September 3, 2013

Can Obamacare Close The Longevity Gap?

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If you’re 65 and living in Connecticut, you can expect – on average – roughly 16 more years of good health, according to a new federal study. In fact, the state ranks number seven for healthy seniors, says another study, this one from the United Health Foundation.

That’s if you’re white.

If you’re African American, your healthy life expectancy drops to 12 years, or age 77. And from other studies, Hispanics and Latinos don’t fare much better.

Connecticut faces what people are calling a silver tsunami – a state with a rapidly aging population which presents a potential drastic drain on public resources. Sadly, the tsunami will crash onshore with the same racial disparity in health as exists in housing, in wages, in nearly all measurable marks of well-being in one of the country’s wealthiest states. In 2010, the Connecticut Health Foundation published a study that looked at a decade of efforts to achieve health equity in the state, and said Connecticut “still has a long way to go” – so long, in fact, that the foundation recently announced it would shift its focus strictly to health equity.

A 2009 report by the state Department of Public Health said that even while Connecticut is becoming more racially diverse, there remains “striking” inequalities that result in a mortality rate among African American residents that was 1.2 times higher than that of Caucasian residents. African American residents of Connecticut don’t live as long as their white neighbors, and they’re not as healthy.

According to the study, for the time period studied (2000-2004), the leading cause of death among all Connecticut residents was heart disease, followed by cancer and stroke –illnesses that can be heavily influenced by social factors such as access to healthy food. Diabetes was the seventh leading cause of death, but compared to Caucasians, diabetes was the cause of death 2.5 times more often among African Americans, and 1.5 times more often in Hispanics. African Americans were nearly four times more likely to face amputation as an effect of diabetes; Hispanics were 3.1 times more likely.

The list goes on, from an unequal amount of screenings, tests, and well-patient doctor visits – all of which factor into mortality rates. Add to that subsequent research on the effect of housing, neighborhood safety, fair wages and jobs, and transportation, and you have a recipe for gross inequality that cuts lives short – or hampers the later years with health maladies that are utterly preventable.

The immorality of that imbalance is staggering, but let’s look at some numbers.

Nationally, health care inequity among races will cost $300 billion by 2018, according to the Urban Institute. The Connecticut Commission on Health Equity, created by legislative mandate in 2008, is particularly attuned to the disparity between races and ethnicities among people living with HIV/AIDS, diabetes, cancer, cardiovascular disease, and asthma, as well as the consequences of low-birth weight. By not paying attention, a recent report from the commission says the disparity creates a “significant” financial burden to the state, as well as to the patients and their families.

The same inequality exists throughout the country, according to a healthy life expectancy study published recently in the Centers for Disease Control and Prevention’s journal, the deliciously-named Morbidity and Mortality Weekly Report.

In every state except New Mexico and Nevada, Caucasians could expect a longer healthy life than African Americans. (No other races were included in the study.)

Healthy life expectancies after age 65 were lower in the south; Mississippi had the shortest, at 10.8 years. The average healthy life expectancy was 14, said the study’s lead correspondent Man-Huei Chang.

Obamacare is supposed to level the playing field for health care access, but officials in other states have approached the landmark legislation with varying levels of enthusiasm. Connecticut was among the first states to opt in to Medicaid expansion.

For all the questions surrounding the historic Affordable Care Act, if it’s going to work anywhere, let’s hope it works here.

 

 

 

 

One thought on “Can Obamacare Close The Longevity Gap?

  1. As long as our healthcare system continues to ration healthcare based on ability to pay, a system that prioritizes corporate profits over patient outcomes, a system that ObamaCare® reinforces, there can never be anything close to “health equity” in Connecticut or anywhere else. This becomes especially significant for senior citizens where, in Connecticut, (as of 2011), 6% live with incomes below 100% of the official poverty measure, (13% below the supplemental measure), and 26% live with incomes below 200% of the official poverty measure, (46% below the supplemental measure). And considering Connecticut’s continuing growth in income disparity, (PDF), “health equity” within a for-profit healthcare system becomes even less attainable.

    There’s only one way to begin to come close to “health equity”: a national healthcare program that guarantees equal access to all medically necessary medical goods and services, a system “making sure every American has the security of quality, affordable healthcare.” Everybody in…nobody out. Single Payer.

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