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Monday, June 17, 2024

Racial and ethnic disparities in Indiana’s health care system persist

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A new report released Thursday shows racial and ethnic disparities persist in health care access, quality, and outcomes across the nation, including in Indiana.

The Commonwealth Fund, a private U.S. foundation which supports independent research on health care issues, released the 2024 State Health Disparities Report.

It compares medical outcomes for people of different races and ethnicities in each state, and ranks how well each state’s health system addresses medical conditions for each racial and ethnic group.

In Indiana, White people experienced the highest health system performance, scoring in the 64th percentile among all population groups nationally. Black people experienced the lowest health system performance in the state, scoring in the 14th percentile. However, researchers found Indiana has less severe racial and ethnic health disparities compared to other states in the Great Lakes region. 

The findings highlight continued disparities in Indiana health outcome metrics including life expectancy. 

David Radley, a senior scientist with The Commonwealth Fund, said health disparities are related to a variety of factors like a lack of affordable, quality health care options and health insurance. 

“Where a person lives matters, and this is especially true for people of color,” Radley said. “We also see big differences in people’s abilities to access care. Not only do uninsured rates vary from state to state, we also find big differences within states where we see large coverage gaps between people from different racial and ethnic groups.”

In Indiana, 21% of Hispanic adults are uninsured, compared to 12% of uninsured Black adults and 8% of White, Asian American, Native Hawaiian, and Pacific Islander adults. That leads to residents putting off medical care because they don’t want to incur medical debt. 

Compared to other states, Indiana’s health care system was ranked worse than average for different racial groups, where there was enough data to make a calculation:

  • Indiana ranked 22nd of 31 states in health system performance for Asian American, Native Hawaiian, and Pacific Islander people.
  • Indiana ranked 34th of 39 states in health system performance for Black people.
  • Indiana ranked 28th of 47 states in health system performance for Hispanic people.
  • Indiana ranked 38th of 51 states in health system performance for White people.

Inequities for people of color were exacerbated by the COVID-19 pandemic and led to a sharper decline in average life expectancy compared to White people. Additionally, communities of color are more likely to die from medical issues including treatable conditions or during or after pregnancy; and are at a higher risk for chronic health conditions, such as diabetes and hypertension.

Disparities in premature mortality — when people die before the age 75 due to health conditions that are considered preventable and treatable — occurred at a higher rate among American Indian and Black people compared to other groups. These deaths are higher for both Black and White community members in Midwest states like Kentucky and Missouri, compared to other states. 

In order to address these issues, researchers suggest implementing policies that ensure affordable, comprehensive, and equitable health insurance coverage for all; strengthening primary care services; lowering the administrative burden for patients and providers and investing in social services. 

Laurie Zephyrin, senior vice president of advancing health equity for The Commonwealth Fund, said diversifying the health care workforce and implementing community health workers are some of the critical changes that are needed to improve the health care system.  

“Quality in health care and delivery of health care are really critical to address and need to be improved,” Zephyrin said. “You really can’t have quality without having equity, and it’s important for delivery systems to partner with patients and community members to fully understand the needs and experiences of the people that they serve.” 

Researchers hope policymakers, health system leaders, and community members will work to provide a more equitable health care system by addressing the impact of health policies on different racial and ethnic groups. 

Contact WFYI’s health reporter Elizabeth Gabriel at egabriel@wfyi.org

Side Effects Public Media is a health reporting collaboration based at WFYI in Indianapolis. We partner with NPR stations across the Midwest and surrounding areas — including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio and WFPL in Kentucky.

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