Look up the word “disparity” in the dictionary and the first definition you're likely to find is “inequality.” And in America, supposedly the land of equal opportunity, that's a term that makes most of us squirm.
Healthcare just one sector struggling to close gap between haves and have-nots
Our country continues to struggle with far too many disparities. There's the pervasive income gap, whether by gender or minority group. We also have a growing wealth gap, a vast chasm between the haves and have-nots. Meanwhile, our students have been confronting educational disparities for decades.
And then we have the U.S. healthcare system. Overall quality, access to care and the outcomes of that care have long been wildly inconsistent whether locally or regionally, but especially socio-economically.
Of course we know it's a Utopian ideal to expect equality for everyone in all things. In education, for example, yes, all children have different gifts and abilities, but it doesn't mean we can't try to level the playing field when it comes to financial resources, access to the latest textbooks and hiring experienced teachers.
The same concept applies to healthcare. While we all have different predispositions to disease, everyone should have access to preventive care and adequate health insurance. And no, it is not correct to say that all Americans have equal access to care just because we can always head to the nearest emergency room and be treated.
But it's not as if the healthcare industry hasn't been trying to mitigate the disparities. Our shelves are stacked high with studies, and healthcare organizations have been actively working the problem. Modern Healthcare reporter Paul Barr wrote just last week about a new initiative (July 25, p. 10).
As he reported, five prominent organizations—the American College of Healthcare Executives, American Hospital Association, Association of American Medical Colleges, Catholic Health Association and the National Association of Public Hospitals and Health Systems—are pooling their resources in a fittingly titled Equity of Care campaign.
The key message is that the disparity issue is really a quality issue, with about one-third of our nation's population—racial and ethnic minorities—at risk of suffering from disparities in quality of care. And that percentage is growing. The campaign aims to make progress through data collection and analysis, an emphasis on “cultural competency,” and broadening the diversity of healthcare governing boards.
We laud these organizations for their efforts and urge others to join them.
Meanwhile, one area where we're clearly on the wrong track when it comes to eliminating disparities involves the economic health of our population. In a widely cited study issued last week, the Pew Research Center reported that the “wealth gap” between whites and minorities is the widest in 25 years.
According to Pew, the median net worth of whites is now 20 times that of black households and 18 times that of Hispanic families. Blame it on the Great Recession. From 2005 to 2009, white households saw median net worth fall 16%, but for Hispanics the drop was a stunning 66% and for blacks, 53%.
Most of the drop for the minority groups tracks the decline of home values—the main investment of many families. For whites, according to Pew, a larger percentage of net worth was in other investments such as equities, which recovered significantly from their recessionary lows. Not so for home prices.
These results are relevant in the healthcare arena because they show just how fragile the personal safety nets of these families have become. When they face unemployment and loss of health insurance, they have few resources left should a medical emergency arise.
The findings point to more uncompensated care and bad debt for providers. Worst of all they mean more economic misery for our neighbors.
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