There are many pressing issues facing American healthcare right now, including a primary care physician shortage, the rise in Type II diabetes, and the lasting impacts of the COVID-19 pandemic. One of the most serious issues, however, is healthcare disparities. According to the Centers for Disease Control and Prevention (CDC), healthcare disparities are “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.”
Understanding healthcare disparities and their effects on society is crucial for fostering a fair and equitable healthcare system—and also has implications for the future prosperity of the country’s economic system. A 2022 analysis by Deloitte Insights, for example, determined that the preventable illnesses and death caused by health disparities cost the U.S. $320 billion per year currently, and could account for as much as $1 trillion in costs by 2040. This post looks at some of the main factors that influence disparities in healthcare and how diversifying the healthcare workforce can help alleviate these inequities.
One of the primary contributors to healthcare disparities is socioeconomic status (SES), which is roughly defined by a person’s income and education level. People from a lower-SES background often face significant barriers to accessing quality healthcare.
Limited financial resources, inadequate health insurance coverage, and lack of education can all influence a lower-SES person’s decision to seek care. They may delay or forgo scans and tests that could catch some conditions, such as certain cancers, earlier. These factors may account for why a 2016 Stanford-led study of income level and life expectancy (figure 2) found that women in the top 1% of incomes lived an average of 10 years longer than women in the bottom 1%, while the highest-earning men lived almost 15 years longer than the lowest-earning men.
Race and Ethnicity
Census figures show that approximately 41% of Americans are from non-white ethnic and racial backgrounds as of 2021, and Census projections indicate (p. 7) that diverse Americans will be the majority of the population sometime in the 2040s. Regardless of this growth, race and ethnicity continue to play a significant role in healthcare disparities thanks to structural racism, unconscious biases, and language or culture barriers between patients and providers.
A 2023 analysis of healthcare disparities by the Kaiser Family Foundation (KFF) found that Black, Hispanic, and American Indian/Alaska Native (AIAN) people fared worse than white people across a broad range of healthcare outcomes and social determinants of health, including health insurance coverage, life expectancy, and infant mortality. The KFF report also found that people of color were significantly less likely to have access to mental health care than white people.
While SES and race or ethnicity may overlap, a 2022 analysis of research on unconscious bias in healthcare decision-making indicates there is some evidence that physicians and other healthcare providers are prone to making decisions about patient care based on socially reinforced racial and ethnic stereotypes, especially in situations where they are uncertain about a diagnosis.
Geographic location is another crucial factor influencing healthcare disparities. Rural and remote areas often face challenges in healthcare access due to limited healthcare infrastructure, shortage of healthcare professionals, and transportation barriers. In poorer rural areas, closures are even more of a crisis.
A 2023 report by the Center for Healthcare Quality and Payment Reform (CHQPR) warns that nearly 30% of rural hospitals across the country could be at risk of closure within the next few years. In an interview with U.S. News and World Report, the president and CEO of the CHQPR noted that many rural hospitals also operate an area’s clinics. When a hospital goes, so do the clinics and all the professionals who work in them.
Diversifying the Healthcare Workforce to Address Disparities
Diversifying the healthcare workforce is a crucial step toward addressing healthcare disparities. Evidence shows that increased diversity of the healthcare workforce fosters improved patient-provider communication. Practitioners with direct lived experience as a member of a community at risk of healthcare disparities may be more able to anticipate the barriers patients like them may face in seeking care and target their advice accordingly.
Initiatives such as targeted recruitment, scholarships, and mentorship programs can play a vital role in creating a more diverse and inclusive healthcare workforce. Contributing to a more diverse healthcare workforce is part of what we aim to do with the Tiber Health Master of Science in Medical Science program. Our program is intended to empower talented students from a range of under-represented social and economic backgrounds an opportunity to strengthen their academic credentials to become the doctors, dentists, and other health professionals of the future—professionals who can help move the needle toward greater equity in healthcare.