Of the 30 million uninsured Americans, about half are people of color, according to Brookings. This is an example of a health disparity.
Health disparities are preventable circumstances relating to individuals’ health status based on social factors such as income, ethnicity, education, age and gender. These factors can result in circumstances such as a lack of access to proper health care resources (including insurance) or decreased life expectancy rates. However, there are a number of ways health administrators and medical professionals can work toward lowering the impact of health disparities.
Examples of Health Disparities
Health care administrators can help advance health equity by looking at the data. It can help them understand health disparities and who it affects the most. Health disparities include the following:
- Mortality
- Life expectancy
- Burden of disease
- Mental health
- Uninsured/underinsured
- Lack of access to care
Mortality
The gap in mortality rates between older white and Black adults remains, according to a study published in JAMA Network. The gap has narrowed for individuals in urban areas in the last 60 years. However, the gap has widened between Black and white men living in rural areas during the same period. The National Cancer Institute highlights disparities in mortality based on educational background: Less-educated individuals from any race are more likely to die from colorectal cancer before 65.
Life Expectancy
The 20th century began with a life expectancy difference of 14 years between Black and white Americans. The gap decreased to four years recently thanks to improved access to health care and economic status.
The COVID-19 pandemic has put a stop to the progress. The average life expectancy is down by a year for everyone. However, for Black and Latino populations, the reduction is four times higher than the average, according to research published in the Proceedings of the National Academy of Sciences.
Burden of Disease
Causes of disparities in diseases, such as asthma and diabetes, include systemic inequities based on race or ethnicity. For example, Black and Hispanic populations are more likely to have asthma than other U.S. residents. Puerto Ricans, in particular, “have the highest rate of asthma prevalence compared to any other racial or ethnic group in the U.S.,” according to a report from the Asthma and Allergy Foundation of America.
Genetics may play a role in the differences between these populations, but the evidence points to asthma disparities being “significantly rooted in numerous multidimensional social and structural determinants,” according to the report.
In another example of health disparities, American Indians/Alaska Natives have the highest rates of diagnosed diabetes, according to the Centers for Disease Control and Prevention (CDC). Location plays a factor too: Rural Appalachian regions see higher rates of colorectal, lung and cervical cancers than other parts of the U.S., according to the National Cancer Institute.
Mental Health
About 1 in 5 U.S. adults — 51.5 million people — lived with a mental illness in 2019, according to the National Institute of Mental Health (NIMH). However, some groups are affected more than others; for example, about 70% of young people in the juvenile justice system have been diagnosed with a mental illness, according to the National Center for Youth Opportunity and Justice.
The causes of the disparities in this juvenile justice group include exposure to childhood trauma and unaddressed behavioral health issues. Mental health disparities also exist between genders: 24.5% of women have been diagnosed with mental illness versus 16.3% of men, according to NIMH.
Uninsured/Underinsured
Before the Affordable Care Act (ACA), about 1 in 3 Hispanic Americans were uninsured, according to Brookings. The rate of uninsured people was even higher among Black Americans: 1 in 5. The geographic location of those most impacted by the health insurance disparity is another factor. According to the Kaiser Family Foundation, states with the largest populations of Black Americans, especially in the South, see disproportionately higher rates of uninsured people. This is largely due to the lack of expanded Medicaid coverage under the ACA in those states.
Lack of Access to Care
Individuals from certain racial and ethnic groups, people who come from low-income backgrounds, and individuals who live in rural areas often face barriers to accessing health care in the U.S. For example, the low-income, rural Appalachian region has fewer mental health providers and fewer specialty physicians than the rest of the nation — 35% and 28% fewer, respectively — according to the Appalachian Regional Commission (ARC). Telehealth may improve health care access, but internet subscription rates in the region are lower than in the rest of the country.
Potential Solutions for Health Disparities
Health care leaders and medical professionals can advance health equity by working to improve access to care and reduce uninsured rates. Additionally, care facilities can implement community outreach efforts and chronic disease management programs to advance health knowledge in affected populations. Below are other possible solutions.
Raising Awareness Among Health Care Providers
Raising awareness through education can help address health equity. Improving resource coordination can also help populations most harmed by health disparities. For example, health care organizations can help reduce ethnic health disparities by offering cultural competency training to health care providers.
Increasing Health Literacy in Affected Communities
Health care organizations can play a pivotal role in increasing the health literacy of affected groups by expanding educational programming. For optimal impact, health care organizations should identify the highest-risk groups and accordingly target educational and support programs.
Advancing Health Equity
Social, racial and economic inequities cause many examples of health disparities. Health care providers can engage with policymakers, urging action to help communities impacted by these factors. For example, they can use health disparity data and evidence-based clinical knowledge to recommend expanding health coverage to individuals with limited health care access.
Providing More Resources
Racial and ethnic groups are less likely to have proper access to health resources and are typically underrepresented in the health care workforce. Similarly, rural and low-income communities typically have fewer health care professionals per capita than urban and high-income areas.
These communities share a common problem: little to no choice regarding where to seek care. Strengthening and sustaining health care resources can help providers better serve people in these at-risk areas.
Partnering with Organizations
Health care facilities can collaborate with agencies, organizations, coalitions, boards and councils working on initiatives to address the root causes of health disparities. For example, the American Medical Association (AMA) works to diversify the physician workforce to reflect communities’ racial and ethnic backgrounds. The AMA also funds public health literacy programs.
Tracking Results
Monitoring and documenting a program’s effectiveness and health impact enables health care organizations to determine what’s working and find improvement opportunities to improve health outcomes for all.
Prepare to Address Health Equity Issues
Every day, health administrators face multiple real-world examples of health disparities, recently heightened by the COVID-19 pandemic. Expanding their knowledge and skills can help them find solutions to benefit underserved communities over the long term.
Health care administrators who are ready to address the challenges can enroll in USC’s online executive MHA program to prepare themselves to improve health services and reduce health disparities. An internationally recognized and virtually accessible faculty teaches the online degree program’s combined clinical and management curriculum.
Learn more about USC’s online Executive Master of Health Administration degree program.
Recommended Readings
The Financial Impact of COVID-19 on Health Care Organizations
Homelessness and the COVID-19 Outbreak
The 5 Populations in Need of Better Access to Healthcare
Sources:
American Medical Association, Reducing Disparities in Health Care
Appalachian Region Commission, “Getting Health Care—And Getting to Health Care—In the Appalachian Region”
Asthma and Allergy Foundation of America, 2020 Asthma Disparities in America
Brookings, “There Are Clear, Race-based Inequalities in Health Insurance and Health Outcomes”
National Cancer Institute, Cancer Disparities