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Unequal treatment: States with the greatest costs


Health care expenses, lost productivity, premature deaths are adding up to billions in costs for the nation, a new study says.

Unequal treatment of patients based on race, ethnicity, and socioeconomic status is costing the United States billions of dollars a year.

A new study aimed to quantify the financial cost of disparate treatment, based on three components: excess medical care expenditures, lost labor market productivity, and premature death.

The estimates are a range because researchers used different data sets to tally them – and they are all expensive.

As of 2018, the estimated burden of racial and ethnic health inequities ranged from $421 billion to $451 billion. Based on education-related inequities, the costs ranged from $940 billion to $978 billion – the latter figure being about twice as large as the annual growth rate of the U.S. economy for the same year.

The National Institute on Minority Health and Health Disparities (NIMHD) commissioned the study and compiled the figures with Tulane University School of Public Health and Tropical Medicine, Johns Hopkins Bloomberg School of Public Health, Uniformed Services University, TALV Corp., and the National Urban League.

“The exorbitant cost of health disparities is diminishing U.S. economic potential,” NIMHD Director Eliseo J. Pérez-Stable, MD, said in a press release. “We have a clear call to action to address social and structural factors that negatively impact not only population health, but also economic growth.”

“The Economic Burden of Racial, Ethnic, and Educational Health Inequities in the US” was published in JAMA. The Tulane University Institute for Innovation in Health Equity has created a website,, dedicated to the research.

This slideshow presents the 17 states where the economic burden of racial and ethnic health inequities, with education-related health inequities, totaled $10 billion or more, based on 2018 data.

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