1. Health Inequalities

2. Health
The system of health care in the US is very different from the UK.
In the USA national health care provision is very limited.
There are some programmes which provide limited healthcare to older people and poorer people.
However, most Americans are expected to pay for their own health care through private medical insurance.

3. Health
Most Americans (58%) receive their private health insurance through their employer. Companies like BlueCross BlueShield are among the leading private health care providers.
US Government health programmes cover around 28% of the population and include:
Medicare – Mostly for people over 65 years of age and administered by Federal Government.
Medicaid – Covers people on low incomes including children, pregnant women and the disabled. Administered by States.
According to the United States Census Bureau, in 2012 there were 48.0 million people in the US (15.4% of the population) who were without health insurance.

4. Problems with the US health care system (pre-2010)
The US health care system works well for those with full- coverage private medical insurance. Facilities and treatment can be world class, public satisfaction rates are high and waiting times are virtually non-existent. However…
The USA spends the most money on health care in the world ($2.26 trillion; 15.2% GDP) but outcomes (life expectancy, infant mortality, etc.) are poorer than many other developed countries.
There is a great deal of duplication/inefficiency in the US health care system as companies compete for business. Also, bureaucracy (paper work) costs are high.
The system is hugely unfair. Around 1.5 million Americans lose their homes every year due to unaffordable medical costs.

5. Health Impact of US health care system on minority groups
As Blacks and Hispanics are more likely to have lower incomes or to be unemployed, they are, as a result, less likely to have private medical insurance. They are also more likely to depend on Medicaid or be uninsured.
50% of Blacks and 42% of Hispanics have private health insurance compared to 74% of Whites.
21% of Blacks and 32% of Hispanics were uninsured compared to only 13% of Whites and 14% of Asians.

6. Percentage of adults aged 18–64 who were uninsured
2010 – June 2017
Although there have been clear improvements in the number of people getting health insurance in the past 7 years it is clear that inequality still exists in healthcare regarding race: Hispanics and African Americans are still more likely to be uninsured.

7. Health
Overall Health
Ethnic minorities suffer worse health compared to whites. Black women have the highest death rates from heart disease, lung cancer and strokes. Hispanics are more likely to be employed in high-risk occupations.
Infant mortality is twice as high for Black infants as it is for white infants.

8. Health Selected health statistics by ethnic group
Life expectancy (years) 2010
Whites Blacks Hispanics Asians Native Amer.
Infant mortality rates (per 1,000 births) 2009
Whites Blacks Hispanics Asians Native Amer.
In basic terms, infant mortality rates for black and Hispanic Americans are higher than for white Americans which suggests that whites (and Asians) have better health.

9. Hispanic mortality paradox
If Hispanic Americans are more disadvantaged and experience health inequality – why do they live longer than whites? The short answer is we don’t know!
Hispanic culture may have some protective effect. Tight-knit families and immigrant communities offer crucial support to people battling illnesses.
Hispanics, especially recent immigrants, also tend to behave in more healthy ways, smoking and drinking less.
However, some suggest that the Hispanic mortality paradox is mostly a result of migration and miscounting.
Others say that immigrants are in better physical condition, - the “healthy migrant” hypothesis.
Others argue that sick Hispanic immigrants tend to return to their home countries, so they don’t show up in the statistics. This is the “salmon bias” hypothesis.

10. Healthcare Questions
Explain which groups in America are more likely to suffer from health and healthcare inequalities – give examples.
Explain why ethnic minorities more likely to suffer from health/healthcare inequalities than White and Asian Americans (link to poverty/income/employment).