LEARNING AREA: Health Equity
Front cover of 'Medicaid as a Multiplier"

Medicaid as a Multiplier






In the United States, the COVID-19 pandemic not only brought longstanding health inequities to greater awareness, but also exacerbated them, to devastating effect. Black, Native American/Native Alaskan people, and Hispanic/Latinx people were hospitalized at nearly four times the rate of white-identified counterparts. Black and Native American/Native Alaskan people were nearly two times as likely to die from COVID-19 as white people of a similar age. These COVID-19 outcomes are an extension of other health inequities: looking at life expectancy alone, Black men live ten years less than white men, and men with the highest 1% of incomes can expect to live 14.6 years longer than those in the bottom 1%.3 While factors within healthcare systems directly contribute to these inequities, for some time, there has been a growing recognition of the importance of addressing health inequities “upstream.” Some have estimated that only 15% of health outcomes are determined by the healthcare system, while the remaining are the result of social, environmental, and economic factors. These factors are collectively called social determinants of health (SDoH), and are defined by the World Health Organization (WHO) as the “conditions where people are born, grow, live, work, and age.”