White Americans received 72% of all healthcare spending in 2016 despite making up 61% of the population, according to a new study that found major disparities in racial and ethnic health spending.
The study, published Tuesday in the Journal of the American Medical Association and conducted by the Institute for Health Metrics and Evaluation at the University of Washington, comes as the Biden administration has made a major commitment to addressing health equity gaps. The research also showed details on where some minority groups are getting care.
“This study provides a clear picture of who is benefiting from and who is being left behind in our healthcare system,” said Joseph Dieleman, Ph.D., associate professor in the Department of Health Metric Sciences at the University of Washington, in a statement Tuesday.
The study found that white, non-Hispanic Americans got 72% of all healthcare spending despite compromising only 61% of the population.
“On the other hand, Hispanic and Asian Americans received the least spending relative to their proportion of the population: Hispanic patients benefited from 11% of healthcare spending despite accounting for 18% of the population, while Asian, Native Hawaiian and Pacific Islander individuals received 3% of spending while making up 6% of the population,” according to a release on the study.
African Americans make up 12% of the population and accounted for 11% of healthcare spending. However, the spending was skewed based on how African Americans were getting care.
African Americans got 26% less outpatient care compared to whites but spent 12% more on emergency department care, the study found. This likely contributed to African Americans getting more expensive care when conditions worsened instead of getting more preventive outpatient care, experts said.
“Many people based on whatever beliefs they had based on misinformation about preventive care would stay away from outpatient care until the condition they have is very serious,” said George Mensah, M.D., senior adviser for the National Heart, Lung and Blood Institute within the National Institutes of Health, during a press briefing Monday. “We can do something about this.”
The analysis also showed spending inequity in the types of care that different groups received. For example, white Americans got 15% more spending on outpatient care on average. This suggests that they got more access to routine preventive services than other groups did.
“They also receive more spending on dental care and pharmaceuticals than other groups,” the release said. “Non-white Americans, on the other hand, were less likely to visit ambulatory care or receive prescriptions.”
Researchers looked at data from 7.3 million health system visits combined with data from the National Health Interview Survey and spending estimates from the Disease Expenditure project, which found that $2.4 trillion was spent on healthcare in 2016 in the areas of care the study evaluated.
The study’s results come as the Biden administration is seeking to close equity gaps and exploring how to do that via regulation. The Centers for Medicare & Medicaid Services has asked for feedback from providers on how to address health equity gaps and how to collect race and ethnicity data on patients.
The agency also laid out a new vision for the development of value-based care payment models that aims to put health equity at the center.