PHOTO | Courtesy of Blue Cross Blue Shield of Massachusetts Foundation
Audrey Shelto, president and CEO of the Blue Cross Blue Shield of Massachusetts Foundation
Updated: June 26, 2023
Viewpoint
Viewpoint: Health inequities are a $6B economic problem
By Audrey Shelto
Health care is a point of pride in Massachusetts. The industry is a major driver of our economy, accounting for about one in every five jobs. We have major academic medical centers and a world-class biotech base pushing the boundaries of medicine. Our state led the way on health reform, providing near-universal coverage while inspiring the Affordable Care Act, improving access for the nation.
Progress on these fronts was never easy but made possible because of a sense of shared responsibility that permeated the partnerships necessary to get the job done. That sense was present again on June 13 at the inaugural Health Equity Trends Summit in Boston, a diverse convening of hundreds ranging from hospital CEOs to social workers.
Those present were committed to – or perhaps recommitting to – addressing the vexing problem of health disparities and racial inequities persisting in health care. Despite years of national research and local studies, we have made some progress around the margins but we are nowhere near where we want to be. A new data point put it bluntly: The economic burden due to health inequities experienced by communities of color total nearly $6 billion a year in Massachusetts.
At the summit I shared the story of Dudley Flood, an educator and administrator tasked with desegregating schools in North Carolina in the late 1960s – some 15 years after the passage of Brown v. Board of Education, the landmark civil rights case supposed to put an end to such racial segregation. The unflappable Flood said when faced with any dilemma, we should ask ourselves three questions: What? So what? Now what?
The first question we have been asking ourselves for a long time: What is causing racial disparities and inequities in health? While the answers are complex, we now recognize the underlying problem: structural racism permeates nearly every aspect of our society, including the healthcare system. The second question – so what? – has been answered strongly, time and again. People of color are not afforded the same opportunities to live healthy lives, and as a result they are sicker and dying younger. While that moral imperative may move us, it is not moving us fast or far enough. That is why we added another response – the economic imperative – to the so what question. We now better understand how racial inequities in health are a major burden on the economy.
Now what? Flood said the key to achieving desegregation in North Carolina’s schools was helping people learn how to work together. We know how to do that in Massachusetts. Our history of working together on health reform gives me hope we can do so again. We can harness that same political will, innovation, energy, and persistence to right these wrongs.
Audrey Shelto is president and CEO of the Blue Cross Blue Shield of Massachusetts Foundation, a private, nonprofit organization whose mission is to ensure equitable access to health care for those who are economically, racially, culturally, or socially marginalized.
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