For a full American recovery, start with health equity and chronic diseases
As Americans increasingly confront a history rooted in oppression — wading deeper into a long-overdue national reckoning — we’re presented with a sobering reality: Our past is so deeply embedded in the DNA of who we are as a nation that millions of Americans still feel the consequences of our origin story, every day.
People of color are failed by public institutions that are often underpinned by the same racially homogenous impulses that kickstarted our great American experiment. From housing and labor to education and public safety, communities of color continue to face hurdles to accessing basic necessities and resources — a direct result of structural disadvantages intentionally created and now cemented into the institutions that our communities need the most.
There’s a lot to fix about America’s broken systems. One of the most important is healthcare.
In the ongoing fight for racial justice, we must call on those in power to center the fight for equity around health. For too long, our country’s racist infrastructure has overburdened the physical and mental health of our communities. Without access to quality healthcare, people of color will not be able to live out the lives they deserve.
This week, our country’s healthcare advocates, civil rights leaders, and patient organizations came together to form a new coalition — The Healthy Equity Coalition for Chronic Disease — a group of our nation’s top experts who are calling for laser-focused attention on health equity. In the fight for racial justice, health equity must be the first step. So long as historically marginalized Americans are suffering, we will not be able to effectively rebuild and heal our nation.
The situation is dire. People of color face higher rates of diabetes, obesity, stroke, heart disease and cancer than white Americans. Black Americans are 77 percent and Hispanic Americans are 66 percent more likely to be diagnosed with diabetes compared to their white counterparts, and high blood pressure is more common among Black Americans than any other racial or ethnic group. Native Americans born today also have a life expectancy that is 5.5 years less than any other race. And new studies are just now revealing the serious health disparities among Asian American subgroups that were previously masked by aggregation.
Addressing health inequities and prioritizing care for chronic diseases will not only make communities healthier but will also have a residual positive impact on socioeconomic disparities.
The cost of chronic conditions is high — Americans with one or two chronic conditions pay double the out-of-pocket costs compared to Americans with no chronic conditions. At the same time, the onset of a chronic disease reduces wages by 18 percent, leaving Hispanic and Black households who have median incomes that are 140 and 171 percent less than their white counterparts without the necessary resources to stay healthy. Addressing chronic diseases could save the United States $794 billion per year, the projected cost of lost productivity alone between 2016 and 2030.
In its first year, HECCD is dedicating its attention towards obesity, one of the most pervasive and stigmatized chronic diseases. Nearly half of Black Americans and 44.8 percent of Hispanic Americans are living with obesity, compared to only 42.2 percent of white Americans. American Indians and Alaska Natives are also 50 percent more likely than white Americans to live with obesity, and those numbers are growing across the board.
As a catalyst for countless other health issues, stakeholders in the healthcare continuum must come together to halt the compounding impact of this treatable disease. For a first step, we’re calling on lawmakers to address outdated policies in our public programs like Medicare that wrongfully discriminate against FDA-approved, lifesaving obesity care. To make progress, it’s critical that our laws reflect science and the wisdom of our top medical experts.
In his executive order on advancing racial equity, President Biden acknowledged that “entrenched disparities in our laws and public policies, and in our public and private institutions, have often denied that equal opportunity to individuals and communities.” President Biden was right, and Medicare’s policies on obesity care are just one example of how current laws fail to help communities of color get healthy and stay healthy.
But the onus is not only on lawmakers. We all must do our part — including stakeholders in the private sector, academia and advocacy realms — to raise awareness around the devastating impact of health inequities. Together we must face a harrowing reality and take united action to make a change. We cannot let chronic diseases continue to be the silent killer of our loved ones.
Our entire nation, but especially communities of color, will feel the impact of immediate action. One study on the impact of COVID-19 found that reducing the U.S. obesity rate by 25 percent would have resulted in 120,000 fewer hospitalizations, 45,000 fewer intensive care unit admissions, and 65,000 deaths by April 2021 — and nearly half of the reductions would be among Black Americans.
Achieving health equity will not happen overnight, but with meaningful commitments from those who hold positions of power — and in collaboration with all stakeholders — we can make a difference. More impactful strides toward health equity begin today for our communities who need help now. Black and other nonwhite Americans should not be dying sooner than their white counterparts — our fight for justice starts with the fight for life.
Tammy Boyd (Chief Policy Officer and Counsel of Black Women’s Health Imperative), Dr. Elena Rios (President and CEO of the National Hispanic Medical Association), and Dr. Gary A. Puckrein (President and CEO National Minority Quality Forum) are the co-chairs of the newly formed Health Equity Coalition on Chronic Disease.
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