Health inequalities are costing America billions

© Mohd Azrin –

Racial and ethnic health disparities have grown to a trillion dollar problem in the United States.

The researchers analyzed the financial cost of treating patients inequitably based on race, ethnicity and socioeconomic status, and estimates run into the hundreds of billions of dollars, according to a press release.

In 2018, the estimated burden of racial and ethnic inequalities in health ranged from $421 billion to $451 billion. Based on education-related inequalities, the costs ranged from $940 billion to $978 billion – the latter figure being about twice as high as the annual growth rate of the US economy in the same year.

The economic burden is based on three components: overspending on health care, lost labor market productivity, and premature death. The estimates are a range because the researchers used different data sets to count them.

“The results of this study demonstrate that health inequality not only represents unfair and unequal health outcomes, but also has a financial cost,” study leader Thomas A. LaVeist said in a press release. LaVeist is dean of Tulane University School of Public Health and Tropical Medicine, who compiled the analysis with researchers from the National Institute on Minority Health and Health Disparities (NIMHD), Johns Hopkins Bloomberg School of Public Health, Uniformed Services University, TALV Corp. , and the National Urban League.

“Investing to achieve health equity would not only help people live longer, healthier lives, it would also pay dividends economically that would benefit the long-term well-being of the community,” said LaVeist. “Of course, significant resources will be needed to address health inequalities, but it is also true that the costs of not addressing health inequalities are substantial.”

main conclusions

Funded by the National Institutes of Health, the study used four national databases to estimate the economic burden of health inequalities for five racial and ethnic minority groups: Asians, American Indians/Alaska Natives, Blacks, Latinos, and Native Hawaiians/Islanders. Pacific.

The researchers said key findings include:

  • The black population bore 69% of the economic burden of racial and ethnic inequalities due to premature mortality.
  • Hawaiian/Pacific Native and American Indian/Alaska Native populations had the highest economic burden per person, at $23,225 and $12,351, respectively.
  • The black population had the greatest economic burden of racial and ethnic health inequalities in most states (33), followed by Hispanics/Latinos (nine states), American Indians/Alaskan Natives (eight states), and Native Hawaiians/Islands Pacific (a state). .)
  • The burden of racial and ethnic inequalities on each state’s GDP ranged from 0.14% in Vermont to 8.89% in Mississippi.
  • 17 states had a burden greater than the annual growth rate of the US economy in 2018.

education is important

In addition to racial and ethnic disparities, education is a driver of the economic burden of health inequalities, the researchers said.

Adults with high school diplomas had the highest cost, $9,982, and bore 61% of the burden of education-related health inequalities. Adults with less than a high school diploma cost $9,467; this group represented 9% of the population but bore 26% of the economic burden. The financial burden for adults with some college was $2,028, according to the study.

Estimated costs were based on premature deaths, which accounted for 66% of the burden; loss of productivity in the labor market, of 18%; and excess health care costs by 16%.

‘The right thing to do’

In recent years, there have been compelling appeals to social justice arguments as a reason to devote more resources to closing health disparities.

“Addressing health inequalities is ‘the right thing to do,'” the study said. “However, there is also a compelling utilitarian argument. Health inequalities are a significant drag on the economy and affect everyone.”

NIMHD commissioned the study, and director Eliseo J. Pérez-Stable, MD, agreed with this finding.

“The exorbitant cost of health disparities is diminishing America’s economic potential,” Pérez-Stable said in the press release. “We have a clear call to action to address social and structural factors that negatively impact not only population health but also economic growth.”

“The Economic Burden of Racial, Ethnic, and Educational Health Inequities in the US” was published in JAMA. The Tulane University Institute for Innovation in Health Equity created a website,, dedicated to the research.

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