Latinos Experience Major Health Inequities in Most U.S. States

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We know Latinos and other racial/ethnic minorities experience health, social, and environmental inequities that increase their risk for disease.

But just how widespread is the problem?

Very few states do not face major issues with health inequities and health disparities, according to the Commonwealth Fund’s new report, “Achieving Racial and Ethnic Equity in US Health Care: A Scorecard of State Performance.”

The authors of the report list many inequities that make an impact, and they also note that the system that promotes these trends is to blame.

“Decades of policy choices made by federal, state, and local leaders have led to structural economic suppression, unequal educational access, and residential segregation, all of which have contributed in their own ways to worse health outcomes for many people of color,” the report states. “The failure to ensure all Americans have reliable health coverage has paved the way to inequitable access to health care.”

The Report and Its Findings on Health Inequities

Health equity is where everyone has a fair, just opportunity to be their healthiest.

But health equity is rare because of widespread systemic racism and discrimination, according to the Commonwealth Fund’s new scorecard.

“The scorecard finds that health equity does not exist in the U.S.,” Dr. David Blumenthal, president of the Commonwealth Fund, told Fierce Healthcare. “In nearly every state, healthcare is better for white people.”

The scorecard tracks how each state’s healthcare system functions by monitoring certain factors from three major “performance domains”:

• Health outcomes
• Health care access
• Quality and use of health care services

Calculating factors in these domains, the Commonwealth Fund was able to score states on a scale of 1 to 100 — the experts say these scores reflect an accurate “composite” of each state’s standings.

Healthcare system performance for Latinos is below average in most states.

Even the states with better performance numbers, such as Massachusetts, Connecticut, Rhode Island, Hawaii, Oregon, and New York, still contained considerable inequities.

The report also shows how different groups are treated differently within each state.

For example, Latinos in California have better healthcare access than those in Texas but both states benefit whites over that demographic.

This, yet again, shows that Latinos across the country face disparities and discrimination throughout the country, according to Blumenthal.

“There’s little doubt that the pandemic has exacerbated these inequities and other weaknesses in our healthcare system. Structural racism to generations of disinvestment in communities of color are chief among the many factors contributing to these progressive issues,” he told WAMC Public Radio. “We need to dismantle the racist policies and practices that have led us here and create a truly equitable health care.”

Inequities worsened amid the COVID-19 pandemic, according to Dr. Laurie Zephyrin, vice president for Advancing Health Equity at the Commonwealth Fund.

“I think for many of the pandemic has highlighted the impact of structural racism, and how, you know, not having, you know, access to communities that are, for example, have adequate housing, or having access to health insurance, or having the ability to work from home, or other inequities in the social determinants, are drivers of health, really impact health and health and health care,” Zephyrin told WAMC Public Radio.

“We’ve also seen with the with the pandemic, also just strained healthcare infrastructure, you know, significant income impacts, and really worsening of social determinants of health in terms of the economic inequalities, in addition to some of the care delivery challenges as well.”

The way to address systemic health inequities is for leaders to recognize the issue and its severity.

“Knowledge is power and data like this tells us a very specific story,” Zephyrin told Fierce Healthcare.

How Can We Advocate for Health Equity & Address Health Inequities? 

The Commonwealth Fund authors suggest pursuing four broad policy goals to create an equitable, antiracist health system:

1. Ensuring affordable, comprehensive, and equitable health insurance coverage for all
2. Strengthening primary care
3. Lowering administrative burden for patients
4. Investing in social services

The fight against health disparities is critical when it comes to improving life for people of color.

“Racial and ethnic disparities in health outcomes and health care are pervasive both across and within states. Transformative change will depend on policy and practice changes to make access to care more equitable and to ensure equal treatment in the delivery of care,” the report authors wrote.

At Salud America!, we believe that improving healthcare by making it more accessible and culturally tailored for people of color will help build health equity.

That is why we are helping people address implicit bias.

Doctors have subconscious preferences for white patients over those of color, studies show. This is implicit bias. These biases — stereotypes that affect our understanding and decisions about others beyond our conscious control — lead to discrimination and health disparities.

Fortunately, implicit bias can be “rewired” for compassion for patients of color.

Download the free Salud America! Action Pack “Health Care Workers and Researchers: Find If You Have Implicit Bias and What to Do Next.”

“This Action Pack will help you see if you have implicit bias, learn from others who have overcome their own implicit bias, and encourage colleagues to learn about implicit bias, too,” said Dr. Amelie G. Ramirez, director of Salud America! at UT Health San Antonio.

GET THE ACTION PACK!