Quality of Care Often Depends on Race and Income

Cheryl Clark, for HealthLeaders Media , June 10, 2009

Two new federal reports highlight the extent to which health disparities exist across the country between racial and ethnic minorities and whites, as well as between the rich and the poor.

"Minorities and low-income Americans are more likely to be sick and less likely to get the care they need," said Health and Human Services Secretary Kathleen Sebelius, who on Tuesday released one of the reports on health disparities in America. "These disparities have plagued our health system and our country for too long. Now it’s time for Democrats and Republicans to come together to pass reforms this year that help reduce disparities and give all Americans the care they need and deserve."

In that report, entitled "Health Disparities: A Case for Closing the Gap," researchers discovered higher rates of obesity, cancer, diabetes, and AIDS among racial and ethnic minorities than among whites. "One of the most glaring disparities is apparent in the African-American community, where 48% of adults suffer from a chronic disease compared to 39% of the general population," the report said.

The report added that 48% of all African-American adults suffer from a chronic disease, compared with 39% of the general population. And 15% of African-Americans develop diabetes, compared with 8% of white Americans, 14% of Hispanics, and 18% of American Indians. Hispanics were one-third less likely to receive counseling on the dangers of being obese compared to whites.

The study was compiled from statistics from numerous agencies, including The Commonwealth Fund, the Centers for Medicare and Medicaid Services, the American Cancer Society, the Centers for Disease Control and Prevention, and the Agency for Healthcare Research and Quality.

The second report, from the Healthcare Cost and Utilization Project, a division of the AHRQ, found major gaps between care of people in rural versus urban areas, and between poor families (those in communities whose annual median household income is less than $38,000) versus those in other income brackets. The report was based on data gathered in 2006.

For example, the rate of hospitalization among people in poor areas was 22% higher compared to people in wealthier communities.

And people in poor communities were more likely to be admitted to a hospital for preventable conditions, such as asthma–87% more likely to be admitted to a hospital; diabetes complications–77%; chronic obstructive pulmonary disease–69%; congestive heart failure–51%; skin infections–49%; pneumonia–42%; dehydration–38%; urinary tract infections–37% and nonspecific chest pain–32%.

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