Resource Library

A Scorecard of State Performance
INTRODUCTION
Profound racial and ethnic disparities in health and well-being have long been
the norm in the United States.
Black and American Indian/Alaska Native (AIAN) people live fewer years, on
average, than white people.1
 They are also more likely to die from treatable
conditions; more likely to die during or after pregnancy and to suffer serious
pregnancy-related complications; and more likely to lose children in infancy.2
Black and AIAN people are also at higher risk for many chronic health conditions,
from diabetes to hypertension.3
 The COVID-19 pandemic has only made things
worse, with average life expectancies for Black, Latinx/Hispanic, and, in all
likelihood, AIAN people falling more sharply compared to white people.4
People’s health also varies markedly across and within states, as does access
to health services and overall quality of care.5
 Large racial and ethnic health
inequities, driven by factors both inside and outside the health care delivery
system, are common. In many communities of color, poverty rates are higher
than average, residents tend to work in lower-paying industries, and residents are
more likely to live in higher-risk environments — all contributors to COVID-19’s
disproportionate impact.6
Issues around cost, affordability, and access to care also contribute to inequities.
Black, Latinx/Hispanic, and AIAN populations are less likely to have health
insurance, more likely to face cost-related barriers to getting care, and more
likely to incur medical debt.7
 It is also less common for individuals from these
groups to have a usual source of care or to regularly receive preventive services
like vaccinations.8
 In addition, many people of color contend with interpersonal
racism and discrimination when dealing with clinicians and more often receive
lower-value or suboptimal care.9