In Dr. Johnston’s hometown of St. Louis, like other cities, has fewer health care providers and specialists in low-income and minority neighborhoods, which is a function of structural racism and a legacy of residential segregation, said Dr. Johnston.
“It’s not a question of insurance – it has more to do with the supply side,” he added. “If you want access to a good specialist, your cardiologist choices will be different if you live in the more affluent areas than the poor areas of northern St. Louis.”
Another study in the journal compared health care expenditures by race and ethnicity and found that spending for whites at $ 8,141 per year is higher than for Americans of other races and ethnicities, and the proportion of that for outpatient care is above that Average lies.
Health care spending for blacks is $ 7,361 a year, and a smaller portion of the budget is spent on outpatient care. The cost of caring for blacks in emergency rooms and hospitals is 12 and 19 percent above the national average, respectively.
“This is about poverty, geography, and where people live and where primary care clinics are, and it’s about health insurance,” said Joseph Dieleman, associate professor at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle an author of the study.
However, the difference also reflects patient behavior. “It is also about people’s previous experiences with the health system and the quality of care they or their loved ones have received, which creates hesitation or resistance to early access to health care,” said Dr. Dieleman.
The results may explain some of the inequalities in health outcomes, but social and economic factors also play a role, including poverty, food deserts, and neighborhoods that pollute residents and offer few opportunities for physical activity and recreation.