Silhouette of a woman and a child
Despite progress being made through initiatives like The Affordable Care Act, health equity remains a persistent issue across the U.S. Pixabay.com

NEW YORK CITY - Despite progress made in the last couple of years, minority communities continue to face health disparities across the U.S., according to a new report by The Commonwealth Fund.

In a new study titled "Advancing Racial Equity in U.S. Health Care," The Commonwealth Fund found a plethora of alarming trends when looking at healthcare from an ethnicity and racial perspective.

The group collected data for 25 indicators of health system performance, specifically focusing on health outcomes, access to health care and quality and use of health care services for Hispanic, Black, white, American Indian and Alaskan Native (AIAN), and Asian American, Native Hawaiian and Pacific Islander populations (AANHPI).

They then produced a health system score for each of the five groups in every state where they were able to make comparisons.

Overall, the study found that "health equity does not exist in any state in the U.S.," according to David Radley, a senior scientist at the Commonwealth Fund and an author of the report.

The differences in how healthcare opportunities affect each demographic are nuanced.

For instance, Black and AIAN people tend to live fewer years, on average, than white and Hispanic people and are more likely to die from treatable conditions, more likely to die during or after pregnancy and suffer serious pregnancy-related complication.

Nevertheless, the disproportionate impact of COVID-19 on certain communities, particularly Black and Hispanic ones, led to a sharp decline in average life expectancy since 2020 compared to white people.

Hispanic people are also less likely to have insurance than their white counterparts. However, nationally, Hispanic people generally have lower premature mortality rates compared to Black and white people. This stems, according to the study, most likely due to lower rates of risky health behaviors such as smoking.

In several southwestern and mountain states, including New Mexico, Arizona, Colorado, Oklahoma, Texas and Wyoming, premature mortality rates for Hispanic residents are higher than the low rates for that group found elsewhere in the U.S., where they align more closely with rates for white residents.

Conversely, Rhode Island, Massachusetts, Connecticut, Hawai'i, New Hampshire and New York had above-average health system performance for all racial groups, but the data still shows health disparities in those states.

So what accounts for these racial and ethnic health disparities? They can be attributed to many factors, the study argues.

For instance, in many communities where people of color live, poverty rates are higher than average, levels of pollution and crime are elevated and green spaces are few, all of which can contribute to a decline in health. Similarly, a lack of affordable, quality health care options can make it difficult to get timely treatment— a barrier that people of color disproportionately face.

Policy choices at the federal, state and local level have also made these disparities more prevalent. Impacts like economic suppression, unequal educational access, and widespread housing segregation are all factors that tend to contribute to worse health outcomes for people of color, according to The Commonwealth Fund.

When it comes to policy, the researchers acknowledge the progress that certain initiatives, like The Affordable Care Act, have made for closing racial and ethnic health gaps. But they argue there's still a long way to go.

"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 and to take steps to ensure an equitable health care system for the future," the study said.

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