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Racial and ethnic health disparities have become a trillion dollar problem in the United States.
Researchers have analyzed the financial cost of treating patients unequally based on race, ethnicity and socioeconomic status, and estimates run into the hundreds of billions of dollars, according to a press release.
In 2018, the estimated burden of racial and ethnic health inequalities ranged from $421 billion to $451 billion. Based on education-related inequality, the costs ranged from $940 billion to $978 billion – the latter figure roughly twice the annual growth rate of the US economy for the same year.
The economic burden is based on three elements: excessive medical expenses, loss of labor market productivity and premature death. The estimates are a range because the researchers used different data sets to tally them.
“The results of this study demonstrate that health inequalities not only represent unfair and unequal health outcomes, but also have a financial cost,” said study leader Thomas A. LaVeist. , in a press release. LaVeist is dean of the Tulane University School of Public Health and Tropical Medicine, which compiled the analysis with researchers from the National Institute on Minority Health and Health Disparities (NIMHD), Johns Hopkins Bloomberg School of Public Health, Uniformed Services University, TALV Corp. , and the National Urban League.
“Investing in achieving health equity would not only help people live longer and healthier lives, but it would also reap economic dividends that would benefit community well-being in the long run,” said LaVeist. “Certainly it will take significant resources to address health inequalities, but it is also true that the costs of not addressing health inequalities are considerable.”
Main findings
Funded by the National Institutes of Health, the study used four national databases to estimate the economic burdens of health inequalities for five racial and ethnic minority groups: Asian, Native American/Alaska Native, Black, Latinos and Native Hawaiians/Pacific Islanders.
The researchers said key findings include:
The black population bore 69% of the economic burden of racial and ethnic inequality due to premature mortality. had the highest economic burden of racial and ethnic health inequalities in most states (33), followed by Hispanic/Latino (nine states), American Indian/Alaska Native (eight states) and Native Hawaiian/Pacific Islander (one state). The burden of racial and ethnic health inequalities relative to each state’s GDP ranged from 0.14% in Vermont to 8.89% in Mississippi. 17 states had a burden greater than the annual growth rate of the US economy in 2018. Education matters
In addition to racial and ethnic disparities, education is a driver of the economic burden of health inequalities, the researchers said.
Adults with a high school diploma had the highest cost at $9,982 and bore 61% of the burden of education-related health inequalities. Adults without a high school diploma had a cost of $9,467; this group represented 9% of the population but bore 26% of the economic burden. According to the study, the financial burden for adults with a college education was $2,028.
The estimated costs were based on premature deaths, which accounted for 66% of the burden; loss of productivity in the labor market, at 18%; and excess medical expenses at 16%.
‘The right thing to do’
In recent years, there have been compelling calls for social justice arguments as a reason to devote more resources to eliminating health disparities.
“Tackling health inequalities is ‘the right thing to do’,” the study says. “However, there is also a compelling utilitarian argument. Health inequalities are a major drag on the economy and affect everyone.
The NIMHD commissioned the study, and director Eliseo J. Pérez-Stable, MD, accepted that finding.
“The exorbitant cost of health disparities diminishes the economic potential of the United States,” Pérez-Stable said in the press release. “We have a clear call to action to address the social and structural factors that negatively impact not only population health, but also economic growth.”
“The Economic Burden of Racial, Ethnic, and Educational Health Inequalities in the United States” was published in JAMA. The Tulane University Institute for Health Equity Innovation has created a website, costofinequity.org, dedicated to research.
