Lown Institute: Hospitals across 15 major cities deliver high racially segregated care

A new report found that hospitals in 15 large U.S. cities — led by Detroit and St. Louis — were highly segregated, but care for COVID-19 was more equitable.

The report released Thursday by the think tank Lown Institute comes as the Biden administration has made a major push to address health equity in the healthcare industry. The study also found that patients who got elective procedures skewed predominantly white. 

“Given the destructive impact of the pandemic on communities of color, a return to business as usual isn’t acceptable and almost guarantees slipping backwards on racial equity,” said Vikas Saini, the president of the Lown Institute. 

Researchers relied on Medicare claims data from 2020 to examine the proportion of hospitals whose patients closely matched the demographics in a community compared to facilities whose patients didn’t. 

“In the 10 most segregated cities, at least 50% of hospitals did not match the demographics of their communities,” according to a release on the study. 

The city with the most racially segregated hospitals was Detroit, where nine out of ten hospitals contributed to its status as a segregated market. 

Other cities with segregated hospital care were St. Louis; Kansas City; Atlanta; Philadelphia; Washington, D.C.; East Long Island, N.Y.; Houston; Baltimore and Manhattan, N.Y.

Researchers relied on Census data to determine the racial and ethnic groups in a hospital’s zip code.

“Hospitals received higher scores if they had higher patient counts from zip codes with greater proportions of non-white patients compared to their community area,” the report said. 

However, the report did find that racially segregated facilities did a better job of providing equitable treatment for COVID-19. 

For instance, while Detroit had a large segregation rate of 90%, the segregation for COVID-19 patients was at zero.

“Hospitals deserve praise for stepping up to the plate and being more inclusive during COVID, but we need them to be more inclusive all the time,” said Saini in a statement.

However, the study also found that 70% of hospitals had worse racial inclusivity for elective procedures than their whole patient population, underscoring that the patients getting elective procedures were predominantly white.

The study comes as the Biden administration is figuring out how to close major gaps in health equity.

The Centers for Medicare and Medicaid Services released a report late last year outlining its plan to address equity, including calling for an expansion on the collection of racial disparity data in communities. 

The advance notice for Medicare Advantage and Part D also asked for comments on how health equity can be factored into quality measures that affect a plan’s star ratings.