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Oregon performs better in health equity, but disparities remain

A new national state scorecard confirms dramatic inequities, finds regional variations
A critical care nurse at OHSU receives a vaccine during the height of the COVID-19 pandemic. | COURTESY OHSU
April 23, 2024

Racial disparities are vast across the nation and in Oregon, a new report shows. But the statistics reveal some surprising differences among states.

In some statistics that measure outcomes for different racial and ethnic groups, Oregon, like Washington, does better than most states. In other measures, it does worse.

For the first time in three years, The Commonwealth Fund, a nonprofit health care research and advocacy group, has issued its state-by-state measurements of health care disparities. The report compiled data on 25 health care measures tracking outcomes, quality, access and use of services by five different racial and ethnic groups — Black, white, Hispanic, American Indian and Alaska Native, as well as Asian American, Native Hawaiian and Pacific Islander. Researchers then aggregated them to create what amounts to a scorecard.

The report is called Advancing Racial Equity in U.S. Health Care: The Commonwealth Fund 2024 State Health Disparities Report. Its findings are similar to earlier research from 2021 that found the performance of Oregon’s health system as experienced by different groups tended to be better in some measures than most states.

But there are still major problems, according to David Radley, the longtime leader of The Commonwealth Fund’s scorecard project. Two years ago he joined the Center for Evidence-Based Policy at Oregon Health & Science University as its director of data and analytics.

“There are still big disparities” in Oregon, he said. “There's still a lot of improvements to be made.”

For instance? For Black people in Oregon, the rate of deaths before age 75 for causes that are treatable through health care is 141 per 100,000. For white people, however, the rate is slightly less than half that: 69 per 100,000.

Meanwhile, the proportion of people who reported skipping needed health care due to cost was 7% for white people, but double that or more for people who are Black, Hispanic or American Indian and Alaska Native.

The statistics are more complex than they seem on the surface, according to Radley. In effect, they measure not just the provision of health care but the effects of social factors that contribute to health outcomes, such as access to healthy food and stable housing. Other reports, by The Commonwealth Fund as well as the Coalition of Communities of Color in Oregon, have focused on issues like structural racism.

Asked about the study, state Rep. Ricki Ruiz, a Gresham Democrat, said he thinks improvements need to be a priority in access to primary care, affordability and interpreter services. With parents that moved to the United States from Mexico, he served as the family interpreter with health care providers starting when he was six years old — and not exactly fluent in health care terms.

 “As a first-generation citizen, one of the things we always struggled to navigate was the health care system,” he said. “Disparities still exist. And that is something that is alarming. That is something we need to continue to study—  to be able to minimize that as much as we can.”

State measures show ranking

The report provides a state-by-state overview of statistics and their rankings among states (and Washington, D.C.) where sufficient data was available in all categories for that group. 

It found that Oregon and Washington score similarly to one another when it comes to measures broken down by race and ethnicity. And they do better than most other states.

For people who are Asian American, Native Hawaiian, and Pacific Islander:

  • In health outcomes, Washington ranked 13th and Oregon 19th. among 33 states.
  • In health care access, Washington ranked 5th and Oregon 7th among 34 states.
  • In health care quality, Washington ranked 15th and Oregon 16th among 41 states.

For people who are American Indian and Alaska Native:

  • In health outcomes, Washington ranked 4th among 10 states while Oregon data was insufficient.
  • In health care access, Washington ranked 3rd among 11 states while Oregon data was insufficient.
  • In health care quality in 11 states, Washington ranked 8th among 11 states while Oregon data was insufficient.

For people who are Black:

  • In health outcomes, Washington ranked 4th and Oregon 9th among 40 states..
  • In health care access, Washington ranked 19th and Oregon 22nd  among 40 states.
  • In health care quality, Oregon ranked 11th and Washington 28th among 41 states.

For people who are Hispanic:

  • In health outcomes, Oregon ranked 3rd and Washington 9th  among 49 states. .
  • In health care access, Washington ranked 18th and Oregon 22nd among 48  states.
  • In health care quality, Oregon ranked 10th and Washington 21st among 48  states.

For people who are White:

  • In health outcomes, Washington ranked 12th and Oregon 21st among 50 states plus Washington, D.C.
  • In health care access, Washington ranked 15th and Oregon 26th among 50 states plus Washington, D.C.
  • In health care quality, Washington ranked 14th and Oregon 24th among 50 states plus Washington, D.C.

According to Radley, the findings for Oregon call for making health care more affordable, while also focusing on strengthening the state’s provision of primary care. 

That includes ensuring access to care with community health workers and providers that speak the same language as the patient.

“That's one of the best tools we have to fight these kinds of disparities,” he said.

You can reach Nick Budnick at [email protected] or via @NickBudnick.


Submitted by Debra Bartel on Tue, 04/23/2024 - 16:26 Permalink

Filling out yet another form will not help these disparities.  All that does it frustrate patients and steal time away from what should be spent with the providers they are able to see.  REALD is a huge waste of money and hasn't made ANY positive changes.  When asked about the data and what we're doing about the disparities it shows, OHA tells us "oh we don't see any changes for at least 20 years".  That is ridiculous and just shows how poorly this expensive program was designed and implemented.  There are much better ways to gather this critically needed data.  Inaccurately translated forms is just scratching the surface.