New Report on America's Health Rankings on Health Disparities

A version of this article initially appeared in RACmonitor on 8/12/21 and appears with explicit permission of the publisher

Over the past year I’ve talked a great deal about health and mental health disparities, an ongoing priority for the industry to address. America’s Health Rankings, published by United Health Foundation, has assessed the health of the nation for well over 30 years. However, for 2021, its authors embarked on a unique journey: to provide a comprehensive and thorough view of America’s Health Rankings and Health Disparities. However, the report details clear ongoing gaps mandated for attention; we've got miles to go before we attain true wholistic health equity!

This latest report was developed with guidance from a committee of national advisors involved in public health and health equity. The data encompasses 30 distinct measures of health for disparities across all 50 states and the District of Columbia, sorted by gender, geography, educational attainment, and race and ethnicity. Four publicly available sources contributed the data:

1. the American Community Survey (ACS),
2. Centers for Disease Control and Prevention’s (CDC’s) Behavioral Risk Factor Surveillance System (BRFSS),
3. Current Population Survey’s Food Security Supplement (CPS-FSS), and
4. National Vital Statistics System (NVSS).

A total of 3-5 years of data was gathered across three time periods between 2003 to 2019, and focused on the following social determinants of health (SDoH) indicators:

• Social and economic factors;
• Physical environment;
• Clinical care; and
• Health behaviors and health outcomes.

Among the key results are the following:

1. Uninsured rate:
   • A 37-percent decline was identified across all subpopulation groups.
   • The rate of uninsured among American Indian/Alaska Native populations in Wyoming was 24 times higher than the rate of uninsured among white populations in Washington, D.C.
2. Black infant mortality:
   • Rates declined in 22 states, although Black infants continue to have the highest infant mortality rate in the U.S.: 11 out of every 1,000 births. The number is 2.8 times higher than the nearest group, Asian/Pacific Islander infants, at 4 out of 1,000.
3. Maternal mortality worsened considerably:
   • Black mothers experienced the highest rate of maternal mortality at 43.8 deaths per 100,000 live births; the maternal mortality rate was 3.4 times higher than that of Hispanic mothers, with 12.7 deaths per 100,000 live births.     
   • White mothers faced a 55-percent increase.
4. Food insecurity rates skyrocketed:
   • It measured 39 percent for American Indians.
   • Households headed by an adult without a high school education had six times the rate of food insecurity compared to households headed by college graduates. It’s a good thing we’ll see a new ICD-10-CM Z code for food insecurity (Z59.41) in October along with other code shifts.

This data speaks volumes to me, as well as program planners, population health specialists, integrated care professionals, and grant funders everywhere. Those wishing to take a deeper dive can access the report directly through the URLs in this article.

This week’s Monitor Mondays Listeners Survey asked which of the areas in the report is the largest priority for our listeners. The ongoing clinical and fiscal impact of the SDoH is evident for organizations, as evidenced through the survey results, viewable here.