State of Urban Health: Eliminating Health Disparities to Save Lives and Cut Costs
For over 100 years, the National Urban League (NUL) has been committed to the mission of economic empowerment in underserved communities – a mission that is inextricably linked to the reduction of racial health disparities in America. Health disparities inflict a significant level of illness, disability, and death on the nation’s racial and ethnic minorities. However, in addition to excess morbidity and mortality, health disparities impose a significant economic burden on society. In 2009, health disparities cost the U.S. economy $82.2 billion in direct health care spending and lost productivity. African Americans bore the majority of that cost with $54.9 billion, followed by Hispanics with $22 billion. The Southern region of the country had the highest economic burden associated with health disparities with $35 billion, and the West had the next highest with $26 billion. Over 90 percent of the medical care and lost productivity costs were in urban areas. Private insurance plans paid 38.4 percent of the healthcare costs of health disparities, but the second highest cost burden goes to individuals and families through out-of-pocket payments of 27.7 percent -- more than Medicare and Medicaid combined.
These costs impose an unnecessary economic burden on minority communities, but also represent a loss to the American economy through lost productivity. That makes the elimination of health disparities not just a minority issue, but a national issue. President Obama and Congress -- through the Affordable Care Act, the Department of Health and Human Services and by executive order --have developed several strategies to achieve the goal of reducing racial/ethnic disparities in health by 2020 with various agencies assuming different roles. These national strategies rely heavily on civic engagement and identify community based organizations as major stakeholders in addressing health disparities in that many of the interventions are to be implemented at the local level reaching individuals, families, churches, and communities. By prioritizing targeted investments and enhancing existing policies, the National Urban League and its affiliate movement are well positioned to advance creative and innovative strategies, like NUL’s Project Wellness
– nationally and locally – that will help to alleviate the impact of health disparities.
However, apart from what individuals and community based organizations like the National Urban League can do to promote better health, education and economic outcomes in minority communities, there are a number of federal policy levers that will help to eliminate disparities and help to realize the promise of the Affordable Care Act. The historic passage of the new health care reform law put in place several strong provisions, including developing research priorities, awarding community transformation grants, and evaluating and expanding effective community prevention services that will all go a long way to addressing health disparities, particularly in African American communities.
This report helps to make the case for why although the complexity of factors contributing to health disparities makes eliminating them costly, inaction or action that results in further cuts to important health programs that help to address these disparities will prove to be much more costly. Therefore, allocating the appropriate amount of financial resources to reduce racial/ethnic disparities in health is not only a moral imperative, but also a fiscally responsible one.