Racial health disparities in the United States

Abstract

Disparities between Black and White Americans in health care coverage and health outcomes are pervasive in the United States. In this paper, we describe the evolution of the market-based approach to health insurance and health care delivery in the United States and its implications for racial disparities. First, we discuss the history of the United States’ predominantly private health insurance system. Second, we illustrate the persistence and pervasiveness of disparities through three present-day epidemics: maternal mortality, opioid use, and Covid-19. Through the epidemic case studies, we highlight the systemic roots of racial inequality in health care. Finally, we conclude with a brief discussion of potential policy approaches for reducing disparities in the health care system.