3: Racial and Socioeconomic Disparities in Healthcare
Race and Ethnic Background Influence Quality of Healthcare:
Despite experiencing illness at high rates, having the lowest life expectancy compared to other demographics, and being one of the most economically disadvantaged racial groups in America, current challenges to healthcare are affecting African-Americans at disproportionate rates. Native Americans and Hispanics are also subject to such difficulties and inequalities. Health disparities, a lack of accessibility to healthcare services, and failure to expand Medicaid in the South are all major issues that philanthropy needs to take into further consideration.
Limited Accessibility:
According to the Health Resources and Services Administration (HRSA), Health Professional Service Areas (HPSAs) illustrate healthcare provider shortages by using either geographic, population, or facility-based data, taking into account primary care, dental health, and mental health. The HRSA also defines Medically Underserved Areas and Populations (MUA/Ps) as geographic areas or populations that do not have sufficient access to primary care providers; MUA/Ps identify the populations (i.e. the homeless, racial groups, low-income) that experience inadequate health services. Both HPSAs and MUA/Ps are important for highlighting the imbalance between healthcare availability and needs of care among varying groups of people.
Some Facts:
1) About 80 percent of Americans living in rural areas are "medically underserved"
2) The number of rural doctors is expected to decrease over 23 percent by the next decade while the number of urban doctors remains consistent due to the "Gray Wave"3) 640 US counties are medical deserts
4) Medical deserts are particularly devastating in Texas and Georgia
The IHS
A combination of underfunding and a lack of access to care facilities are typical barriers among the Native American population. Through the Indian Health Service (IHS) and other health centers, the federal government is required to provide direct medical care to Native Americans and Alaska Natives. Regardless of this effort, this organization is severely underfunded and only receives a fixed amount of money each year. The facilities on the reservation lands do not have proper equipment (such as MRI machines), and free drugs are exclusively available through these IHS establishments, which are hours away. As a matter of fact, IHS spending per person was $4,868 less than national healthcare funding (Kaiser Health News).The IHS's response to the current pandemic has made matters worse. Some tribal-run facilities reported having difficulties in treating their COVID-19 patients due to a lack of testing resources and personal protective equipment (PPE); in addition, not all IHS testing sites acquired rapid tests. In general, staffing shortages have been a long-standing problem within the IHS—the vacancy rate for care providers is 25 percent, ranging from 13 to 31 percent across eight different IHS locations ("Indian Health Service"). Consequently, IHS establishments fail to provide their patients with quality care and resort to sending them to receive treatment elsewhere. Targeting this problem is an issue in and of itself, as the IHS does not have access to agency-wide information on its number of temporary workers, preventing it from pinpointing the specific facilities that need more resources to improve IHS services across all its locations. Immediate action is essential, given that Native Americans and Alaskan Natives have the shortest life expectancies and are more likely to die from preventable causes than any other race in the United States ("Indian Health Service").
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