Two Disparities

We have recently learned that blacks have been disproportionately dying from the coronavirus.  This is not because the virus is sensitive to the race of its victims.  It is because blacks are much more likely to have health issues that undermine their abilities to survive the virus – asthma, diabetes, obesity, etc.

A recent study, with which I am involved, starkly portrays the disparities.  I live in Ward 3 in Washington, DC.  Ward 3 has a life expectancy 16 years longer than Ward 8.  Ward 3 has a 2% incidence of diabetes.  Ward 8 has a 15% incidence.  Not surprisingly, the number of coronavirus cases is similarly skewed.  Ward 3 is well provisioned with urgent care capacities. Residents in Ward 8 rely on Emergency Room services, even for routine care.

Deaths of Despair (Princeton, 2020) by Anne Case and Angus Deaton address a different disparity. The life expectancy of non college-educated white Americans has been decreasing due to suicide, drug overdoses, and alcohol-related liver disease.  These deaths of despair have been sufficiently prevalent to decrease overall US life expectancy for the past three years.

Case and Deaton have found that places with a lower percent of the working-age population employed have higher rates of death of despair.  Median wages for white working class men have been declining for four decades.  Their total earnings have declined by 21% while their total compensation, including benefits, has risen by 68%.  This amazing difference is attributable to the costs of employer-based health insurance.

In both of these examples, the US healthcare system is killing our citizens by both how we provide care and how we pay for it.  The system works well for many but not for everyone, particularly the most vulnerable.  The current crisis might provide the impetus to address this dreadful situation.  On the other hand, we do have a tendency to just move on and get back to what we were doing before the crisis.

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