Health care system in Arizona works best for whites, worst for Native Americans, report says

Wide racial and ethnic disparities exist in how the health care system works in Arizona, a new report shows.

White people and Asian Americans experienced the highest health system performance in Arizona, the report by the Commonwealth Fund found. Native American, Latino and Black people experienced the lowest performance.

"There's just a lot of disparity in Arizona," said David Radley, a senior scientist at the Commonwealth Fund, a nonprofit research group that concentrates on health care issues. "If you are a white person in Arizona, things are pretty good from a health care perspective" compared with other racial and ethnic groups in the state.

When compared with white people in other states, however, white people in Arizona also don't fare well in health system performance, the report found.

The health system performance for Native Americans in Arizona was particularly alarming. Native Americans in Arizona scored in the fourth percentile compared with all people in all states, the lowest of any racial or ethnic group in Arizona by far, the report found.

Latinos scored in the 18th percentile, the report found. Black people scored in the 23rd percentile.

The health care system in Arizona works best for white people and Asian Americans, who scored in the 73rd percentile and 66th percentile, respectively, in health system performance, the report found.

The report recommends four broad policy goals: ensuring affordable, comprehensive and equitable health insurance coverage for all; strengthening primary care; lowering administrative burdens for patients and providers; and investing in social services.

The disparities in health system performance are not unique to Arizona. The disparities exist even in states where the overall health system performance is the highest, including Massachusetts, Minnesota and Connecticut, said Joseph Betancourt, president of Commonwealth Fund.

The report measured health system performance for each racial and ethnic group based on data from the 2020 and 2021 years for multiple health categories, including health outcomes such as death rates from treatable and preventable causes; access to health care; and quality of health care received.

The report found a wide racial divide in premature deaths from preventable and treatable causes in Arizona, especially among Native Americans.

The death rate for Native Americans in Arizona for deaths before age 75 for preventable causes was 766 per 100,000 people, that report said. That is nearly twice as high as Native Americans in other states and more than three times higher than the U.S. overall, the report said.

The high number of preventable deaths among Native Americans in Arizona partially reflected the COVID-19 pandemic, which hit the Navajo Nation, the largest of Arizona's 22 tribes, especially hard, Radley noted.

When compared with other states, Arizona ranks in the bottom half of states for health system performance for all racial and ethnic groups, including white people, the report found.

Arizona ranks 31st out of 51 states for health system performance for white people, the report found. Whites make up about 53% of the state's population.

Arizona ranks 35th out of 47 states where calculation was possible for health system performance for Hispanic people, the report found. Latinos make up about one-third of the state's population.

Of the 10 states where calculation was possible for Native Americans, Arizona ranked sixth, the report found. Native Americans make up about 5% of Arizona's population of 7.4 million.

And finally, the report found that Arizona ranks 28th out of 39 states for health system performance of Black people and 20th out of 31 for Asian Americans. Black people make up 5.5% of the population and Asian Americans about 4%, according to census data.

The health inequities found in the report are not new and are rooted in past and current local, state and federal policies, the report said.

The research underscores the need for action to address health disparities, said Laurie Zephyrin, senior vice president for advancing health equity at the Commonwealth Fund.

This article originally appeared on Arizona Republic: Arizona health care: Report finds wide inequities in performance