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There Are Clear, Race-Based Inequalities in Health Insurance and Health Outcomes

Worth is putting the spotlight on several inequities inside the U.S. health care system and exploring steps we can all take to create a more equitable and just health care system for all.

Photo courtesy of Hush Naidoo Jade Photography via Unsplash

The United States health care system continues to face massive challenges in ensuring that people of all races, ethnicities and socioeconomic groups have equal access to care. Traditionally, certain groups have benefitted more from the U.S. health care system than others. As a result, racial and ethnic minorities continue to experience higher rates of chronic disease and early death in the U.S. 

In honor of Black History Month, I’m putting the spotlight on several inequities inside the U.S. health care system and exploring some steps we can all take to create a more equitable and just health care system for all.

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Racism: A Public Health Threat

In 2021, the director of the Centers for Disease Control and Prevention (CDC), Dr. Rochelle P. Walensky, declared racism a serious public health threat in the U.S. This has become even more visibly apparent during the COVID-19 pandemic. According to the CDC, American Indian/Alaska Native (Non-Hispanic), Black (Non-Hispanic) and Hispanic/Latino individuals are nearly twice as likely to die from COVID-19 compared to white, non-Hispanic individuals. 

This health disparity extends to multiple other diseases as well. Certain racial and ethnic minority populations continue to suffer more from heart disease, diabetes, asthma and other chronic illnesses than their white counterparts. 

My current work is focused on closing the racial gap in ovarian cancer risk detection—to improve health outcomes and to improve access to critical care. For example, we know that certain blood tests which detect a woman’s risk for ovarian cancer have different abilities to detect disease, depending on the patient’s race. The test most commonly used today, CA 125, is 40+ years old and does not detect ovarian cancer risk in Black women as accurately as it does in white women. Yet, this is still the most common test providers and payers choose—despite its poor performance in Black women and despite the fact that Black women die from ovarian cancer at a rate 1.3 times higher than white women. While this statistic most likely has many factors contributing to it, the use of testing that performs poorly in Black women could be related.

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It’s Time to Take Action

Working together, we can identify solutions that will create more equity, more opportunities and better life experiences for millions of Americans. Here are some ways we can help:

  1. Increase access to quality care by investing in expanding telehealth and virtual health care services. Together, we can reduce access barriers and make care easier to “touch.” 
  2. Support and educate on programs that provide health care coverage to underserved populations, including Medicare and Medicaid. At Aspira, we have made it a priority to ensure that our products are covered under these policies to address those access inequities.
  3. Speak out; demand change and advocate for those in need. In September 2021, my team joined the Black Women’s Health Imperative for a congressional briefing to discuss current racial and ethnic disparities related to ovarian cancer. It was a powerful experience which helped us build and strengthen many relationships that will enable us to partner on new policy in the future.
  4. Change the status quo and ensure that your employees have the proper support they need to be able to take time off for themselves or their sick family members. Lower-paid workers, in particular, are less likely to take time off to tend to their own health needs or the needs of members in their family. 
  5. Invest in and support clinical research that recruits diverse research subjects so that we can improve health care for people of all races and ethnicities. We are not a “homogeneous” society and, historically, clinical research has largely been focused on white research participants. A 2021 cross-sectional study of 688 randomized clinical trials found that white participants were consistently overrepresented in trials, with a median inclusion rate of 84 percent. The day has come that study inclusion criteria must represent the population at large, not just those who can participate or have access to clinical trials. 

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We Can No Longer Be Silent

Racial inequity pervades our entire health care system, from young to old, and it is jeopardizing the well-being of millions. As a leader in the health care industry, I believe we can—and we must—come together to remedy these unacceptable truths. And to address the disparities that exist, we must also acknowledge the historical, political and social context that has led us to where we are now. 

It is up to us to be the changemakers and, as a result, we can work toward creating a more just, equitable and accessible health care system for all. The time is now, don’t you think?

Valerie Palmieri is the president and chief executive officer of Aspira Women’s Health.

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