Disparities in Health and Health Care: Five Key Questions and Answers

Executive Summary
1. What are Health and Health Care Disparities?

Health and health care disparities refer to differences in health and health care between population groups. “Health disparity,” generally refers to a higher burden of illness, injury, disability, or mortality experienced by one population group relative to another group. A “health care disparity” typically refers to differences between groups in health coverage, access to care, and quality of care. While disparities are commonly viewed through the lens of race and ethnicity, they occur across many dimensions, including socioeconomic status, age, location, gender, disability status, and sexual orientation.

2. Why do Health and Health Care Disparities Matter?

Disparities in health and health care limit continued improvement in overall quality of care and population health and result in unnecessary costs. Recent analysis estimates that 30% of direct medical costs for Blacks, Hispanics, and Asian Americans are excess costs due to health inequities and that the economy loses an estimated $309 billion per year due to the direct and indirect costs of disparities. As the population becomes more diverse, with people of color projected to account for over half of the population by 2050, it is increasingly important to address health disparities.

3. What is the Status of Health and Health Care Disparities Today?

Today, a number of groups are at disproportionate risk of being uninsured, lacking access to care, and experiencing worse health outcomes, including people of color and low-income individuals. Hispanics, Blacks, and American Indians/Alaska Natives as well as low-income individuals all are much more likely to be uninsured relative to Whites and those with higher incomes. Low-income individuals and people of color also face increased barriers to accessing care, receive poorer quality care, and ultimately experience worse health outcomes.

4. What Key Initiatives are in Place to Address Disparities?

Recognizing the continuing problem of disparities, in 2010, the Department of Health and Human Services (HHS) developed an action plan for reducing racial and ethnic health disparities. The HHS Disparities Action Plan establishes a vision of, “a nation free of disparities in health and health care,” and sets out a series of priorities, strategies, actions, and goals to achieve this vision. The action plan builds on existing HHS initiatives, such as the Healthy People initiative. States, local communities, private organizations, and providers also are engaged in efforts to reduce health disparities.

5. How Does the Affordable Care Act Impact Health and Health Care Disparities?

The Affordable Care Act (ACA) advances efforts to reduce disparities and to improve health and health care for vulnerable populations. The ACA health coverage expansions will significantly increase coverage options for low- and moderate-income populations and particularly benefit vulnerable populations. The ACA also includes provisions to strengthen the safety-net delivery system, improve access to providers, promote greater workforce diversity and increase cultural competence, strengthen data collection and research efforts, and implement an array of prevention and public health initiatives.