The NJ health system is failing under-served groups. How to bridge the gap in care?
Blacks and Hispanics in New Jersey fare worse than whites and Asians in overall health and access to care, according to a national analysis by the Commonwealth Fund, a nonprofit research group based in New York.
The Analysis – which looked at state-by-state data to assess health care access, quality, and outcomes for Blacks, Whites, Hispanics, Asian Americans, Hawaiians, Islanders Pacific and Native Americans – revealed that health systems typically fail to underserved groups in the Garden State and across the country.
For example, Whites and Asians in New Jersey were in the 90th and 94th percentile, respectively, in the Commonwealth Fund’s overall rating system – well above the median – while Hispanics were at 47% and Blacks. at 42%.
The score takes into account health outcomes, access to care and the quality and use of care services.
Many of the factors contributing to serious disparities are social determinants – such as nutrition, housing and transport – and need to be addressed, experts say.
One of the most marked drop-offs has been found in the frequency of deaths before the age of 75 from preventable and treatable conditions.
Blacks had the highest rate of such deaths – 141 per 100,000. Whites were at 67, Hispanics at 55, and Asians at 37.
âIt’s a running story,â said David Radley, scientist and lead author of the âAchieving Racial and Ethnic Equity in Health Care in the United Statesâ study. âNew Jersey is similar to what we see in other parts of the country. We see better overall health performance for whites in New Jersey, but for Latinos and blacks we see below par [experiences]. “
Although New Jersey does not have as great a racial or ethnic disparity as most other states, Radley said, the importance is that health and access to care is different for blacks and Hispanics than it is for blacks and Hispanics. whites and Asians in the state.
âThe important message is that even though New Jersey is doing better than, say, North Carolina or Mississippi, there is still a long way to go in New Jersey,â Radley said. âOur results show that race is an important factor. [Health inequity] is rooted in a long-standing structural racism in our country. Blacks have had the cards in hand against them, not only in health care but in other aspects of life. “
Blacks and Hispanics made up the highest percentage of uninsured adults and children in New Jersey, and those most likely not to seek medical attention because of the cost.
Asians did better – and equal to whites – in many categories.
Radley said socio-economic factors likely played a role, although he cautioned that there is great diversity within Asian and Hispanic communities.
“It is difficult to know exactly” why Asians, who are also discriminated against, do well in many categories, he said. “It probably has something to do with higher income levels, probably more comparable to white income levels.”
The report notes that Hispanics have lower preventable death rates than whites and blacks, despite “their relatively limited access to health care.”
“These lower rates could be linked to immigration factors, a younger average age, or lower rates of health risk behaviors like smoking,” the report says.
Nicole Harris-Hollingsworth, Vice President of Social Determinants of Health at Hackensack Meridian Health, said that many factors of disparity in care can be easily addressed.
“Diabetes, cancer, access and insurance [are] all of the things that tend to be easily managed, âsaid Harris-Hollingsworth. âIt’s a problem that we can solve and change. It’s not so entrenched that there’s no way to get rid of it.
Hackensack Meridian Health works to address the social determinants that contribute to health by using a digital platform, NowPow, to connect patients to food banks, rental assistance and transportation, and more resources, said Harris-Hollingworth.
They have made approximately 50,000 support referrals since this summer.
âOne in four patients we see has a need,â added Harris-Hollingworth.
Commonwealth Fund analysis showed promising gains for underserved communities in New Jersey. Black women, for example, had the highest rate of mammograms among all groups. But at the same time, they had the highest incidence of breast cancer deaths – 28 per 100,000. This was higher than white women, who were 22 per 100,000, and more than double that of Hispanics ( 12) and Asians (11).
âIt’s not the first time we’ve seen this,â Radley said.
He hypothesized that even though black women are screened, breast cancer may not be detected in them until it is advanced. He said they didn’t have data that could provide context – like the type of treatment black women diagnosed with cancer receive compared to other women – for the gap.
Dr Richard Marlink, founding director of the Rutgers Global Health Institute, said it was important to invest in “improving the social condition” of all groups, which “will then improve health”.
âWe are still a country that does not have universal health care,â said Marlink, professor at Robert Wood Johnson Medical School. “We are a country with 30 million people who are uninsured, and they are disproportionately colored.”
Shereef Elnahal, CEO and President of Newark University Hospital, the state’s only public acute care facility, said it was time to take the well-established fact that there are racial and ethnic disparities. glaring in health care in the United States and begin to work on solutions.
âThe Commonwealth Fund report is a well-conducted study that gives us an up-to-date picture of health disparities across the country, and the result is sobering,â said Elnahal. âRace, ethnicity and postal code should not be the primary determinants of health outcomes. But studies like this don’t surprise people in our community.
âMany have told me that they are fed up with just hearing other characterizations of disparities in communities like theirs – they already know there are disparities because they experience them. Instead, we need the gears of politics to focus on executing against the root causes of society that lead to the disparities outlined in this report. “
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