Little progress seen in closing racial, ethnic gaps in health care: Report

Racial health care disparities persist in every state in the nation despite two decades of attempts to improve health outcomes for minorities, according to a new report released Wednesday.

The report from the National Academies of Sciences, Engineering, and Medicine found that structural racism and people’s environment have contributed to worse health outcomes for minorities.

Wednesday’s 300-page report comes 21 years after the first from the organization.

“When the Institute of Medicine (now named National Academy of Medicine) released its landmark Unequal Treatment report in 2002, we shed light on the fact that your race could determine the quality of the care you receive,” Victor J. Dzau, president of the National Academy of Medicine, said in a statement. 

“Twenty years later, it is clear that our nation has not made enough progress. There are still major inequities inherent in the health care system,” Dzau continued. “It is imperative that we achieve equitable health for all by committing to pursuing and implementing the goals and actions laid out in this new report.”

The report found that racial and ethnic minorities are significantly less likely to have primary care. During emergency room visits, minorities experience longer wait times and are assigned less acute triage severity scores. Long-term care facilities serving minority residents offer fewer clinical services and have lower staffing levels. 

In an analysis of diabetes, that report unearthed that nonwhite patients are less likely to receive newer, higher cost drugs and diabetic technology. Black patients with diabetes experience hospitalization rates more than 2.5 times higher than those for white patients.

The report offers actions the federal government can do to combat the gaps in health care. 

One action is to report data on the inequities. The report calls on the Office of Management and Budget to aggressively enforce requirements for routine collection of race, ethnicity, tribal affiliation and language data by all federal health care agencies and research programs.

The report also urges the National Institutes of Health and other research funders to expand funding for research aimed at addressing health care inequities, structural racism and health-related social needs. 

The report calls on Congress and the United States Department of Health and Human Services to enable the Office for Civil Rights the ability to enforce the Affordable Care Act’s prohibition on discrimination in health programs.

And, the report concludes, Congress should establish a pathway to affordable, comprehensive health insurance for everyone.

“Eliminating health care inequities is an achievable and feasible goal, and improving the health of individuals in the nation’s most disadvantaged communities improves the quality of care for everyone,” said Georges C. Benjamin, co-chair of the committee that wrote the report and executive director of the American Public Health Association. “This is not a zero-sum game — we are all in this together.”