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A new analysis of health inequities shows that racial and ethnic disparities are widespread and persist in all 50 states, including Minnesota.

 released Wednesday by the Commonwealth Fund, a nonprofit private foundation that supports independent research on health policy and health systems, analyzed 24 indicators to measure health care access, quality of care and health outcomes for five racial and ethnic groups from 2022 to 2024.

Authors of the report note that recent federal policy changes, such as cuts to Medicaid funding and the expiration of Affordable Care Act subsidies, are not reflected in the data; but these changes are likely to have worsened existing disparities and are expected to widen them even further.

Minnesota is one of the top states for overall health care system performance, surpassing 38 other states. White people in the state experience the best health care outcomes, scoring in the 91st percentile among all population groups nationwide. In contrast, American Indian and Alaska Native people face the poorest health care outcomes in the state, scoring only in the 13th percentile. Additionally, when compared to other states, Minnesota's health care system performs below average for Black residents.

“As a primary care physician, I’ve seen how racial and ethnic disparities not only harm the people experiencing them but also weaken the entire system. Our report shows even high-performing states are not immune,” Dr. Joseph Betancourt, president of the Commonwealth Fund, said in a statement.

In Minnesota, 24 percent of Hispanic adults are uninsured compared to 13 percent of uninsured Black adults and 7 percent of Asian American, Native Hawaiian and Pacific Islander adults.

Data from every state indicate that premature deaths and avoidable deaths — defined as those occurring before the age of 75 from preventable causes or treatable conditions like diabetes and certain cancers — are more prevalent among Black individuals than among other racial and ethnic groups. However, the highest rates of premature deaths are found among the American Indian and Alaska Native population in Minnesota.

The authors of the report noted that racial disparities in the U.S. health care system are among the most persistent and well-documented issues. They referenced landmark studies showing that these disparities continue to exist, even when accounting for factors such as insurance coverage, income level and access to care. 

The root causes of these disparities are complex and multifaceted, they said, including the enduring effects of structural racism, the impact of social determinants of health, variations in health coverage and unequal treatment within the healthcare system.

In order to address these issues, researchers suggest implementing policies that ensure affordable, comprehensive and equitable health insurance coverage for all, strengthening primary care services and protecting access to preventative care.

Laurie Zephyrin, senior vice president of achieving equitable outcomes at the Commonwealth Fund, said in a statement that examining state-level health care reveals significant disparities in the quality of care received by different populations.

“Those differences are not random,” Zephyrin said. “They track along racial and ethnic lines in every state, and the federal policy changes now underway will make it harder to improve health for everyone. But this report also shows that state policy choices matter: when states invest in coverage and care, people benefit.”

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Erica Zurek

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Racial disparities in the U.S. healthcare system are among the most persistent and well-documented issues.

A health care professional performs check ups on patients.

Minnesota among top health systems, yet racial gaps remain stark

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