Health care system failing people of color


Racial and ethnic inequities persist in all 50 states.

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, 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 healthcare 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 says.

Even in states with historically poor care for white and Black patients alike such as Mississippi and Oklahoma white patient still received much better care than their Black peers, according to the release.

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 healthcare 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, the release says.

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:

  • Ensuring affordable, comprehensive, and equitable healthcare insurance for all
  • Strengthening primary care
  • Lowering administrative burden for patients
  • Investing in social services

The authors also note that due to health inequities varying across states, there are opportunities for state-level programs tailored to address the specific needs of minority communities within the state.

This article was initially published by our sister publication Medical Economics.

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