Some Americans receive worse healthcare than others. Some of us are more likely to be uninsured; some of us have poorer outcomes; some have lower health literacy and other obstacles to access. Most would agree that eliminating these care gaps for our fellow citizens should be a top priority.
But add a few details about these disparities and many people start to get uncomfortable. Race and ethnicity are often strong determinants of healthcare quality. Immigrants tend to struggle in the system. Poverty also plays a role and often overlaps with demographics.
It's not that providers, politicians, and the rest of us don't care about these factors. It's that Americans still don't talk about race and ethnic issues very well, or maturely. Our shameful history of segregation, civil rights struggles, and even slavery isn't that far behind us and still taints our discussions, so we often avoid them altogether or treat them as a spectacle.
In all of the debate about reforming healthcare in the last year, very little has been said about the importance of reducing racial and ethnic care disparities. Yet, these disparities persist, and in some cases they are growing more severe.
There are numerous other studies that highlight factors ranging from provider discrimination to wellness to genetic differences as possible causes of racial and ethnic disparities. But eliminating these gaps isn't simply a matter of finding a single problem and fixing it. These are complex structural issues for which there aren't always easy solutions.