A History of Health Policy and Health Disparity

Overlooked and Damaging Impact of Structural Racism and Implicit Bias on US Health Care

“…For example, the Hill-Burton Act led to the revamp and new construction of health care facilities irrespective of race; however, states were still allowed to construct separate and unequal facilities for Black and White patients. 31 The result was segregated systems, often providing inferior care and limited resources compared with those designated for Whites. 32 Similarly, whereas laws were passed to increase wages and offer protections for workers, including pad sick leave and health insurance, other laws supported segregation in work environments.…”

“…31 Minority populations and rural populations experienced the greatest increase in insurance coverage, but the ACA also enabled higher-quality care through new delivery models and quality programs. 31 The ACA also protects individuals from discrimination by prohibiting individualized risk ratings that often resulted in higher costs based on gender. The Affordable Care Act trends also show that Black and Latino people have fewer access issues related to cost.…”

“…The Affordable Care Act trends also show that Black and Latino people have fewer access issues related to cost. 31 However, disparities in health insurance coverage persist. Nearly 30 million Americans are still uninsured, and 43% have inadequate coverage.…”

“…Early US policy, dating as far back as the Jim Crow era, has sought to provide access, while also creating additional barriers. For example, the Hill-Burton Act led to the revamp and new construction of health care facilities irrespective of race; however, states were still allowed to construct separate and unequal facilities for Black and White patients 31 . The result was segregated systems, often providing inferior care and limited resources compared with those designated for Whites 32 .…”

“…For those not qualifying for Medicaid, ACA provisions required and incentivized employer-sponsored coverage, as well as other protections for people with preexisting conditions and disabilities. Human Health Services also invested in its own infrastructure by establishing offices of minority health within each of its 6 agencies 31 . Minority populations and rural populations experienced the greatest increase in insurance coverage, but the ACA also enabled higher-quality care through new delivery models and quality programs 31 .…”