Racial and Ethnic Minorities’ Stake in Health Reform

Our guest blogger is Sonia Sekhar, a Special Assistant for Health Policy at American Progress Action Fund.

As Congress argues about health care reform, within sight of the Capitol, African American babies are dying at three times the rate of white babies born in the U.S. Nationwide, African-American women are 35% more likely to die of heart disease than white women, and 28 percent of Latinos report having little or no choice in where to seek care. Only 15 percent of whites report this difficulty.

People of color represent a third of the U.S. population, but more than half of the uninsured, leaving them particularly exposed to the vulnerabilities of our broken health care system. A report released today by the Center for American Progress by Dr. Lesley Russell highlights the health experience of racial and ethnic minorities in America and how pending health reform legislation take steps to address some of these issues.

The report explores the health care access, coverage, and quality that minorities tend to experience at lower levels than the white population, and how these factors are reflected in lower health outcomes.

The report highlights that:

– Racial and ethnic minorities tend to receive lower quality health care than non-minorities even when controlled for access-related factors such as insurance status and income.

– As many as one in five Spanish-speaking Americans report not seeking medical care because of language barriers.

– Half of Hispanics and more than a quarter of African Americans do not have a regular doctor, compared with only one-fifth of white Americans.

– African Americans and Latinos have been affected by the decrease in employer-sponsored insurance over the past eight years to a greater extent than whites and were less likely to have it to begin with.

Current bills in the House and Senate contain provisions to address racial and ethnic health care disparities, including:

– Provisions that attempt to realign payment incentives so that they are tied closely to outcomes rather than the quantity of services rendered. Shifting to a quality-based payment system will help improve the care that people of color experience.

– Demonstration programs to promote access for Medicare beneficiaries with limited English proficiency by providing reimbursement for culturally and linguistically appropriate services.

– Incentives to encourage a range of needed health professionals to work in primary care settings, in public health services, and in areas of workforce shortage.

– Improved data reporting and collection in an effort to better evaluate programs and develop targeted strategies for addressing racial and ethnic health care disparities.

The Institute of Medicine cites expanding coverage — key aspects of both the House and Senate bills — as the most critical factor in addressing health disparities because it gets everyone in the system, and helps ensure access to prevention services, early diagnosis and treatment. Many of the broader reforms in the bill will also help improve access to care for minorities.


However, the report makes it clear that while the bills are a good start to closing the gap on health care disparities, more must be done if policy makers hope to elevate the nation’s “medical apartheid” to a top policy priority rather than treating the problem through a collection of small-scale, uncoordinated initiatives funded for a few years and then forgotten.

Health care disparities generate a significant human and economic cost that is borne directly by the individuals involved and indirectly by all Americans. As minorities become an increasing percentage of the population — Census estimates project them to be the majority by 2042 — their health status will increasingly define the nation’s health and drive health care spending.