New N.C. health disparities report highlights inequities among marginalized groups

On Sept. 18, the North Carolina Department of Health and Human Services published the 2024 Health Disparities Analysis Report.

In the report’s key category results, African American/Black, American Indian and Hispanic/Latinx people and people with disabilities were found to have less access to health care than white people and those without disabilities. These populations were also found to have higher rates of chronic diseases and death.

The report analyzes health disparities across several population groups: race and ethnicity, disability status, socioeconomic status, geography and age.

Health disparities are identified in six categories: social drivers of health; access to health care; chronic disease, communicable disease; mental health, substance abuse, and suicide and violence prevention; and health across the lifespan.

Executive Director of the American Public Health Association Georges Benjamin said 80 percent of what makes a person healthy occurs outside of the doctor’s office.

“There’s several things that result in health inequities,” Benjamin said. “One, access to care. Number two, differences in the quality of care received within the healthcare setting. Three, differences in health-seeking behavior, kind of what we do to be healthy, and the fourth one is social determinants.”

Vaile Wright, senior director for the Office of Healthcare Innovation at the American Psychological Association, said certain communities still experience a lot of stigma about seeking care when it comes to their emotional well-being.

"And for good reason, because the healthcare system has not always done a good job with certain, particularly racial and ethnic, communities,” she said.

The COVID-19 pandemic created enormous disparities, Benjamin said. He said the pandemic resulted in a year of loss of life expectancy for the whole population but two to three years for communities of color.

William Bleser, research director of healthcare transformation for social needs and equity at the Duke Margolis Institute for Health Policy said that once COVID-19 vaccines became available, some health equity gaps closed.

“But initially things just got worse and worse for historically marginalized populations during COVID," Bleser said. "But then there was some strong work to make sure that they were included and focused on in some of the vaccination and prevention work."

Potential solutions to health disparities 

Wright said the updated Federal Mental Health Parity and Addiction Equity Act can help address behavioral health inequities.

“What that law says is that health insurance companies have to cover the same behavioral health benefits as they do physical health benefits,” Wright said. “And with the new law, there's a new enforcement requirement as well that ideally will actually ensure that that happens.”

Benjamin said one way to promote health equity is getting a system with everyone in and no one out. He commended North Carolina’s Medicaid expansion.

Another way to promote health equity is to continue to do research around why some people receive higher quality care than others, Benjamin said.

Rebecca Whitaker, a research director for North Carolina healthcare innovation and Medicaid transformation at the Duke Margolis Institute, said the organization is trying to generate some evidence-based recommendations to better center equity in North Carolina.

“And so we are really starting at the question of what do people, Medicaid members and their families, what do they want and need to be healthy, and then trying to design payment models that can better fit the things that folks are telling us that they want to, need to be healthy,” Whitaker said.

@DTHCityState | city@dailytarheel.com