Communities of color most impacted
Health care equity is a moral imperative and a new study reveals that it is a financial one as well.
The economic burden of health inequities experienced by Black, Hispanic/Latino, and Asian populations in Massachusetts totals $5.9 billion annually, according to research commissioned by the Blue Cross Blue Shield of Massachusetts Foundation in collaboration with the Health Equity Compact.
Mental health was one of the 13 conditions considered in the study. The $5.9 billion total reported includes $1.5 billion associated with avoidable health care spending, $1.4 billion associated with lost labor productivity because of higher rates of poor health, and $3.0 billion is associated with the cost of premature death.
If no action is taken, the annual overall economic burden is projected to nearly double to $11.2 billion in the next 30 years, said Kaitlyn Kenney Walsh, Ph.D, senior director of policy and research, Blue Cross Blue Shield of Massachusetts Foundation.
“Health disparities have been experienced by communities of color in Massachusetts for decades, but this hasn’t shifted us from awareness to solving the problem,” said Walsh. “Our hope was that putting an economic value to these issues would help initiate a shared call to action from awareness to solving the problem.”
While Black, Hispanic/Latino, and Asian populations have experienced a disproportionate economic burden related to illness and disease, the White population of Massachusetts is also not at optimal health. Given this group’s size, it also contributes significantly to the total $23.5 billion economic burden of health inequities reported across all major racial and economic groups in the state.
Mortality rates for people of color and their financial impact cited in the report were startling, Walsh added.
According to the report, the economic burden of premature death in Massachusetts corresponded to $2,265 per resident in all racial and ethnic groups. The economic burden for the state’s Black population was disproportionate, at nearly $4,000 per resident annually.
“The Black population in particular does significantly worse than almost every group in almost every age cohort,” Walsh said. “If the moral imperative isn’t enough — which it should be, this study illustrates that there is a significant opportunity as a Commonwealth to improve people’s health and think about ways this would improve all of us from an economic perspective.”
Carlos Cappas, a member of the Health Equity Compact, agreed. Cappas is also chief behavioral health officer at the Lynn Community Health Center.
“It is unsurprising that structural racism and barriers to healthcare is putting a financial strain on our state’s business communities, healthcare industry, and economy,” Cappas said in an interview via email. “It confirms that when we withhold insurance accessibility, we only increase our economic strain down the line. When patients don’t have access to mental health support when they need it, we see more severe consequences later—and therefore more expensive solutions.”
These inequities are not limited to Massachusetts. KFF analysis of U.S. Census Bureau American Community Survey data reveals that more than half of white adults (52%) in the United States with any mental illness received mental health services in 2021, compared to only 39% of Black adults, 26% of Hispanic adults, and 25% of Asian adults.
To address the gap in health care coverage for communities of color in Massachusetts, in early 2023, the Health Equity Compact filed a bill, An Act to Advance Health Equity. If passed, this measure would expand MassHealth coverage to all those otherwise eligible, regardless of immigration status.
Other key provisions include establishing an Executive Office of Equity, defining health equity zones in communities, and standardizing health equity data collection.
A hearing on the bill — which would also overhaul payment models to incentivize the integration of behavioral health, oral health, and pharmacy services in primary care settings — was held in late September at the Massachusetts State House.