Societal issues in the U.S., including systemic racism, poverty and mass incarceration, contribute to health inequity, a new series of studies has found.
The Lancet released a five-part look at health inequity in the U.S., titled the “United States of Health,” and researchers found that institutional racism, the increasing income gap and high rates of incarceration are all factors that make it harder for minorities and the poor to access healthcare. And the healthcare system, as it is financially structured today, only makes this problem worse, the researchers concluded.
…Poor Americans have made limited gains in life expectancy over the past 15 years, researchers found. Since 2001, the poorest 5% have not seen their survival rates increase at all, while while middle- and high-income people have seen their life expectancy increase by two years. The richest 1% of Americans live between 10 and 15 years longer than those who are among the poorest 1%.
Economic insecurity is a key factor in some of today’s biggest public health crises, including the opioid epidemic and increasing rates of obesity, study author Jacob Bor, Sc.D., assistant professor at the Boston University School of Public Health, said in announcement. But despite their increasing health concerns, it is becoming increasingly hard for Americans in poverty to pay for healthcare, creating a “health-poverty trap,” Bor said.
Poor Americans are also the most likely to be uninsured. Though the Affordable Care Act has made strides toward decreasing the number of people without insurance, a lack of options in ACA exchanges, particularly in states that did not expand Medicaid, leaves many poorer people in the U.S. with few avenues to get health insurance, researchers found. In 2015, for instance, about a quarter of poor Americans were uninsured, compared with just 7.6% of people with middle or high incomes.
Minority groups are also hit hard by societal barriers that lead to health inequity, and research reflects poorer outcomes—for instance, infant mortality rates for black populations are twice those for white ones, according to the study. Structural racism relegates many black Americans to neighborhoods with poor housing options, high rates of crime and air pollution. These neighborhoods may also be neglected by public health officials, worsening the problems, researchers found.
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