Racial and ethnic health care disparities exist in every U.S. state, despite the passage of laws designed to improve health care for minorities and increased awareness of health care disparities over the past two decades, according to a new national report. Photo via Getty Images.
Racial and ethnic disparities in health care exist in every U.S. state, despite the passage of laws to improve the health of minorities and increased awareness of health care disparities over the past two decades, according to a new national report released Wednesday.
The more than 300-page document from the National Academies of Sciences, Engineering and Medicine details how structural racism and people’s environments have contributed to poorer health outcomes for minorities. It also offers recommendations and solutions for health organizations and the federal government, such as creating a more diverse workforce and adjusting payment systems to make health care more affordable.
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Dr. Georges Benjamin, executive director of the American Public Health Association and co-chair of the committee that authored the report, said people of color in the United States face higher rates of maternal and infant mortality, lower life expectancy and numerous chronic diseases.
“Injustices are an integral part of our health care system. If we eliminate them, everyone benefits,” said Benjamin.
Racism and bias on the part of health care providers have also contributed to poorer health outcomes, says the report, which comes 21 years after the organization’s first report.
The committee behind the report warned that having more practicing doctors from diverse backgrounds and the communities they serve could improve several problem areas. For example, studies show that people of color generally receive better care when treated by people who look like them.
The study also found that language barriers in health care persist and that training on how to deal with prejudice and better address cultural issues does not lead to long-term improvements in the health of minorities.
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Health systems should work to strengthen patient-provider relationships – so that patients have a say in their care – and include key community voices, the report recommends.
“Health systems should work with populations to understand their needs and engage them early and often,” Benjamin said.
The measures taken to overcome racial and ethnic disparities have not been implemented across the board, the report says, and there are few checks and balances to ensure they are enforced. The report points to the 10 states that have so far refused to expand Medicaid under the Affordable Care Act, as well as legal challenges that have prevented the widespread implementation of several provisions.
The report’s authors called on Congress, the U.S. Department of Health and Human Services, the National Institutes of Health and the Centers for Medicare & Medicaid Services to better coordinate their health equity plans – which the report says are siloed – and to establish a federal oversight agency to implement those plans.
Other proposed measures include collecting better data on health care at the federal level and providing more money for research and programs proven to reduce racial and ethnic inequalities.
The quality of health care in the United States is not what it should be compared to other high-income countries, largely “because we have not addressed health disparities,” said Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity and one of the report’s reviewers. She said that has become even more evident during the COVID-19 pandemic.
“We’re only going to make progress if we really pay close attention to this issue,” she said. “We’re failing everyone in our health care system. It’s just that some populations are suffering even more.”
Even if it takes years, the recommendations must be implemented, Benjamin said. Otherwise, people will continue to “die unnecessarily and unjustly.”
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