Health Disparities Can Reduce with Insurance

Health Disparities Can Reduce with InsuranceAccording to a study from Harvard, universal healthcare coverage could reduce many health disparities in the general population.

The results are a part of the national debate on revamping healthcare to cover uninsured Americans and they showed that health coverage in the form of Medicare eligibility narrowed the health gaps between Americans of different races, ethnicities, and education levels. Previous studies had shown that the people most likely to lack coverage were black, Hispanic, and those with less education.

In the study published in the Annals of Internal Medicine J. Michael McWilliams and colleagues from Brigham and Women's Hospital at Harvard University in Boston and the Cambridge-based National Bureau of Economic Research reviewed health data from more than 6,000 people ages 40-85 with diabetes, high-blood pressure and high cholesterol, from the National Health and Nutrition Examination Survey from 1999 to 2006.

They found after eight years measures related to blood pressure, blood sugar, and cholesterol were all better. They saw a 10 % lowering of blood pressure and a 21 % improvement in blood sugar although the differences between socioeconomic groups remained. An
8 % gap in blood pressure rates between white and black people and a 15 % gap in diabetes control rates between people who had completed high school and people who had not was seen.

McWilliams, lead author of the study said disparities between people of different socioeconomic groups persist through middle age, with some groups healthier than others. After age 65, when Medicare coverage kicks in, "we found a reduction in disparities."

After age 65, the racial gap in systolic blood pressure dropped by 60 % and for blood sugar levels, the racial gap reduced by 78 % and the education gap by 83%, while for cholesterol, the educational gap disappeared.

"With national healthcare reform back on the agenda, I certainly think this study, along with our prior work and a lot of other studies at this point, really support the notion that universal coverage would improve health outcomes for a lot of adults with chronic conditions who are in vulnerable groups," McWilliams said.

Dr. Ashwini R. Sehgal of Case Western Reserve University in an editorial also appearing in the Annals said, "Simply improving quality of care will not eliminate disparities. Because minority, socioeconomic, and insurance status often overlap, providing universal health coverage has the potential to reduce several types of disparities."

Camille Watson, coordinator of the Disparities Action Network at Health Care For All, said, "Access to quality healthcare is important but not singular to managing chronic disease," she said. "Massachusetts can be really proud we extended coverage the way we have, but there are some additional things we can do."

"I think the challenge for us is to translate this research paper into something policy makers and others take home and understand," she said. "We are worried about the absolute outcomes for all people and we are worried about those gaps."