The NCSL Blog

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By Tammy Jo Musgraves

Health disparities—differences in health and health care experienced by groups based on social, economic and environmental factors—persist across the nation.

Dr. Ala Stanford administers a COVID-19 swab test outside Pinn Memorial Baptist Church in Philadelphia last month. Stanford and other doctors formed the Black Doctors COVID-19 Consortium to offer testing and help address heath disparities in the African American community. Matt Rourke/The Associated PressEach year, health disparities lead to significant human and financial costs as certain people experience poorer living conditions, manage chronic illnesses and have more difficulty accessing health care services and treatment than other population groups.

Health disparities can be found in the United States based on age, sex, income, disability status, sexual orientation, language, geographic location and other factors. They are measured as differences in health status or treatment outcomes between population groups in areas such as mental or physical health, disease or illness, injury and disability, and life expectancy. A disparity exists when a certain demographic or cultural group experiences negative health status at a greater rate than another group.

Health disparities are in the spotlight as the COVID-19 pandemic disproportionately affects certain populations. While the general population is susceptible to contracting COVID-19, the Centers for Disease Control and Prevention (CDC) has identified people most at risk for longer hospitalizations and premature death are those who have chronic conditions, are uninsured, distrust the health care system and therefore will not seek treatment, experience language barriers, are essential workers, don’t have sick leave or live in densely populated areas. 

According to the CDC, long-standing systemic health and social disparities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age. As of June 12, the CDC reported:

  • Hospitalization rates are highest among non-Hispanic American Indian or Alaska Native and non-Hispanic Black persons.
  • Non-Hispanic American Indian or Alaska Native persons experience a rate approximately five times that of non-Hispanic white persons.
  • Non-Hispanic Black persons have a hospitalization rate approximately five times that of non-Hispanic white persons.
  • Hispanic or Latino persons have a rate approximately four times that of non-Hispanic white persons.

State Action

In recent years policymakers have recognized the disparities experienced by various populations and related financial costs to the health care system and state. A 2017 report by NCSL highlights different state actions regarding health disparities legislation related to:

  • Improving access to health care services.
  • Increasing health care workforce diversity and cultural competency.
  • Addressing disparities in chronic disease and other health conditions racial and ethnic minorities experience.
  • Supporting task forces, committees or research focused on health disparities.
  • Addressing social determinants of health.

In the wake of COVID-19, and the evidence highlighting health disparities among minority populations, several states have changed data reporting requirements, passed legislation, issued executive orders and declared racism as public health crisis as a means to spur change across all sectors.  

According to a May report by Princeton University, approximately 17 states are now providing information about the distribution of cases by race and ethnicity compared to the underlying population distribution to better understand how COVID-19 affects certain populations. In their COVID-19 data reporting, 47 states report on race, while 44 report on ethnicity; a significant increase from 27 and 21, respectively, in April.

In June, the New York Senate passed SB 8245A. This act requires the department of health to conduct a study on the health impacts of COVID-19 on racial and ethnic minorities in New York. The short-term goal of this act is to identify ways to reduce and eliminate disparities that contribute to COVID-19 infection, hospitalization, recovery and mortality. Long-term, the state plans to use this information to make recommendations for legislative or other actions to reduce or eliminate racial and ethnic disparities and increase access to health care services.

Governor Mike DeWine of Ohio and Governor Jon Bell Edwards of Louisiana created task forces in April to examine the impacts of COVID-19 and health disparities. DeWine formed the Minority Health Strike Force after data from the Ohio Department of Health illustrated 21% of individuals who have tested positive for COVID-19 are African American and make up approximately 14 percent of Ohio's population. 

In Louisiana, Edwards created the Louisiana COVID-19 Health Equity Task Force to address racial disparities related to the COVID-19 pandemic. The governor allotted $500,000 from the governor’s coronavirus relief fund to the task force to examine the causes and identify possible solutions for the high rate of deaths within the state’s African American community and other affected populations.

Health disparities are the result of a complex array of factors, including social, economic and environmental conditions. State leaders are at the forefront of innovative health policy development, and policy is a key part of the context that affects health disparities.

Tammy Jo Musgraves is a policy specialist in NCSL's Health Program.

Email Tammy Jo

This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

Posted in: Health, COVID-19
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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.