The ACA led to major reductions in uninsured individuals in all racial groups. Between 2013 and 2016, the uninsured rate for Hispanic Americans decreased from 26% to 17%. Furthermore, the uninsured rate for Black Americans decreased from 17% to 12% between 2013 and 2016. During this time, the uninsured rate among White and Asian populations both lowered to 8%, with the uninsured rate for the Asian population starting at 15% and the uninsured rate for the White population starting at 12% in 2013.
Jim Crow laws represented a formal, codified system of racial apartheid that dominated the American South for nearly a century beginning in the 1890s. The presence of Jim Crow laws led to segregation and the disenfranchisement of Black Americans. The laws mandated segregation of every aspect of daily life including parks, schools, restrooms, trains, and restaurants. A commonly overlooked effect of Jim Crow is the segregation of hospitals and medical facilities. During the Jim Crow era of segregation, many hospitals, clinics, and doctor’s offices were totally segregated by race. Furthermore, several medical facilities maintained separate wings or medical staff that could never be intermingled under the law.
Because of historical structural violence, present racist structures, and racial disparities in income, Black Americans are still less likely to have access to high quality medical care today. Research has shown that Black patients tend to live closer to higher quality hospitals than White patients but are 25% to 58% more likely than White patients to receive surgery at lower quality hospitals. This startling statistic shows that the medical system is still haunted by the Jim Crow era, with Black Americans often having restricted access to higher quality healthcare. Unfortunately there is a gap in the research literature on segregated hospitals, but we can still conclude that restricted access to quality healthcare may be a contributing factor to many of the racial health disparities that Black Americans face from maternal mortality to life expectancy.
- Penson, D. F. (2013). Re: Black Patients More Likely than Whites to Undergo Surgery at Low-Quality Hospitals in Segregated Regions. The Journal of Urology, 190(6), 2211. doi:10.1016/j.juro.2013.07.080