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%.
The rate of hospital stays among those ages 45-64 was nearly 50% higher for people in the lowest income communities versus wealthier areas.
"Low socio-economic status is associated with higher hospital admission rates, possibly due to lower utilization of routine and preventive health care services among poorer individuals that could prevent the need for hospitalization," according to the report.
Perhaps surprisingly, poor people admitted to the hospital received services that cost $700 less ($7,800) than for wealthier inpatients ($8,500), although their five-day lengths of stay was the same as for wealthier patients. The report did not suggest a reason why the poor incurred lower costs.
However, the report noted, people who live in poorer communities were 8% more likely to be admitted through the emergency department, compared to patients living in more affluent communities, and were 63% more likely to leave against medical advice.
One disparity that is often overlooked involves the difference in care between people residing in poor rural versus wealthier rural or urban areas. According to the report, "the rural poor had the highest rate of hospitalization, (1,597 stays per 10,000 population), which was 22% higher than in wealthier rural areas."
But the largest disparity in hospitalization rates occurred in large urban areas, where the poor were admitted 27% more often than people in wealthier large urban areas.
The report offered insight on the reasons for the different admission numbers for poor versus wealthier residents. For example, chronic obstructive pulmonary disease was the sixth most common reason for poor patients, but the 16th most common reason for wealthier patients.
Osteoarthritis was the seventh most common reason wealthier patients were admitted, but the 19th most common for poorer patients.