By MaLaysia Mitchell | Publisher

*This article was prepared or accomplished by Intersected Project. The opinions expressed are the author’s own and do not reflect the views and/or work of the author’s employer and/or sponsors.

After slicing my toe on an exposed tile in a doorway in 2018, I landed a hospital bill that was roughly $1,500 for a procedure that lasted about 15 minutes and did not require local anesthesia. I had to make challenging financial decisions in order to make the payment. It was my own firsthand experience and realization that many Americans are one medical bill away from a financial catastrophe. This is even more of a reality for people of color.

The United States has one of the most complex healthcare systems in the world, leaving 32.8 million without health insurance and 19% of households in medical related debt — 27.9% of Black households compared to 17.2% of white households. 

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Many are simply unaware of how to optimize their healthcare plans. There are confusing premiums, high deductibles, and in or out-of-network providers that limit care options. 

In light of the complexity, It is not surprising that national healthcare expenditures have climbed each year. According to the Centers of Medicaid and Medicare Services, the U.S. spent nearly $3.8 trillion on healthcare in 2019, with 31% of this cost attributed to hospital care. These figures were anticipated to rise once calculated for 2020 in light of the COVID-19 pandemic. 

However, in addition to our deeply fragmented and complex healthcare system, healthcare disparities specifically come with fiscal and human consequences that potentially cost billions each year.

A working definition of health disparities

Health disparities are gaps in health and healthcare outcomes derived from structural and systemic factors including but not limited to social, economic, geographical and/or environmental disadvantages. Those with histories of being marginalized are often dispositioned to experience the adverse impacts of health disparities. Marginalization may be based on social markers such as race, gender, sexual orientation, religion, disability, and nationality or citizenship status.

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The Impact of Health Disparities on Racial Minorities

COVID-19 has manifested differently amongst communities of color, with Blacks having higher hospitalization and death rates. However, the gaps in key health measures have been a long-standing feature of our healthcare ecosystem. Compared to their white counterparts, Blacks and Native Americans have fared worse when it comes to obesity, heart disease, diabetes, cancer, and overall life expectancy

It is easy to consider these outcomes at the individual level and place full responsibility on one’s health behaviors. However, many minoritized communities have social and economic barriers affecting access to quality preventative healthcare services.

Insurance coverage is one of the leading measures in healthcare accessibility. Yet in 2019, 21.7% of Native Americans, 20.0% of Latinos and 11.4% of Blacks were without health insurance. Furthermore, many deferred healthcare treatment due to the high cost, which can have deleterious impacts on health. 

Even after gaining access to care, it is not guaranteed that Americans will receive high quality, culturally competent services. Almost half of healthcare quality measures indicate that Blacks and Native Americans are receiving worse care than whites, due in part to lingering implicit racial biases

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The Cost of Healthcare for Marginalized Communities

In addition to the moral incentives to mitigate health disparities, improvement in healthcare access can also have a positive impact on our nation’s economy. 

The existing gaps are not only detrimental to health — and in some cases fatal — but they also come with a hefty price tag. According to the Harvard Business Review, over $245 billion is lost each year due to racial health disparities: $200 billion in premature deaths, $10 billion in productivity loss, and $35 billion in excess healthcare spending. 

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What You Can Do 

Increase Awareness

It is increasingly important to research and become well-informed on current social trends. Healthcare data and monitoring can support your own decision-making when it comes time for federal and local elections. Check out this tracker to keep abreast with health equity. 

Shop Around

Although the price of healthcare may be climbing, we as consumers can put pressure on health facilities with our buying power. As of January 11, 2021, the Department of Human and Health Services established final rules for transparency in healthcare cost. This means that beneficiaries will soon be able to know the cost of their services beforehand, in lieu of the shock of seeing the costs after receiving care. 

Advocate for Increased Access (and Quality of Care)

If you are in a state that does not have policies in place for Medicaid expansion, consider lobbying your local politicians. States with Medicaid expansion have shown improvements in health insurance coverage, which in turn has increased access to essential healthcare like mental health services.

One thought on “The economic and human costs of health disparities

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