Cara James, the president and CEO at Grant Makers Health, visited ETSU on a virtual panel to discuss racial and ethnic disparities in relation to health.

Cara James, the president and CEO at Grant Makers Health. (Contributed/ETSU)

James spoke about identifiers such as sex, race, socioeconomic status, education level and more. She also noted the danger of using such identifiers.

“It’s worth noting that none of us fit in just one of these boxes,” said James. “We are looking at the intersection of how all of these factors come together.”

Disparities often start at conception. For example, American Indians, Alaskan Natives and Black people are often born in disparity, with less access to healthcare, such as oral care and dental coverage.

There are also disparities related to leading causes of death for Pacific Islanders, American Indians and other people of color. Having a regular healthcare provider is a significant factor in the quality and depth of care provided for these people, and many minority groups report not having a regular healthcare provider.

Income plays a role in the rate of care received as well, and many Hispanic, American Indian, Asian American and Black individuals report being unable to receive adequate healthcare.

Data is gathered on the progress of disparity in relation to health by the National Healthcare Quality and Disparities Report, which is conducted on an annual basis.

“Overwhelmingly, we are not making progress on disparity,” said James. “While quality care is improving for everyone, the disparity is largely staying the same.”

James gave numerous examples of rates of disparity in relation to chronic illnesses, obesity, diabetes, depression and rates of suicide. About one in four Black adults and one in four Hispanic adults said they could not see a doctor because of the cost. A large part of this challenge is due to rural living conditions.

“There have been about 180 rural hospital closes between 2005 and today,” said James, “Ninety-seven of those 180 completely closed.”

Economic stability, education, social and community context, health, healthcare, neighborhood and built environment can all have an impact on health disparity. The easiest factor to understand is income.

“These differences start young,” James said. “About a third of Black children are living in poverty, and about a quarter of those who are Hispanic are living in disparity.”

Ultimately, these are not easy issues, and achieving health equity is a constant process of working towards a goal.