Recent advancements in healthcare, such as telemedicine, automation, and clinical studies, have propelled the industry forward, unleashing new possibilities for fostering better patient outcomes. While many are lucky enough to reap the rewards of new research and technology, critical communities are being left behind.
The Medicaid population, who typically benefits from progress last, still grapples with harmful biases within the healthcare system that pose extreme barriers to care. A new report peeks into the experiences of New England’s Medicaid population to reveal that even within this medically prestigious region, health inequities fueled by income, race, and gender ring true. Although this is a tale as old as the healthcare system itself, what the data uniquely shows is that maternal and mental health are facing the highest rates of disparities among this group today.
Income and Race Reduce Quality of Maternal Care
The maternal healthcare crisis has shown modest improvement over the past decade and remains just that – a crisis. Despite the recent number of valuable research and tech developments, this sector remains at a complete standstill. Low-income and women of color face the brunt of this stagnation as 84% of all maternal-related deaths are deemed preventable, with black women three times more likely to die than white women.
Research lays the foundation for equitable healthcare and where there is a lack of research, notable biases are present. Women’s health has been neglectfully under-researched, contributing to conditions going undiagnosed, incorrect treatment plans, and procedure failures. Pregnant women are one of the most underrepresented groups in clinical trials, black pregnant patients even more so, leaving OBGYNs unequipped with the knowledge needed to provide accurate care in all scenarios.
For lower-income communities, the quality of care is put at an even higher risk with exponentially more racial bias and far less access to proper maternal resources like skilled personnel and in some cases, NICUs. 75% of New England’s Medicaid population notice those with a low income are subject to inadequate maternal care – while 54% have noticed minorities receive poor maternal care first-hand.
Adequate representation is also a crucial piece of the puzzle. People believe more firmly that it’s important for maternal healthcare providers to be of the same race or gender as the patient to provide proper care, compared to any other healthcare provider. For pregnant women of color, having a doctor of the same race or ethnicity could eliminate some of the racial biases that lead to poor and sometimes fatal outcomes.
Mental Healthcare Burdened by Financial Barriers
The mental healthcare sector has received a much-needed awareness boost in recent years. But since this critical care area has been overlooked for too long, it has yet to reach the same level of accessibility other specialties offer. For the Medicaid population, receiving this type of care is more challenging and increasingly necessary.
The CDC found that in 2020, 18.4% of US adults reported being diagnosed with depression in their lifetime – for the Medicaid population of New England, this figure more than doubled to 44%. For women, LGBTQ+ people, and patients with disabilities the rate of depression continues to rise due to perceived gender and social biases.
Not only is mental health a key contributor to quality of life, but not having proper care increases the risk of complex conditions during a person’s lifetime. People suffering from depression have a 40% higher risk of developing cardiovascular and metabolic diseases than the general population. When accessing mental healthcare, the Medicaid population struggles with finding doctors, experiences long wait times, feels judged, and contends with increased financial burdens.
Addressing Healthcare Bias Head-on
Race, income, and gender biases continue to perpetuate health inequities in all areas of care, and especially within maternal and mental healthcare. In addition, to receiving inadequate treatment, the stigma that comes with these biases can discourage individuals from seeking necessary care altogether. As a result, the disparities in health care accessibility and outcomes between racial and socioeconomic groups are widening, which we cannot allow to negatively impact our communities any further.
Acknowledging these disparities is the first step to addressing them, which must be done by both payers and providers. This can start with diversifying hiring and recruitment or offering local support programs which are being heavily utilized to bridge gaps in care. For New England’s Medicaid population, mental health centers and programs for pregnant women are seeing the highest usage rates (29% and 23% respectively).
Above all, identifying the health-related social needs (HRSN) that impact health outcomes for the lower-income populations on Medicaid is key. Leveraging existing data on social drivers of health (SDoH) and HRSN to incorporate into treatment plans can help eliminate many of the accidental biases and overlooked barriers that lead to poor patient care. Factors like air quality, access to fresh foods, education level, time and distance to the nearest hospital all have an instrumental impact on health and well-being. By prioritizing HRSN, doctors and health plans can be better equipped to treat patients of all demographics.
About Kim Webb
Kim Webb is the Vice President of Health Strategy at Siftwell Analytics where she serves as the strategic thought partner with plan and community stakeholders and helps to guide Siftwell’s development of solutions that improve the health and wellness of vulnerable populations. Previously, she was the Enterprise Vice President for Population Health and Clinical Operations at AmeriHealth Caritas, where she led a team of 1,000 associates across 15 Medicaid, Marketplace and Medicare markets. Her previous experience includes serving as National Director for Magellan Health’s Clinical Center of Excellence, as well as clinical operations, care delivery implementation, clinical programs, and strategy roles with Evolent Health, CareFirst BCBS and Novartis. Kim earned a Master of Science in Population Health Management from Johns Hopkins Bloomberg School of Public Health and upon graduation was commissioned into the U.S. Air Force serving five years on active duty as a nurse.
