There are clear, race-based inequalities in health insurance and health outcomes (2024)

Commentary

Christen Linke Young

There are clear, race-based inequalities in health insurance and health outcomes (1)

Christen Linke Young Deputy Assistant to the President for Health and Veterans Affairs - Domestic Policy Council for Health and Veterans, Former Fellow - USC-Brookings Schaeffer Initiative for Health Policy

February 19, 2020

  • 2 min read

Editor's note:

This is part of a video series in which Brookings experts highlight race-based disparities or discrimination in public policy. VisitRace in American Public Policyfor more videos in this series and related research from Brookings experts.

In the United States, there are significant racial disparities in access to health coverage and in health outcomes. People of color are far more likely to be uninsured in America, due in part to several states’ refusal to expand Medicaid. The infant and maternal mortality rates for Black babies and mothers are also far higher than those of white babies and mothers – and nobody really knows why.

Policymakers, scientists, and physicians should all be paying more attention to these issues, and together we should ask ourselves what more we can do to address them.

Try to imagine what would happen if white mothers and white babies were dying at the rate of Black mothers and Black babies.

WHAT YOU SHOULD KNOW

  • Prior to implementation of the Affordable Care Act (ACA), nearly one in three Hispanic Americans and one in five Black Americans were uninsured, compared to about one in eight white Americans.
  • Since the ACA’s core coverage provision came into effect in 2014, uninsured rates fell across all racial and ethnic groups, with the biggest gains among Black and Hispanic people.
  • Still, 30 million people remain uninsured. About half of those 30 million are people of color.
  • Fourteen states have refused to expand Medicaid under the ACA, which is one of the reasons why people of color are disproportionately likely to be uninsured today. This includes some of the states with the largest populations of Black Americans.
  • More than 90 percent of the people who don’t have insurance because their state did not expand Medicaid live in the South.
  • Expanding Medicaid in these states and taking other steps to move toward universal coverage will reduce racial disparities in access to health insurance.
  • In the U.S., based on data from 2016, white babies die before their first birthday at a rate of 4.9 per 1,000, and white women die from pregnancy and childbirth-related causes at a rate of 13 per 100,000. While those numbers are far higher than other wealthy countries, the picture is far worse for Black babies and mothers.
  • Black babies die before their first birthday at a rate of 11.4 per 1,000, and Black moms die from childbirth-related causes at a rate at a rate of 42.8 per 100,000 – more than double and triple the rates of white babies and moms, respectively.

READ MORE

Next steps in health reform: Hospitals, Medicaid expansion, and racial equity

Time for justice: Tackling race inequalities in health and housing

Author

There are clear, race-based inequalities in health insurance and health outcomes (3)

Christen Linke Young Deputy Assistant to the President for Health and Veterans Affairs - Domestic Policy Council for Health and Veterans, Former Fellow - USC-Brookings Schaeffer Initiative for Health Policy @clinkeyoung

There are clear, race-based inequalities in health insurance and health outcomes (2024)

FAQs

What is health inequality and health outcomes? ›

Health disparities include differences in health outcomes, such as life expectancy, mortality, health status, and prevalence of health conditions. Health care disparities include differences between groups in measures such as health insurance coverage, affordability, access to and use of care, and quality of care.

Why are there racial disparities in healthcare? ›

Racial and ethnic health disparities are perpetuated by less insurance coverage and unequal access to high-quality care. Large disparities in health care access between white people and members of most other racial and ethnic groups are apparent across states.

How does race affect health insurance? ›

Blacks, Hispanics, and some Asian populations, when compared with whites, appear to have lower levels of health insurance coverage, with Hispanics facing greater barriers to health insurance than any other group (Institute of Medicine, 2002).

What are the factors that may lead to inequalities in health outcomes? ›

They include income, education, access to green space and healthy food, the work people do and the homes they live in. It is widely recognised that, taken together, these factors are the principal drivers of how healthy people are, and that inequalities in these factors are a fundamental cause of health inequalities.

How to solve inequalities in healthcare? ›

Raising awareness through education can help address health equity. Improving resource coordination can also help populations most harmed by health disparities. For example, health care organizations can help reduce ethnic health disparities by offering cultural competency training to health care providers.

How do you identify health inequalities? ›

Health inequalities can be seen and measured through differences in:
  1. prevalence of conditions and mortality.
  2. behavioural risks to health such as smoking.
  3. the wider determinants of health such as housing and employment.
  4. access to care.
  5. the quality and experience of healthcare services.

How do race and ethnicity affect health? ›

Racial and ethnic health disparities result in higher rates of illness and death across a wide range of health conditions. Research shows that these disparities are costly, resulting in excess medical care costs and lost productivity, as well as additional economic losses due to premature deaths.

Are there racial disparities in access to health insurance? ›

That is, after accounting for differences in population distribution, African Americans are 8 percent more likely to live without health insurance than whites. Seventy-eight percent of the Hispanic-white disparity in insurance coverage is explained by their greater rates of coverage loss.

Why is racial diversity important in healthcare? ›

Promoting diversity in health care is critical because it offers several patient benefits. These advantages include a reduction in care disparities, improved and optimized care delivery, and improved access to care.

What race is most likely to have health insurance? ›

Private health coverage rates ranged from 43.1% among American Indian and Alaska Native, non-Hispanic people to about 74.2% for White, non-Hispanic people. Lower rates of private coverage for some groups were partly offset by higher rates of public coverage for these groups.

How does the lack of health insurance contribute to health disparities? ›

Lack of health insurance coverage may negatively affect health. Uninsured adults are less likely to receive preventive services for chronic conditions such as diabetes, cancer, and cardiovascular disease.

What does race insurance cover? ›

Required Coverages

Protects your participants, coaches, and volunteers from many types of third-party claims, including injury, property damage, and legal defense. Applicant can request additional running race insurance coverage for sexual abuse/molestation.

How to reduce racial disparities in health care? ›

Increase awareness of racial and ethnic disparities in health care among the general public. Strengthen patient-provider relationships in publicly funded health plans. Apply the same managed care protections to publicly funded HMO participants that apply to private HMO participants.

What is the health outcome inequality? ›

Health inequities are systematic differences in health outcomes. Health inequities are differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work and age.

How do health disparities impact health outcomes? ›

A few examples are illustrative: infant mortality for black babies remains nearly 2.5 times higher than for white babies; the life expectancy for black men and women remains at nearly 1 decade fewer years of life compared with their white counterparts; diabetes rates are more than 30% higher among Native Americans and ...

What is the meaning of health inequality? ›

Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society. These include how long people are likely to live, the health conditions they may experience and the care that is available to them.

What is the definition of health outcomes? ›

Definition. Health outcomes refer to the health consequences brought about by the treatment of a health condition or as a result of an interaction with the healthcare system.

Which definition best describes health inequalities? ›

Which definition best describes health inequality? Variation in health status across individuals within a population or a difference in the average or total health status between two or more populations.

What are health outcomes in epidemiology? ›

A health outcome may be a disease, condition, death, event or a change in health status or behavior. For example, in addition to diseases, we may study health events such as injuries or the occurrence of an “event” such as preterm birth. Persons who experience the outcome of interest are commonly referred to as cases.

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