The New Health Dialogue

Previously, we've discussed health disparities and barriers to care American women face. We've looked at health disparities facing racial and ethnic minorities. At an event this week, the Kaiser Family Foundation put these issues, literally, on the map. The report, Putting Women's Health Disparities on the Map: Examining Racial and Ethnic Disparities at the State Level, examines the relationship between gender, race, ethnicity, and health on a state-by-state and national basis.

The report looked at three dimensions of indicators:

• Health Status, such as overall wellness, and chronic or mental illness.
• Access and Utilization, such as coverage and regular check-ups.
• Social Determinants, such as income and education.

Though all women experience some level of difficulty with health disparities, the report found women of color were worse off than white women on almost all health indicators.

The report compares the state averages to the national data. Few states were consistently better or worse than the national average. Across all three dimensions, only Georgia, Maryland and Virginia were better than average on all three. Montana, South Dakota, Indiana, Arkansas, Louisiana, and Mississippi were worse than average on all three dimensions.

Different racial and ethnic populations each face a different set of challenges. According to the report:

• Hispanic women had consistent difficulties with access to and utilization of care
• Black women had the worst rates for indicators of health and social determinants
• Asian American, Native Hawaiian and Other Pacific Islander women had lower rates of preventative screenings (for example, 34 percent had not had a recent mammogram, in comparison to only 25 percent of white women)
• White women generally had higher rates of smoking, cancer mortality and psychological distress.

The report contains a wealth of information (although not all the policy implications have been analyzed). For more details, check out Kaiser's Women's Health Disparities on statehealthfacts.org, which features an interactive map. To see the human face of these statistics, the video Women at Risk: A View from the Safety Net documents a day at the Arlington Free Health Clinic in Virginia, where women, many of whom are recently unemployed, seek care. As Agency for Healthcare Research and Quality director Carolyn Clancy stated at the Kaiser event, most data on health care access and quality has a brief time lag, so it is likely that the current economic recession has worsened the disparities.

In her closing remarks at the Kaiser event, Marsha Lillie-Blanton, the foundation's senior adviser on Race, Ethnicity, and Health Care, emphasized the significance of women's health in society. The challenges faced by women, especially racial and ethnic minorities, are the same challenges faced by the families, children, and communities that women support. The persistency of these health disparities stem, in part, from a lack of knowledge about the nature of the problem, and about potential policy solutions. This reports is a step forward in understanding the nature of health disparities, but it is up to policymakers to take on disparities as an aspect of comprehensive health reform.

Though disparities reflect long-standing societal inequalities, Lillie-Blanton stated that we should work towards a future where health and access to care are no longer defined by racial, ethnic, and economic divides. "States doing better than average give us confidence about what is achievable now," she added.