Black, Native Californians have highest death rate from preventable illnesses, study finds

Black Americans and Native Americans in California are more likely to die from medical conditions that are preventable, a nationwide study released Thursday found.

In California, Black Americans die at a rate of 164 per 100,000 due to treatable illness before the age of 75. Native Americans follow slightly behind at 112 per 100,000.

The Commonwealth Fund, a private nonprofit research foundation focused on health care, attributes this to systematic barriers and a history of interpersonal racism and discrimination.

This year’s report is the first where COVID-19 is considered now “largely preventable,” said David Radley, senior scientist of tracking health system performance for the Commonwealth Fund. This year’s report showed the significant impact COVID-19 had on communities of color.

Black and Native communities were disproportionately impacted by COVID-19 in 2020 and continue to face obstacles. Radley said this can be attributed to Black Americans making up the majority of essential workers and a high COVID-19 death rate on reservations.

Historically, Black and Native communities have always been higher on a health disparity measure, COVID-19 just exacerbated these barriers, Radley said. This is due to a lack of access to health care. The study, overall, said that issues with affordability and quality health care options put up barriers to receiving timely care, or even prevent communities from receiving treatments.

Out of any ethnicity in the state, Native people experience the lowest health system performance and stand at systematic disadvantage, Radley said. For example, 14% of Native adults are uninsured in comparison to their white Californians, who have an uninsured rate of 5%.

In California, this disparity also impact Hispanic adults. The study states Hispanic adults face obstacles in health care access, with 15% being uninsured. Fifteen percent of Hispanic adults also said they went without care because they couldn’t afford medical costs, which is the highest percentage out of any ethnic group. And even when they did seek treatment, 12% of Hispanic adults said they had to spent a high amount of money out-of-pocket to even cover medical costs.

In comparison to other states in the West, California has the largest gap in racial and ethnic health disparities. This means that in comparison to other ethnic groups, California has the largest distance between “the best performing group and the worst performing group” said Radley, in terms of health care outcomes.

Radley said these results reflect California’s diversity and that variation is a given. But these findings still show a “huge amount of disparity” between ethnic groups.

California data reflects nationwide trends

California is no different than any other part of the country when it comes to having disparities, Radley said. In every state, there are inequities with health and health care experiences for people of color. Nationwide, the health system performance is worse for people of color compared to white people.

“Health equity does not exist in any state in the U.S., not even in states with historically stronger health systems,” Radley said.

But there are solutions, Radley added. Commonwealth Fund stated that health inequities are “multifactorial” and rooted in federal, state and local policies. The study’s authors suggest that in order to create a equitable health system there needs to be affordable, comprehensive and equitable health insurance for all communities. Additionally, access to primary care should be strengthen and there should be an investment in social services for underserved communities.

“States should be focused on implementing different kinds of policies like the ones we laid out in the report,” Radley said. “Our hope is that those kinds of policies actually start to work to reduce those disparity gaps.”

Laurie Zephyrin, the senior vice president for advancing health equity at the Commonwealth Fund, said these results will act as a guidepost to advancing equitable health care solutions.

“We can’t improve healthcare if we’re not accurately measuring and tracking these outcomes,” Zephyrin said. “There’s opportunities for improving collection analysis of racial and ethnic data, and developing equity focused measures to inform and evaluate policy.”