Study Finds Black Access to Healthcare Lags in States That Show a High Level of Structural Racism

A new study led by researchers at North Carolina State University finds that states that exhibit higher levels of systemic racism also have pronounced racial disparities regarding access to health care.

The authors used publicly available state-level data from the Census Bureau and the U.S. Department of Justice to create an index of state-level racial disparities that serve as a proxy for structural racism. The researchers used the index to determine racism scores for all 50 states and the District of Columbia. They compared this data to the Association of American Medical Colleges’ Consumer Survey of Health Care Access for the years 2014 to 2019.

The results showed that the higher the level of racism in a given state, the less access Black people in that state had to health care. There was no statistically significant relationship between a state’s racism index score and quality of health care. However, Black people who reported experiencing racism with their health care providers also reported lower quality of care. Meanwhile, the higher the level of racism in a given state, the more access White people had to health care. In addition, the worse the state’s racism score, the higher the quality of care White people reported receiving.

“These state-level inequities are symptoms of racism baked into laws, policies, and practices that ensure there is not a level playing field,” explains Vanessa Volpe, the lead author of the study and an assistant professor of psychology at North Carolina State University. “It underscores the need to address inequities in a meaningful, structural way, not just assume that racism is solely an interpersonal phenomenon. And it’s important to use data-driven approaches like the ones we used here, so laws or regulations can be developed by policymakers to more effectively even the playing field.”

The paper, “State- and Provider-Level Racism and Health Care in the U.S.,” was published on the website of the American Journal of Preventive Medicine. It may be accessed here.


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