Black Americans face a unique set of health challenges. April is Minority Health Awareness Month, and we are exploring the health problems affecting black Medicare beneficiaries.
In 2017, nearly 90% of black people reported having health insurance, slightly less than 93% of white Americans. Overall, almost 45% of African-Americans signed up for government health insurance that same year, while 12% did not.
Now let’s break down the numbers of Americans (based on ethnicity) who have health coverage.
|Race / ethnicity||All Traditional Medicare Beneficiaries (32.4 million)||Medicaid (7.0 million)||Employer Insurance (9.6 million)||Medigap (9.5 million)||Other Coverage (0.3 million)||No Supplemental Coverage (n=6.1 million)|
Research shows black Americans are at higher risk for health problems, including strokes, heart disease, COVID-19, among others. They also reportedly have higher numbers of health issues overall compared to white Americans and other races/ethnicities.
Stroke Mortality of Black Medicare Beneficiaries
The Centers for Disease Control and Prevention reports someone dies from a stroke every four minutes. For black Medicare beneficiaries, the survival rate after ten years is lower than other races.
Researchers at Yale University studied Black Medicare beneficiaries (ages 65 and older) enrolled in the federal government program. They discovered black patients die within a decade of having an ischemic stroke. An ischemic stroke is blocked blood flow to the brain.
According to the study, the death rate for black patients is 76.4% compared to white beneficiaries at 75.4%. This study showed 70.3% for those of other races or other ethnic groups.
Researchers studied data for more than 744,000 Medicare beneficiaries treated in U.S. hospitals for ischemic stroke between 2005 and 2007.
Patient files analyzed over a period of ten years found:
- Despite making adjustments for preexisting health problems, the death rate for black patients was 4% higher than white beneficiaries.
- The risk of dying was nearly 8% lower for other races.
- The death rate from ischemic stroke for black Medicare beneficiaries increased within the first year after being discharged from the hospital. Those differences continued over the next ten years.
Lead researcher and professor Judith Lichtman said future research needs to examine the difference in death rates between black Medicare beneficiaries and lower among white patients and other races. Lichtman expressed it comes down to overall health and medical treatment within the first year.
“We need to take a closer look at the recovery period and think about how we can optimize secondary prevention and post-stroke care for everybody. Stroke care during the first year after a stroke plays an important role in the long run.”
COVID-19 Concerns Among Black Medicare Beneficiaries
Over the course of the pandemic, COVID-19 has disproportionately affected black Americans, prompting emergency measures and widespread vaccination efforts. A 2021 article published by KFF, a non-profit organization that focuses on health, reported that older black Medicare beneficiaries have higher rates of COVID-19 hospitalizations and deaths. Other studies back this claim, concluding minorities are twice as likely to die from the virus.
The Centers for Medicare and Medicaid Services has been investigating the health disparities since the start of the pandemic.
Here are the facts:
- Black people enrolled in Medicare are nearly 4 times more likely to be hospitalized with the virus versus white patients.
- Hispanic and black Medicare beneficiaries test positive for COVID-19 at higher rates.
- Low socioeconomic status and racial disparities are behind the staggering numbers.
Researchers say it comes down to vaccination hesitation. This includes concerns over side effects & misconceptions about the shot. This is in addition to socioeconomic status and lack of access to health care. While Telehealth services have reached many communities of color, it’s still not enough. We will address how poverty and lack of education continue to affect the black community.
Addressing Black Medicare Beneficiaries Mental Health
For decades, generational trauma, racism, and lack of adequate insurance have plagued mental health in the black community. Reports show 20% of black people experience psychological distress and 50% are less likely to receive treatment.
Black adults (ages 18-25) live with crippling mental health issues, such as depression and anxiety compared to their white counterparts. Fortunately, conversations around mental health have changed in the past several years. For many Millennials, social media has empowered them to find their voices and form online communities. Today, the media portrayals in shows like HBO’s “Insecure” normalize therapy and mental health.
Millions of Americans have reported feelings of sadness and extreme anxiety during the Covid-19 pandemic. In response, Medicare has made policy challenges to boost access to mental health services. This includes more access to outpatient mental health visits and more financial coverage options.
Black Americans Dying Faster From Cancer
Breast cancer may be killing black women at faster rates compared to white women. Researchers said black women do not receive routine mammograms, increasing their chances of developing cancer. A study published in Annals of Internal Medicine followed black and white women (65 years and older) from 10 states.
They discovered only 12% of black women visited their primary care doctor compared to 20% of white women. Researchers also noted a large gap in the number of both groups who had had a mammogram. For white women, that number was 15% compared to 9% of Black women.
Black Women & Breast Cancer
- African-American women received 26% fewer mammograms than white women.
- Black Medicare beneficiaries and elderly persons, who are disadvantaged, undergo more non-elective surgical procedures that are associated with poor management of chronic disease.
- Researchers believe having health insurance would boost the number of black women getting mammograms.
According to the American Cancer Society, cancer is one of the biggest killers in the black community.
Cancer Facts & Figures
Over the past several decades the cancer mortality gap between black Medicare beneficiaries and white Medicare beneficiaries has narrowed. But the African-American community is still dying at higher rates in comparison to all races.
According to the CDC, black men are twice as likely to die from prostate cancer. They also have higher occurrences of prostate, lung, and colorectal cancers, which made up for a quarter of new cases. Outside of breast cancer, black women also made up more than half of all new cancer cases. This includes both lung and colorectal cancer.
Black Americans also are at the greatest risk for renal disease due to diabetes, high blood pressure, and heart disease. They are also three times higher to suffer from kidney failure, according to Kidney.org.
High blood pressure remains the second leading cause of kidney failure among African-Americans. The good news is that the overall cancer death rate in the Africa-American community has dropped since 1990. Studies estimate that in the last 25 years almost half a million cancer deaths in the black community were avoided.
How Poverty & Discrimination Impacts Black Beneficiaries
The Century Foundation, a public policy research institution, reported that African-Americans live longer but experience lower life expectancy. The CDC said the social factors that contribute to the health disparities are unemployment, smoking, obesity, not owning a home, and not being able to afford medical costs.
The African-American community is one of the most economically disadvantaged demographics in the U.S. Despite federal health programs, people living in improvised communities and older black adults living in rural areas are the most vulnerable.
According to a 2013 Medicare study, black patients lived closer to higher quality hospitals (compared to white patients) but underwent surgery at low-quality hospitals. It’s also been documented that those black Medicare patients had higher chances of dying after major surgery.
A recent study by the Urban Institute underwritten concluded that minorities encounter racism when seeking medical attention.
- 10.6% of black adults reported experiencing discrimination based on race, ethnicity, disability, gender, sexual orientation, or health condition.
- 7.9% of African-American adults felt discriminated against, compared to 3% of all adults question.
- Higher numbers were reported among low-income black adults (14.5%) and black women (13.1%).