impact of health reform on racial and ethnic inequities
DESCRIPTION
This presentation collects all of the available data on how the 2006 Massachusetts health reform law impacted racial and ethnic inequities. Presentation reviews inequities in health insurance coverage, access to care, and some health outcomes.TRANSCRIPT
Impact of Health Reform onRacial and Ethnic Inequities
http://masscare.org
BCBSF: Prior to Reform (2006)
BCBSF: After Reform (2009)
5 Surveys of Health Care Coverage in Massachusetts
Measuring disparities (relative and absolute)
• Absolute disparity: the number gap between one social group and another (e.g. life expectancy for blacks is 5 years lower than for whites)
• Relative disparity: the percentage of the gap between one social group and another e.g. life expectancy for blacks is 15% lower than for whites).
Disparities in Apple Consumption During the Apple Crisis
Absolute Disparities During Apple Crisis Declined Rapidly
Relative Disparities During the Apple Crisis Increased Rapidly
Most Health & Health Care Trends Improve for All Groups Over Time
Disparities in Insurance Coverage
15% 15.1%16.0%
6.7%
4.4%
5.9%
11.0%
8.2%
10.0%
5.0%
5.3%
4.2%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
2004 2005 2006 2007 2008 2009
Uninsurance Rates for African-Americans and Whites (Census/CPS)
Whites African-Americans
18.5% 18.3%
9.8% 9.8% 10.4%
8.6%
7.0%
5.2%
3.3%4.0%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
2005 2006 2007 2008 2009
Uninsurance Rates for African-Americans and Whites (CDC/BRFSS)
Whites African-Americans
Range of Survey Estimates of Uninsurance Rates
18% 17.8%
20.1%
7.2%5.6%
12.0%
11.00%
8.2%10.0%
5.0% 5.3%4.2%
0%
5%
10%
15%
20%
25%
2004 2005 2006 2007 2008 2009
Uninsurance Coverage for Hispanics and Whites
(Census/CPS)
Whites Hispanics
8.6%7.0%
5.2%3.3% 4.0%
23.9% 23.9%
20.7%
15.4%
20.0%
0%
5%
10%
15%
20%
25%
30%
2005 2006 2007 2008 2009
Uninsurance Coverage for Hispanics and Whites
(CDC/BRFSS)
Whites Hispanics
Range of Survey Estimates of Uninsurance Rates
Disparities in Access to Care
12.4%
10.3%
15.8%
9.4%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
2006 2009
Share Reporting No Regular Source of Care, Before & After Health Reform (BCBSMF)
White Non-Hispanic Racial/Ethnic Minorities
9.9%
8.0%
21.9%
19.1%
0%
5%
10%
15%
20%
25%
2006 2009
Share Reporting No Regular Source of Care, Before & After Health Reform (CDC/BRFSS)
White Non-Hispanic Racial/Ethnic Minorities
Disparities in Health Outcomes
0.59 0.62
0.83 0.89
1.28 1.55
1 1
0
0.5
1
1.5
2
Pre-Reform Post-Reform
Odds Ratio for PCIs (Pulmonary Coronary Interventions) by
Race/Ethnicity
Black Hispanics Asians Whites
0.55 0.57
0.83 0.86
1.5
1.82
1 1
00.20.40.60.8
11.21.41.61.8
2
Pre-Reform Post-Reform
Odds Ratio for CABG (Coronary Artery Bypass Surgery) by
Race/Ethnicity
Black Hispanics Asians Whites