Differences in health care expenditures between Black and white adults vary substantially with the local level of racial and economic integration, and tend to be low or nonexistent in highly integrated communities, according to a study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
For their study, the researchers compared health care expenditures for a nationally representative sample of Black and white adults in census tracts across the United States. They found that, at the same level of health, health expenditures by Black adults were much lower than white adults' in census tracts with the lowest levels of racial integration but were virtually the same in tracts where the level of integration was highest.
Because of external factors-;including different levels of exposure to poverty, economic opportunity, health care access, and neighborhood environments-;life expectancy, disease risk, health outcomes, and other health care-related measures have long been known to differ between white and Black Americans. Black adults on average have shorter lives and higher rates of common ailments including diabetes, hypertension, and kidney disease.
For their analysis, the researchers used data from a 2016 U.S. government survey called the Medical Expenditure Panel Survey , which included data on race, socioeconomic status, health status, health care access, health care use, and health care expenditures for a nationally representative sample of Americans. The investigators also used data on each MEPS participant's community levels of racial and socioeconomic integration, based on the U.S.
The analysis, which adjusted for potential confounding factors such as age, sex, and education level, found that in communities where the ICE was highest-;many high-income white adults, few low-income Black adults-;racial disparities in health care expenditures were pronounced. In these relatively non-integrated communities, Black adults spent $2,145 less on health care per year compared to white adults.
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