Racial and ethnic inequities persist in all 50 states.
The United States health system continues to fail people of color as disparities in health care are exacerbated by the COVID-19 pandemic.
According to a news release, The Commonwealth Fund’s new health equity scorecard, Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance,1 found that Black Americans in nearly every state are more likely than their White peers to die from preventable and treatable conditions exacerbated by the lack of timely, high quality health care. Even among high-performing states, the racial and ethnic disparities can be severe.
Specifically, the health care system in Minnesota, which regularly performs well in Commonwealth Fund state scorecard rankings, sees some of the largest health disparities between white and nonwhite patient communities. Other traditionally high-scoring states like Maryland, Massachusetts, and Connecticut—which provide some of the best care in the country to White patients—provide far worse care to many populations of color, the release said.
Even in states with historically poor care for White and Black patients alike—such as Mississippi and Oklahoma—White patients still received much better care than their Black peers.
The scorecard also ranked each state on how well the health system is working for each racial and ethnic group. It found that California’s health care system works better for Latinx/Hispanic people than the system in Texas, but both systems benefit White people more. South Dakota, North Dakota, Montana, and Wyoming all have the worst-performing health systems for the American Indian population, while California’s healthcare system is ranked at the top.
Among the factors leading to these persisting inequities the scorecard finds structural racism and continuing disinvestment in communities of color to be the chief. Many racial and ethnic minorities face an unequal health system and are less likely to have health insurance and more likely to have cost-related barriers to care. The COVID-19 pandemic has only exacerbated these issue.
These inequities are maintained and reinforced through past and current policies at the federal, state, and local levels. The scorecard’s authors recommend these actions to create a more equitable healthcare:
The authors also noted that due to health inequities varying across states, there are opportunity for state-level programs tailored to address the specific needs of minority communities within the state.