A new report maps deep disparities in health by race and ethnicity nationwide, and Wisconsin fairs poorly compared with other states.

The gap in the U.S. between the average health and well-being of white people and people who are Black, Latinx/Hispanic, or American Indian/Alaskan Native (AIAN) is longstanding, according to the report, “Achieving Racial and Ethnic Equity in U.S. Health Care.” The report, constructed as a scorecard of state performance based on extensive health data, was released November 18 by the Commonwealth Fund.

Health systems in every state “are failing people of color,” the Commonwealth Fund stated in announcing the report.

“The COVID-19 pandemic has only made things worse,” the report states, “with average life expectancies for Black, Latinx/Hispanic, and, in all likelihood, AIAN people falling more sharply compared to white people.”

Authors of the report pulled together data for 24 measures of how well health systems perform, and organized the information by state as well as by racial and ethnic groups, including Asian American/Native Hawaiian/Pacific Islander (AANHPI) and white people in addition to the other three ethnic/racial groups.

“Decades of policy choices made by federal, state, and local leaders have led to structural economic suppression, unequal educational access, and residential segregation, all of which have contributed in their own ways to worse health outcomes for many people of color,” the report states

The 24 indicators were grouped according to whether they measure health outcomes, access to health care, or the quality and use of health care services. Each state was then ranked based on the outcomes, health care access and the quality of health care services for various racial and ethnic groups in each state.

Not every state could be compared in the rankings for every ethnic group, so for many of the rankings, the total number of states being ranked is fewer than the potential maximum of 51 (all states plus the District of Columbia).

For Black people, Wisconsin’s health system overall ranked 32 out of 38 states. On health outcomes, the state ranked 35 out of 38 for Black people, and on health care quality for Black people, Wisconsin ranked 34 out of 40. Health care access was stronger than other groups of health measures for Black people, with Wisconsin ranking 18 out of 40.

For Latin/Hispanic residents, Wisconsin ranked 29 out of 42 states overall, 30 out of 42 on health outcomes, 34 out of 48 on health care access, and 26 out of 48 on health care quality.

For White residents, Wisconsin ranked 18 out of 51 overall, 20 out of 51 on health outcomes, 17 out of 51 on access and 23 out of 51 on health care quality.

The report’s data was too sparse for the researchers to rank health care overall or outcomes, access or quality for American Indian/Alaska Native residents. Addressing the nation as a whole, the report urges greater attention to disparities and action to avoid making them worse.

“Racial and ethnic equity in health care should be a top priority of federal and state policymakers,” the authors write. “A good start would be to identify policies and proposed legislation that impede progress toward health equity.”

The report also recommends expanding access to health care and health insurance coverage, particularly for marginalized communities, and focusing the measurement of outcomes in health care on equity.

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