The Agency for Healthcare Research and Quality (AHRQ) released the 2022 National Healthcare Quality Disparities Report.
The 20th annual report to Congress tracks the health care system’s performance on over 440 metrics across six quality priorities: patient safety, person-centered care, care coordination, effective treatment, healthy living, and affordability of care. This year’s report is the first in the series to include data collected in 2020 and show the impacts of the COVID-19 pandemic on quality and inequities in health care. Notably, the report found that life expectancy in the United States decreased for the first time in 2020 and that the decline was greater for Hispanic and non-Hispanic Black groups than for non-Hispanic White groups.
Other major findings from the report include the highest percentage of people under 65 with health insurance recorded since the inception of the report in 2003, but that “people in low-income households, minority communities, and ‘inner city’ and ‘rural’ communities are less likely to have health insurance coverage.” Overall, the report found that racial and ethnic minority communities only have similar outcomes to non-Hispanic White communities for only under half of quality measures. Distressingly, researchers found that for many measures inequities are not improving or are worsening when comparing 2020 (or 2019, if 2020 data was not available) to prior benchmark years.
The report also detailed significant improvements in care for people with breast cancer, colon cancer, heart failure, and HIV/AIDS, which AHRQ attributes to investments in science and health care delivery. For breast cancer and HIV/AIDS, while care has improved across all groups, researchers found that “gains experienced by disadvantaged populations have been insufficient to close the gap.” Specific to breast cancer, the report also noted that Hispanic and non-Hispanic Black people continue to experience worse care on most measures.
The report also presented data in four “Special Emphasis Topics” chosen as priority issues for the Biden-Harris administration and the Department of Health and Human Services: maternal health, child and adolescent mental health, substance use disorders, and oral health. Findings include:
- The overall maternal mortality rate increased in 2020 compared to 2019.
- Maternal health inequities varied by outcomes — the report found that rates of cesarean deliveries in first-time, low-risk pregnancies, severe maternal morbidity, and preeclampsia/eclampsia were higher among non-Hispanic Black people than non-Hispanic White people and that non-Hispanic Asian or Pacific Islander people had higher rates of severe postpartum hemorrhage.
- The suicide rate among adolescents (ages 12-17) increased over 70% between 2008 and 2020, which was greater than the increased suicide rate for the overall population (roughly 16% increase in that same time).
- Inequities in adolescent mental health include a higher suicide rate for non-Hispanic White adolescents compared to Hispanic and non-Hispanic Black adolescents, though Hispanic adolescents had lower access to depression treatments than their non-Hispanic White peers.
- Deaths related to opioids increased for all groups and in all rural-urban locations, though they were highest in American Indian or Alaska Native, non-Hispanic Black, and non-Hispanic White communities compared to Hispanic and non-Hispanic Asian communities.
- Though 1 in 7 people overall were unable to get or were delayed in getting necessary dental care, inequities for children appear to be narrowing. Outcomes for non-Hispanic Black and Hispanic children and for children in the lowest income households improved faster than outcomes for non-Hispanic White children and those in the highest income households.