Big health care disparities persist across the US, new report finds

Deep-seated racial and ethnic disparities persist in health care across the United States, even in states considered the most progressive, a new report shows.

For example, California received a score of 45 for the care its health system provides Hispanic Americans. The Commonwealth Fund report gives each state a 0–to–100 score for each population group living there.

That's better than Florida's health system, which received a 37 for care provided Hispanic Americans there.

But it's far worse than California's treatment of white patients, which received a score of 87.

The report "offers a comprehensive analysis of the way health care systems are functioning for people in every state, evaluating disparities in health and health care across racial and ethnic groups, both within and between states," the report authors said.

Researchers used 25 measures to evaluate states on health care access, quality, service use and health outcomes for different racial and ethnic populations.

They found that disparities exist even in states well-known for their high-performing health systems.

For example, Massachusetts, Minnesota and Connecticut stand out for their relatively high performance in treating all patients, but those states still had considerable health disparities between white and non-white residents, researchers found.

Across the country, premature deaths from preventable and treatable causes occur at a higher rate among Black and American Indian people overall, compared to other groups, the report found.

Further, in several southwestern and Mountain states premature death rates for Hispanics are higher than elsewhere in the United States, where Hispanic rates align more closely to those of white residents. These states include New Mexico, Arizona, Colorado, Oklahoma, Texas and Wyoming.

However, preventable deaths are higher for both Black and white residents in several southern and south-central states, including Arkansas, Mississippi, Louisiana, Tennessee, Kentucky and Missouri.

The report's authors suggest pursuing four broad policy goals to create an equitable health system:

• Make sure affordable, comprehensive and equitable health insurance is available for everyone
• Improve primary care
• Reduce paperwork for patients and providers
• Invest in social services

"Since disparities and health inequities vary across states, there are also opportunities for state programs to tailor interventions that address communities' unique needs," the researchers added.

Advancing Racial Equity in U.S. Health Care: The Commonwealth Fund 2024 State Health Disparities Report is available online.

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