Socioeconomic Status And Health Disparities – The COVID-19 pandemic and racial justice movements across the country over the past few years have increased the focus on health disparities and their root causes and contributed to the priority of increasing health equity. These disparities are not new and reflect long-standing structural and systemic inequalities rooted in racism and discrimination. Although increasing efforts have recently focused on addressing disparities, the end of some policies implemented during the COVID-19 pandemic, including continuous enrollment for Medicaid and the Children’s Health Insurance (CHIP) program, may reverse progress and widen disparities. Addressing health disparities is important not only from an equity perspective, but also for improving the overall health and economic prosperity of the country. This brief provides an introduction to what health and health disparities are, why addressing disparities is important, the current state of disparities, recent federal actions to address disparities, and important issues related to addressing disparities that await.
Health and healthcare disparities refer to differences in health and healthcare between groups that arise from broader inequalities. Health inequalities have many definitions. Healthy People 2030 defines a health disparity as, “a particular type of health disparity related to social, economic, and/or environmental disadvantage” and which systematically affects groups of people who experience greater health barriers. The Centers for Disease Control and Prevention (CDC) defines health disparities as “preventable differences in the burden, disease, injury, violence, or opportunity to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population and community groups. Health care disparities generally refer to health insurance Refers to differences between groups in coverage, affordability, access to and use of care, and quality of care. The terms “health disparities” and “disparities” are sometimes used to describe unjustified differences. Racism is defined by the CDC as structures, policies, practices, and rules. which values and assigns opportunities to people based on their appearance or the color of their skin, resulting in situations that unfairly advantage some and disadvantage others, placing people of color at greater risk of adverse health outcomes.
Socioeconomic Status And Health Disparities
Health equity generally refers to individuals achieving their highest level of health by eliminating health and health care disparities. Healthy People 2030 defines health equity as the achievement of the highest level of health for all people and states that it must value all equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and health and health inequalities. The CDC defines health equity as when everyone has the opportunity to be as healthy as possible.
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A wide range of factors within and beyond the health care system contribute to disparities in health care and health (Figure 1). Although health care is essential to health, research shows that health outcomes are driven by many factors, including underlying genetics, health behaviors, social and environmental factors, and access to health care. Although there is currently no research consensus on the relative contribution of each of these factors to health, research suggests that health behaviors and social and economic factors, often referred to as the social determinants of health, are major determinants of health. Outcomes and the social and economic factors that shape individuals’ health behaviors. Additionally, racism negatively affects mental and physical health directly and creates inequities in the social determinants of health.
Disparities in health and health care are often viewed through the lens of race and ethnicity, but they occur in a wide range of ways. For example, differences occur across socioeconomic status, age, geography, language, gender, disability status, citizenship status, and sexual identity and orientation. Research also suggests that differences occur across the life course, from birth, through midlife, and into older adulthood. Federal efforts to reduce disparities are focused on designated priority populations, including, “members of disadvantaged communities: Black, Latino, and Native American people, Asian Americans and Pacific Islanders, and people of other colors; members of religious minorities; gay, lesbian, bisexual, transgender and queer (LGBT+) people; People with disabilities; People living in rural areas; and people adversely affected by persistent poverty or discrimination. These groups are not mutually exclusive and often intersect in meaningful ways. Differences can also be seen between population subgroups. For example, there are differences in health care and health among Hispanic people based on length of country, primary language, and immigration status. Data often mask underlying differences between subgroups within Asian populations.
Addressing health and health care disparities is important not only from an equity perspective, but also for improving the overall health and economic prosperity of the country. People of color and other underserved groups experience higher rates of morbidity and mortality across a wide range of health conditions, limiting the nation’s overall health. The study also found that health disparities are costly, resulting in excess medical care costs and lost productivity, as well as increased economic losses due to premature deaths each year.
Addressing health disparities is even more important as population diversity and income inequality continue to grow. It is estimated that people of color will make up more than half (52%) of the population by 2050, with the largest increase occurring among people who identify as Asian or Hispanic (Figure 2). Over time, the population has become more racially diverse, reflecting immigration patterns, an increasingly multiracial population, as well as adjustments in how the Federal Census Bureau measures race and ethnicity. Over time, income inequality within the United States has also widened. In 2021, the richest 20% of households accounted for more than half of total household income and had an income of $149,132 or more, compared to the lowest 20% of households that had less than 3% of total household income and an income of $28,007 or less. Households in the top 5 percent of the income distribution have incomes of $286, 305 or more. Research suggests that the differential negative effects of the COVID-19 pandemic on low-wage jobs may have lasting effects that contribute to widening income inequality in the long run.
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Disparities in health and healthcare are persistent and pervasive. Major recognition of health disparities began more than three decades ago with the report of the Secretary’s Task Force on Black and Minority Health (the Heckler Report) in 1985, which documented persistent health disparities that accounted for 60,000 excess deaths per year and synthesized ways forward. Health justice. Heckler Report U.S. The Department of Health and Human Services’ Office of Minority Health and federal recognition and investment in health equity have influenced many areas. In 2003, the Institute of Medicine’s Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care published the report, Unequal Treatment: Addressing Racial and Ethnic Disparities in Health Care, which identified systemic racism as a major cause of health disparities. States. Despite decades of recognition and documentation of disparities and overall improvements in population health over time, many disparities persist and in some cases widen over time.
Despite large gains in coverage since the implementation of the Patient Protection and Affordable Care Act (ACA) in 2014, people of color and other marginalized and underserved groups are more likely to be uninsured. Racial disparities in coverage persisted through 2021, with higher crude rates for non-elderly American Indian or Alaska Native (AIAN), Hispanic, Black, and Native Hawaiian or Pacific Islander (NHOPI) people than their white counterparts (Figure 3). Other groups, including immigrants and people from low-income households, are also at risk of becoming uninsured. Many uninsured individuals are eligible for coverage through Medicaid, CHIP, or the ACA marketplace but face barriers to enrollment, including confusion about eligibility policies, difficulty navigating enrollment processes, and language and literacy issues. Some immigrant families have immigration-related fears about enrolling themselves or their children in Medicaid or CHIP even if they are eligible. Others remain ineligible because their state did not expand Medicaid, because of their immigration status, or because they have access to an affordable marketplace plan or employer coverage offer.
Beyond coverage, people of color and other marginalized and underserved groups continue to experience significant disparities in accessing and receiving care. For example, people in rural areas face barriers to care access due to fewer providers and longer travel times for care, as well as more limited access to health opportunities. There are also disparities in the experiences of health care recipients across groups. For example, the /Undefeated 2020 Survey on Race and Health found that one in five black adults and one in five Hispanic adults reported being treated unfairly when seeking medical care because of their race or ethnicity. Nearly a quarter (24%) of Hispanic adults in the past year and more than one in three (34%) likely undocumented Hispanic adults report that it is very difficult or somewhat difficult to find a doctor who explains things in a way that is easy to understand in 2021.
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