Study Highlights Racial Inequity in Health Care Access, Quality

A recent study found that states with higher levels of systemic racism also show pronounced racial differences in access to health care. In short, the more racist a state, the better white people had access – and the worse black people had.

“This study shows how inequalities in health care are intertwined with other social inequalities such as employment and education,” said Vanessa Volpe, correspondent author of the study and assistant professor of psychology at North Carolina State University. “This helps explain why health inequalities are so persistent. To tackle health inequalities, we need to turn to broader social systems that white people benefit greatly from – and that makes them difficult to change. “

Previous research has examined how people’s individual experiences with racism affect the quality of their health care. There is also research that examines the relationship between structural racism and health outcomes. The current study by Volpe and her coworkers examines structural racism at the state level, people’s individual experiences of racism, the extent to which these things have affected black people’s ability to access health care, and the quality of that health care. The researchers also looked at the opportunities for white people to access health care and the quality of their health care.

For their study, the researchers used the Association of American Medical Colleges’ Consumer Survey of Health Care Access for the years 2014 to 2019. The survey of adults in need of care in the previous year also included measurements of self-reported access to health care, quality and racial discrimination of providers. The survey included 2,110 black adults and 18,920 white adults. Researchers also used publicly available state-level data from the Census Bureau and the U.S. Department of Justice to create a state-level racial index that serves as a guide to structural racism. The researchers used the index to determine racism scores for all 50 states and the District of Columbia.

The researchers found that the higher the level of racism in a given state, the less access to health care was available to black people in that state. There was no statistically significant association between a state’s racism index and the quality of health care. However, black people who said they experienced racism among their health care providers also reported lower quality of care.

The higher the level of racism in a given state, the more access white people had to health care. The worse the state’s racism score, the higher the quality of care white people have received.

“These injustices at the state level are symptoms of racism that are enshrined in laws, guidelines and practices that ensure that there is no level playing field,” says Volpe. “It underscores the need to address inequalities in a meaningful, structural way and not just assume that racism is just an interpersonal phenomenon. And it’s important to use data-driven approaches like the one used here so that laws or regulations can be developed by politicians to make the playing field more effective. “

The article “State- and Provider-Level Racism and HealthCare in the US” was published in the American Journal of Preventive Medicine. The paper was co-authored by Sam Cacace, Perusi Benson, and Noely Banos of NC State; and by Kristen Schorpp of Roanoke College.

– boatman –

Note to the editors: The study summary follows.

“Racism and Healthcare at the State and Provider Levels in the US”

Authors: Vanessa V. Volpe, Sam C. Cacace, G. Perusi Benson, and Noely C. Banos, North Carolina State University; and Kristen M. Schorpp, Roanoke College

Published: June 24, American Journal of Preventive Medicine

DOI: 10.1016 / j.amepre.2021.03.008

Abstract:
Introduction: This study examines associations between government and provider sources of racism and access to and quality of health care for non-Hispanic blacks and whites.
METHODS: Data from 2 sources were integrated: (1) the Consumer Survey of Health Care Access (2014-2019) by the Association of American Medical Colleges, which included measurements of self-reported access to health care, quality and racial discrimination by providers, and (2) administrative data compiled to index racism at the state level. The state-level composite racism scores were calculated from federal sources (US Census, Department of Labor, Department of Justice). The data set comprised 21,030 adults (n = 2,110 blacks, n = 18,920 whites) who were in need of care in the last year. Participants were recruited from a national panel and the survey used retirement insurance rates. In 2020, logistic and linear regressions were performed that were adjusted for demographic, geographic, and health-related covariates.
Results: In white people, more racism at the state level was associated with a 5% higher chance of receiving care and a 6% higher chance of spending adequate time with the provider. Among blacks, more racism at the state level was associated with an 8% lower likelihood of becoming dependent. Providers’ racial discrimination was also associated with an 80% lower likelihood of the provider explaining the care, 77% less chance of the provider answering questions, and a 68% lower likelihood of the provider having adequate time.
Conclusions: State-level racism may mean better access to health care and quality for whites and lower access for blacks. Disparities can be caused by both the advantage of white and the disadvantage of black. State-level policies can be actionable levers for addressing health inequalities with implications for preventive medicine.

source https://dailyhealthynews.ca/study-highlights-racial-inequity-in-health-care-access-quality/