US leads other nations in health inequality: 8 things to know

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There is a wide divide in health outcomes and perceived access to healthcare between the wealthiest and poorest Americans, according to a study published in Health Affairs.

For the study, researchers from Harvard University examined income gaps in self-assessments of personal health and healthcare in 32 middle-and high-income countries. The study covered the period of 2011 through 2013.

Here are eight takeaways from the study.

1. Across the countries studied, the study showed wealthy people generally have better health outcomes than those with low incomes.   

2. The U.S. was among the countries with the largest income-related differences in each of the measures studied, which examined respondents' past experiences and their confidence about having access to needed healthcare in the future.

3. Of the 32 countries studied, only Chile and Portugal had wider health disparities between the rich and the poor than the U.S.

4. In more than half of the countries studied, low-income respondents were less confident than high-income respondents that they would get the best treatment available in their country if they were seriously ill. The U.S. had the third-highest disparity on this measure, behind Bulgaria and Chile.

5. While poor people around the world generally were more likely than their fellow high-income citizens to forgo needed medical treatment because they couldn't afford it, the disparity on this measure was large in seven countries. The U.S. had the second-largest disparity on this measure, behind the Philippines.

6. Among U.S. respondents, 67 percent said "many" people in the country do not have access to the healthcare they need. This is more than 10 percentage points higher than the level in any of the other countries studied.

7. "The wide disparities in health care in the United States are natural consequences of features of its health care system," according to the study. "High out-of-pocket spending combined with fragmented and incomplete insurance coverage that is poorly targeted to meet economic need exacerbate sociodemographic drivers of disparity."

8. The study showed the U.S. spends a smaller proportion of gross domestic product on social safety nets when compared to other high-income countries, and services that can help improve health and access to healthcare are less generous and less comprehensive in the U.S.

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