A new report from the Commonwealth Fund lays out the facts: health care is lacking equity all across this country. The report found that, both across and within states, there are significant health care disparities between the white population and non-white races and ethnicities.

The report, titled “Achieving Racial and Ethnic Equity in U.S. Health Care,” expands upon the organization’s usual scoring of each state health system to evaluate the equity of the systems.

“States that have traditionally done extremely well in the rankings when you don’t think about equity still have equity concerns and considerations,” said Dr. Laurie Zephyrin, vice president for Advancing Health Equity at the Commonwealth Fund. “To me, that just highlights the importance of incorporating equity into these measures. You can’t just look at the overall generic number because that number is going to vary for different people in the population.”

Part of the scorecard included looking at health outcomes, health care access and health care quality for each race or ethnicity. Through these categories, Commonwealth Fund researchers were able to score the states in terms of infant mortality, breast and colorectal cancer deaths, the number of uninsured adults and children, and many other factors.

Chart courtesy of The Commonwealth Fund

Based on these factors, the states with the best health outcomes for Black people are Colorado, Massachusetts and Rhode Island, and the worst were Illinois, Michigan and West Virginia. However, it is important to note that there is still a huge disparity between the best health outcomes in the state and the percentile that Black people fall in, which is lower than 50 in all three states. 

In terms of health care access, Rhode Island, Massachusetts and Maryland were the best for the Black population, and there is almost no disparity compared to the best the state offers. For health care quality, Rhode Island, Massachusetts and Maryland are, again, the best, and though there is a larger disparity, Black people are still in the upper percentiles. 

“It reaffirms what we already knew. The surprises tend to be the states that we think of as being really good,” said Dr. David C. Radley, a senior scientist for the Commonwealth Fund’s Tracking Health System Performance initiative, citing Minnesota and Wisconsin as examples. “When we do reports like this, in the past, [those states] have always done really well. And those states in particular, we see some of the biggest gaps in the country and the experiences between Black residents of those states and white residents in those states. The size of those disparities, maybe, is what was eye opening.”

Going forward, Zephyrin hopes to continue getting better data to more fully understand the problem and which solutions are making a difference. 

“We know that about 80% of our health is related to the drivers of health: Do we have access to affordable housing? Do we have access to insurance? Do we have access to jobs that pay a living wage?” Zephyrin said. “It’s really critical to tackle the inequities and the drivers of health, tackle the structural racism that creates these inequities to really meaningfully address people’s health and access to health care.”