Gaping disparities in health care leaves Hispanic Coloradans experiencing the lowest health system performance when compared with other racial and ethnic groups in the state.
Hispanic people in the state are more likely to die of preventable causes, be uninsured or forgo healthcare because of cost, and are less likely to be fully vaccinated as children than white Coloradans, according to a new report from the Commonwealth Fund.
The new report, which focuses on national data from 2021 and 2022, looks at 25 indicators of health system performance for states across the country. The list focuses on health outcomes, access to health care, and quality and use of health care services for Black, white, Hispanic, American Indian, Alaska Native, Asian American, Native Hawaiian, and Pacific Islander populations. The report looked at data from all 50 states and assigned a “score” for each group.
Hispanic Coloradans scored in the 33rd percentile nationally for health system performance, the lowest of other racial and ethnic groups in Colorado.
“It doesn't surprise me,” said Dr. Ricardo González-Fisher, manager of Ventanilla de Salud, a program of Servicios de La Raza.
In the past 20 years, Hispanic Coloradans have seen significant improvements in cancer overall, heart disease, diabetes, and infant mortality, to name a few. But, there are still significant gaps, said González-Fisher.
“Even if we improved in those 20 years, we’re still below the average in the United States or the average in Colorado,” he said. “We've improved, so just imagine how we were before.”
Since 2001, the Colorado Department of Public Health and Environment has tracked and published data on health disparities.
Health disparities among various racial and ethnic groups have existed for a very long time and affect multiple areas of health including chronic disease, communicable disease, injury, and child health indicators. These disparities can be explained, in part, by differences in social opportunities and socioeconomic factors, such as education or access to health care, according to CDPHE.
For example, patients at the CU Hispanic Transplant Program, part of UCHealth, are more likely to be on Medicaid, have a high school education or less, and are more likely to live in low-income areas, said Dr. Sixto Giusti Torres, director of the Program.
“I think that we still have not addressed the root of the cause or the social issues from the beginning. So trying to make sure that this population gets better educated and carries on through education after high school, trying to make sure that we improve access to health care, which is still not there in the whole community,” he said. “From our perspective, we have seen dramatic improvement with the implementation of the Hispanic Transplant Program per se, but that's only a small part or subset of the whole healthcare system.”
Similarly to CDPHE, for the last two decades, the Commonwealth Fund has tracked health and health care in each state and has consistently found profound racial and ethnic disparities in health, well-being, and life expectancy.
For example, Black, American Indian, and Alaska Native people live fewer years on average than white and Hispanic people. They are more likely to die from treatable conditions, suffer serious pregnancy-related complications, and are at higher risk for many chronic health conditions, from diabetes to hypertension.
Black Coloradans fared only slightly better than Hispanics and ranked in the 38th percentile for overall health system performance.
Black Coloradans have a worse-than-average ranking in health care quality, which means indicators like routine screenings and vaccinations. For example, 76 percent of Black adult women received a mammogram, compared to 84 percent nationally, and 61 percent of adults were screened for colon cancer compared to 65 percent nationally.
The COVID-19 pandemic made things worse, particularly for Black, Hispanic, American Indian, and Alaska Native people, by causing a sharper decline in average life expectancy since 2020 when compared to white people.
In Colorado, overall life expectancy dropped by two years, from 80.9 in 2019 to 78.9 in 2020. For Hispanic residents, life expectancy dropped 2.5 years, for Black people the drop was 3.9 years, Asian/Pacific Islander expectancy dropped 5 years, and American Indian/Alaska Native expectancy slid down 2.9 years. By contrast, the drop for white Coloradans was less than the average at 1.4 years.
In several southwestern and mountain states, including Colorado, New Mexico, Arizona, and Texas, premature deaths for Hispanic residents are higher than elsewhere in the U.S. where Hispanic mortality rates more closely align with white mortality rates, according to the report.
While Hispanic Coloradans fare worse when compared to other groups within Colorado, overall health system performance for Hispanic Coloradans is better than average compared to other states. That’s also true for Black, Asian American, Native Hawaiian, Pacific Islander, and white Coloradans. There was insufficient data for American Indian and Alaska Native Coloradans.
