Systemic Discrimination and Health Disparities in U.S.

Recently many voices have joined the conversation about systemic discrimination in the US. One aspect is how minorities and disadvantaged groups in the U.S. have poorer access to healthcare and behavioral healthcare services and poorer health overall. A recent blog post pointed out the connection between systemic discrimination, chronic stress, and hypertension in Black Americans. It also noted that employers have more than a corporate citizenship responsibility. They have a real and growing business and financial stake in such matters. This is because in our American system – in these uncertain times – private employers largely bear the burden of the high and growing costs of providing decent healthcare insurance for employees. Not to mention the smaller and intentional investments they make in their Employee Assistance Programs (EAPs), health coaching programs, and other lifestyle management services aimed at prevention and early intervention.

It’s widely known now that COVID-19 pandemic in the U.S. has been disproportionally impacting Black and Hispanic communities. These groups have highly disproportionate rates of COVID-19 infections compared to their percentage of the population. While there may be multiple reasons for this, one is the underlying health disparities.

Here are a few more facts that speak to health disparities related to systemic discrimination. Most have been recognized by scholars and researchers for many years, yet they persist.

• About 14% of Black Americans report having fair or poor health compared to 8% of Whites.
• 42% of Black Americans over age 20 have hypertension compared to 29% of Whites.

Disparities extend to behavioral healthcare as well.

• Only 9% of Blacks received mental health services in a recent year compared to 19% of Whites. Yet mental health conditions affect everyone and have no racial preferences.

Disparities are not limited to Black Americans by any means. Similar facts abound for other minorities that regularly encounter discrimination. Asian Americans, Native Americans, Native Hawaiian and Pacific Islander Americans, and Hispanic Americans all have many health status indicators that are worse than Whites in America. For instance, suicide is highly associated with feeling of extreme hopelessness and is the second leading cause of death in young people. In 2017 the number of suicide attempts by adolescent Hispanic females was 40% higher than that of Non-Hispanic White females. Why might that be? Many of these groups have higher rates of obesity, diabetes, smoking, alcohol consumption, coronary disease, hypertension, cervical cancer, and other conditions than to Whites in America. Most also have poorer access to decent health insurance than do Whites, creating an enormous barrier to care. Poor cultural sensitivity by healthcare providers often creates another barrier when patients get to the moment of service.

I hope more employers join this conversation about systemic discrimination, social injustice, and resulting health disparities – and do more than talk or publish statements on their websites. Employers are made up of people. People can be advocates, and advocacy begins with action. Employers can advocate with insurers for patient-centric systems of care that provide and give access to optimum care delivered by culturally competent providers. They can advocate and lobby in the public realm for laws and policies that acknowledge systemic discrimination in American life, work to eliminate it, and diminish health disparities. Finally, employers can examine how minorities in their own workforces are accessing and being served by their EAPs and their other prevention and early intervention programs.

About the Author

Norman Winegar, LCSW, CEAP, is the Chief Clinical Officer for Espyr. Norman has worked in the mental health field for over 30 years and is frequently called on for presentations and as a panelist to share his expertise and experience as a mental health clinician.

Sources

Health and Racial Disparities

Center for American Progress

https://www.americanprogress.org/issues/race/reports/2020/05/07/484742/health-disparities-race-ethnicity/

Overcoming Racial Disparities in U.S. Healthcare

HealthAffairs

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.24.2.445

Health Equity Considerations and Racial and Ethnic Minority Groups

U.S. Centers for Disease Control and Prevention

https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fracial-ethnic-minorities.html

CDC data: COVID-19 hit Hispanics, Blacks and those with underlying conditions harder

CNN

https://www.cnn.com/2020/06/20/politics/cdc-covid-charts-black-hispanic-underlying-conditions/index.html

About Espyr

For over 30 years Espyr, has provided innovative mental health solutions to organizations operating under some of the most challenging conditions. Espyr’s portfolio of customized coaching solutions help employers reduce healthcare costs by identifying and addressing employee mental health issues before they require more expensive, long term care. For more information on how Espyr can help your organization, call Espyr at 888-570-3479 or click here.