. It states, “Being uninsured or underinsured has consequences” including delays in medical treatment.
The quality of care received also varies by race and ethnicity. “Across and within most states, white people overall receive better quality of care than Black, Hispanic, American Indian/Alaska Native, and, often, Asian American and Pacific Islander people,” the report says.
For example, it finds that “Black Medicare beneficiaries are more likely than white beneficiaries to be hospitalized for…conditions that are treatable and manageable with appropriate primary care.”
The disparities stem from factors like poverty, pollution, underfunded health services, and racial discrimination in health settings. “Studies show…many people of color contend with interpersonal racism and discrimination in health care settings,” the report notes.
It calls on policymakers to pursue changes like expanding health coverage, strengthening primary care, reducing administrative burdens on patients, and investing more in social services to bridge the gaps.
“Advancing equity in health and health care should be a top priority of health care leaders and policymakers.”
“Our hope is that policymakers, health system leaders, and community stakeholders will use this tool to investigate the impact of current and past health policies on different racial and ethnic groups,” said the report.
The Commonwealth Fund is a private U.S. foundation that was established in 1918 with the broad charge to “enhance the common good” with a mission to “promote a high-performing, equitable health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including people of color, people with low income, and those who are uninsured.”
