Report: U.S. Health Systems Riddled With Racial, Ethnic Disparities | Best States

Racial and ethnic health disparities are persistent across the U.S., a new analysis shows, with even states that perform best on measures of health equity experiencing wide gaps between whites and communities of color.

Findings released this week by the Commonwealth Fund, a foundation focused on health care research, ranked the performance of state health systems based on health outcomes, health care access, and health care quality and use among racial and ethnic groups.

While scores varied widely by state, the analysis found states consistently scored lowest when it came to performance for their Black, Hispanic, and American Indian and Alaska Native populations. Even among states that were ranked highly overall, wide gaps were found between white and many nonwhite groups.

Massachusetts was ranked as having the highest-performing health system overall among states, according to the report, followed by Rhode Island and Connecticut. But despite their rankings, those states had significant disparities in access to care, the quality of care people receive and health outcomes.

The report examined and ranked state health systems on a 0 to 100 scoring scale using 25 indicators to assess how systems were serving Black, white, Hispanic, American Indian and Alaska Native (AIAN), and Asian American, Native Hawaiian and Pacific Islander (AANHPI) populations. According to the report, racial and ethnic categories included were “aggregated” to obtain a large enough sample size, but authors note local stakeholders should “interpret the findings within the context of their communities.” If states didn’t meet population thresholds for certain racial and ethnic groups, those groups weren’t included in the state-specific analysis.

The report ranked the following states as having the best-performing health systems by specific racial and ethnic group:

Oklahoma, West Virginia and Mississippi scored poorly across assessed racial and ethnic groups. Mississippi, for example, earned a score of 37 for white people, while scoring only a 6 for Hispanics and a 5 for Black individuals. For whites, only four states scored below the national median score of 50. For Black individuals, 43 states scored below the median.

The report ranked the following states as having the worst-performing health systems by specific racial and ethnic group:

“There’s no doubt the U.S. health care system is not immune from the systemic inequalities that plague all facets of American society,” Dr. Joseph Betancourt, president of the Commonwealth Fund, said during a press briefing held on Wednesday.

“Decades of policy choices at the federal, state, and local levels combined with underinvestment in equity among many local health care systems has had a discriminatory impact and contributed to poorer health outcomes for people of color.”

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