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New state-by-state scorecard gives NC failing marks for racial and ethnic disparities in healthcare

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Researchers at the Commonwealth Fund released a new national report this morning (“Achieving Racial and Ethnic Equity in U.S. Health Care”) that looks at how each U.S. state is performing in providing access to healthcare to people of different races and ethnicities.

The disappointing, but unsurprising, conclusion: just about everyone is doing a lousy job. And while North Carolina comes in somewhere around the middle of the pack in most categories, that’s only because a lot of other states are failing even more miserably.

This is from the release that accompanied the report:

A new health equity scorecard released today by the Commonwealth Fund finds deep-seated racial and ethnic health inequities in all 50 states and the District of Columbia — disparities that have been exacerbated by the COVID-19 pandemic.

Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance is a comprehensive examination of how health care systems are functioning for people of color in every state. Part of the Commonwealth Fund’s ongoing series examining individual state health system performance, the report uses 24 measures to evaluate each state on health care access, quality and service use, and health outcomes for Black, white, Latinx/Hispanic, American Indian/Alaska Native (AIAN), and Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations.

The health equity scorecard reveals that even among high-performing states, racial and ethnic health disparities can be dramatic. For example, Minnesota’s health care system, which has historically performed well in Commonwealth Fund state scorecard rankings, has some of the largest health disparities between white and nonwhite communities. Maryland, Massachusetts, and Connecticut are other traditionally high-scoring states where white residents receive some of the best care in the country but where quality of care is far worse for many populations of color. Similarly, in states like Mississippi and Oklahoma whose health care systems have historically performed poorly for both white and Black populations, white patients still received markedly better care.

In addition to showing how people of different races and ethnicities fare within each state, the Fund’s scorecard ranks how well each state’s health system is working for each racial and ethnic group. For instance, the health care system in California works better for Latinx/Hispanic people than the Texas health care system. In both Texas and California, however, the health system benefits white people more. Among states with large American Indian populations, South Dakota, North Dakota, Montana, and Wyoming have the worst-performing health systems for these communities while California’s system ranks at the top — though there are still wide disparities with other populations in the state.

For North Carolina, researchers found that when they looked at overall healthcare system performance based on an assessment of 24 indicators, the state received a 79 for white residents, but only a 61 for Asian American, Native Hawaiian, and Pacific Islander residents, a 33 for Black residents, a 14 for American Indian/Alaska Native residents and a 12 for Latinx/Hispanic residents.

Similar racial disparities were frequently detected in several specific areas, including deaths from conditions that are treatable with timely access to high-quality health care, deaths from complications due to diabetes, deaths for women afflicted with breast cancer and overall healthcare access.

Medicaid expansion — while not a panacea for the problem — clearly makes a difference in narrowing the gap. Of the states rated above North Carolina, all have expanded Medicaid except the much less racially diverse state of Wisconsin.

Click here to explore the report.

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