How states perform in achieving racial, ethnic equity

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While some states perform better than others when it comes to addressing certain racial and ethnic health inequities, disparities exist in all 50 states, even those with stronger health systems, according to a report released Nov. 18 by the Commonwealth Fund.

The report, which serves as a scorecard on racial and ethnic state health system equity, shows all states need to improve equity in their healthcare system. It also provides policy options for states to combat unequal access to care and unequal treatment of people of color in healthcare facilities.

The Commonwealth Fund, a private foundation, examined states and the District of Columbia on healthcare access, quality and use of healthcare services for five racial and ethnic groups:

  • Black
  • White
  • American Indian/Alaska Native
  • Asian American, Native Hawaiian, and Pacific Islander
  • Latinx/Hispanic

After evaluating 24 measures of health system performance for each group, researchers calculated composite summary scores for each state/population group with sufficient data (e.g., Latinx/Hispanic individuals in Texas). Each group within each state also received a percentile score on performance for that population.

The scorecard is retrospective and considers data from 2019 and 2020.

Six findings:

1. Health systems in all states performed noticeably worse for many people of color, particularly Black, Latinx, and AI/AN populations, when compared to white people.

2. Only six states — Massachusetts, Connecticut, Rhode Island, New York, Hawaii and Oregon — had above average performance for all racial and ethnic groups (for which data were available).

3. Some Midwest states such as Minnesota and Wisconsin report some of the largest health disparities between white and nonwhite communities. 

4. Other states such as Mississippi and Oklahoma report substandard performance for all racial and ethnic groups, but still report sizable inequities.

5. While white residents in Maryland, Massachusetts and Connecticut receive some of the best care in the U.S., quality of care in these states is far worse for many populations of color.

6. Black Americans in nearly all states are more likely than white residents to die from preventable and treatable conditions made worse by lack of timely, high-quality healthcare.

To access the full report, click here.

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