Disparities in U.S. Healthcare Access & Outcomes

Instructor: Daniel Murdock

Daniel has taught Public Health at the graduate level and has a Ph.D. in Behavioral Sciences & Health Education.

There are significant differences in healthcare access and health outcomes among different groups of people in the United States. In this lesson, we'll examine these differences, why they matter, and several major efforts to eliminate them.

Health and Healthcare Disparities

We know that, as individuals, we don't all have the same health status or experience the same health outcomes. Health differences can also occur between population groups. For example, in the U.S., African American children are more likely to suffer from asthma compared to white children. Differences in health and healthcare between population groups are called disparities. Disparities can occur across characteristics like age, race, socioeconomic status, gender, geography, and sexual orientation.

Disparities in ''health'' and 'healthcare'' are two separate but closely related concepts. Health disparities refer to differences in the burden of disease or mortality experienced by one group of people relative to another. Healthcare disparities refer to differences between population groups in terms of healthcare access, utilization, and quality. In this lesson, we'll examine why health and healthcare disparities matter, the status of these disparities in the United States, and major efforts to eliminate them.

Why Disparities Matter

Health and healthcare disparities are often considered to be forms of social injustice. This is because these disparities are often avoidable and they often adversely affect socially disadvantaged groups. The presence of health and healthcare disparities violates deeply held American social values and human rights principles related to fairness and equality.

The population groups that face disparities are not the only ones to be affected by them. Disparities limit improvements in the overall health of the broader population and create excess healthcare costs. Nearly a third of all medical expenditures for members of racial and ethnic minorities in the U.S. are associated with health and healthcare disparities. As the U.S. population becomes more diverse, these unnecessary healthcare costs will increase if disparities are not addressed.

Status of Disparities in the United States

Racial and ethnic disparities in health outcomes are some of the largest health disparities in the United States. Blacks and American Indians and Alaska Natives experience poorer health outcomes than whites in many areas. These groups have a higher prevalence of many chronic conditions, including diabetes, asthma, and cardiovascular disease. They also face significantly higher infant mortality rates than whites. Significant health disparities also exist across socioeconomic status. Measures of self-reported health status indicate that low-income Americans of all races report worse health status than do high-income Americans.

We see a similar pattern in healthcare disparities. Members of racial and ethnic minority groups are less likely to be insured than whites, experience more barriers to accessing care, and utilize less care. Low-income Americans also face significant barriers to accessing care and receive poorer quality healthcare compared to high-income Americans. Other groups facing significant healthcare disparities include lesbian, gay, bisexual, and transgender (LGBT) individuals and individuals with limited English proficiency.

Key Initiatives Addressing U.S. Disparities

There has been a growing effort to address health and healthcare disparities in the United States through public health policies and programs. One example is the U.S. Department of Health and Human Services' Healthy People program. Every 10 years, the Healthy People program sets nationwide health promotion and disease prevention goals for the upcoming decade. Over the past two decades, Healthy People's overarching goals have focused on reducing health disparities. The most recent set of goals calls for eliminating health disparities, not just reducing them.

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