By expanding access to private insurance through state health exchanges, improving access for more people who live in poverty through Medicaid expansions, and other reforms, more than 32 million uninsured Americans will gain coverage. All of these provisions would improve the current state of health care for people of color, who are disproportionately un- and under-insured and who face greater barriers than whites to receiving high-quality care, even when insured.
Many other provisions of the ACA have great potential to reduce the risks that make people sick in the first place. These provisions—particularly those that invest in prevention and improving the distribution of health care resources—can significantly improve opportunities for good health for all Americans, and particularly people of color.
A major reason why health inequalities persist is because of differences in the neighborhoods of minorities and non-minorities. Research shows that racial and ethnic minorities are more likely than whites to live in segregated, high-poverty communities, communities that have historically suffered from a lack of health care investment, so they have fewer primary care providers, hospitals, and clinics. To make matters worse, many of these communities face a host of health hazards—such as high levels of air, water and soil pollution, and a glut of fast food restaurants and liquor stores—and have relatively few health-enhancing resources, such as grocery stores where fresh fruits and vegetables can be purchased.
Several provisions of the ACA, such as the authorization to expand the National Health Service Corps, which provides incentives and removes barriers for health care providers who want to work in medically underserved communities, and the Prevention and Public Health Fund, the first mandatory funding stream aimed at improving the public’s health, will directly address these place-related barriers to good health.
Consistent with today’s ruling, efforts to improve opportunities for good health and improve health equity can—and must—be increased. Government at all levels can, for example, improve health opportunities by stimulating public and private investment to help make all communities healthier. They can do so by creating incentives to improve neighborhood food options, by aggressively addressing environmental degradation, and by de-concentrating poverty from inner-cities and rural areas through smart housing and transportation policy.
Given that by the year 2042, according to the U.S. Census Bureau, half of the people living in the United States will be people of color, it is imperative that we be prepared to address the health needs of an increasingly diverse population. Lawmakers should continue to focus on the goal of health equity – a goal that is not only consistent with the American promise of opportunity, but in our long-term economic interest, as well.
Brian Smedley is a vice president at the Joint Center for Political and Economic Studies, a Washington think tank, and director of its Health Policy Institute.