(HealthDay News) — Deep-seated racial and ethnic disparities persist in health care across the United States, even in states considered the most progressive, a new report shows.
For example, California received a score of 45 for the care its health system provides Hispanic Americans. The Commonwealth Fund report gives each state a 0-to-100 score for each population group living there.
That’s better than Florida’s health system, which received a 37 for care provided Hispanic Americans there.
But it’s far worse than California’s treatment of white patients, which received a score of 87.
The report “offers a comprehensive analysis of the way health care systems are functioning for people in every state, evaluating disparities in health and health care across racial and ethnic groups, both within and between states,” the report authors said.
Researchers used 25 measures to evaluate states on health care access, quality, service use and health outcomes for different racial and ethnic populations.
They found that disparities exist even in states well-known for their high-performing health systems.
For example, Massachusetts, Minnesota and Connecticut stand out for their relatively high performance in treating all patients, but those states still had considerable health disparities between white and non-white residents, researchers found.
Across the country, premature deaths from preventable and treatable causes occur at a higher rate among Black and American Indian people overall, compared to other groups, the report found.
Further, in several southwestern and Mountain states premature death rates for Hispanics are higher than elsewhere in the United States, where Hispanic rates align more closely to those of white residents. These states include New Mexico, Arizona, Colorado, Oklahoma, Texas and Wyoming.
However, preventable deaths are higher for both Black and white residents in several southern and south-central states, including Arkansas, Mississippi, Louisiana, Tennessee, Kentucky and Missouri.
The report’s authors suggest pursuing four broad policy goals to create an equitable health system:
- Make sure affordable, comprehensive and equitable health insurance is available for everyone
- Improve primary care
- Reduce paperwork for patients and providers
- Invest in social services
“Since disparities and health inequities vary across states, there are also opportunities for state programs to tailor interventions that address communities’ unique needs,” the researchers added.
Advancing Racial Equity in U.S. Health Care: The Commonwealth Fund 2024 State Health Disparities Report is available online.
What are preventable deaths?
In the health care system, preventable deaths are those that could have been avoided through better care. This includes a variety of situations, from catching illnesses early to preventing complications during hospitalization. Estimates suggest a significant number of deaths fall under this category, highlighting the importance of ongoing efforts to improve healthcare quality.
There are two main ways preventable deaths are categorized:
- Preventable deaths: These deaths could have been avoided entirely through primary prevention measures like vaccinations, healthy lifestyle promotion, and early detection of chronic diseases.
- Treatable deaths: These deaths could have been prevented with timely and effective medical intervention during an illness or hospitalization.
Estimates on the number of preventable deaths in American hospitals vary. The Institute of Medicine’s seminal report, “To Err Is Human,” gained national attention by estimating a range of 44,000 to 98,000 deaths annually due to preventable medical errors. More recent studies suggest a lower figure, with a pooled rate of preventable mortality in hospitalized patients around 3.1 percent (approximately 22,000 deaths annually).
Several factors contribute to preventable deaths in American healthcare:
- Disparities in access: Lack of health insurance or limited access to quality care disproportionately affects certain demographics, leading to delayed diagnoses and poorer health outcomes.
- Fragmented care: The complex American healthcare system, with multiple providers and insurance companies, can sometimes lead to communication breakdowns and gaps in care coordination.
- Hospital errors: Medication errors, missed diagnoses, and inadequate monitoring are significant contributors to preventable deaths in hospitals.
More information
The U.S. Centers for Disease Control and Prevention has more about racism and health.