Healthcare lags for Black, Hispanic and Native American Oregonians

This story was originally published by The Lund Report, an independent nonprofit health news organization based in Oregon. It is republished with permission. You can reach Mike Francis at mike@thelundreport.org.

Oregonians of color generally have higher rates of infant mortality, get fewer flu and pneumonia vaccines, and are more likely to forgo care because of cost than white Oregonians, according to a new report.

And Oregonians who are Black, Asian, Native American and white are all have higher-than-national rates of preventable deaths before age 75. Only Oregonians who are Hispanic outperform the national average for preventable deaths among Hispanics. Further, the health system in Oregon performs dramatically less well for Native Americans compared to their peers in neighboring states.

The findings emerge from the latest annual report from the Commonwealth Fund detailing health disparities between states, produced by the nonprofit research organization focused on healthcare.

Nationally, researchers found that people of color generally lag behind white Americans in terms of access to healthcare, quality of treatment and health outcomes. The disparities, according to Commonwealth, are “persistent and widespread” throughout the country.

Oregon is no different. Healthcare performance for Black, Hispanic, and Native American Oregonians lags that of white residents, with only the Asian-American-Native-Hawaiian-Pacific-Islander group reaching comparable, even slightly better levels. Oregon’s peer states in the West — Alaska, California, Hawaii, Nevada and Washington — have smaller gaps between white residents and other ethnic and racial groups.

“Compared to other states in the West region, Oregon has more severe racial and ethnic health disparities,” the report notes.

But that is largely a function of the disproportionately poor metrics for access, quality and outcomes among Native Americans, said Commonwealth Fund Senior Scientist David Radley. “If you take … the indigenous population out of the picture, the gaps between Hispanic, Black, Asian and white are actually relatively small compared to the rest of the country.”

In terms of preventable deaths, Commonwealth Fund researchers aggregated data from roughly 80 diagnoses, from suicides to alcohol use disorder, so it’s challenging to deduce a single explanation for the higher rates among people of color. As an example, Oregon has a higher-than-average rate of deaths from drug overdoses than many states; that’s one of the drivers of the overall results for all ethnic groups.

Researchers examined health data from each state, comparing infant mortality, rates of mammogram screening, numbers of people going without insurance coverage because of costs and 21 other measures to complete the state-by-state analysis.

The data is drawn mostly from 2023 and 2024, which covers part of the pandemic era and the post-pandemic rollback in enhanced benefits. It does not include the significant health and immigration policy changes that have occurred in the second Trump administration, including the expiration of enhanced health insurance subsidies and increased immigration enforcement. These changes, the report notes, “have likely worsened — and are on track to further exacerbate — existing racial and ethnic disparities in access, affordability, and outcomes.”

“The disparities we are bringing into the spotlight today are not inevitable,” said Joseph Betancourt, M.D., president of The Commonwealth Fund. “They are shaped by policy choices and health system decisions that can be changed.”

Among the Oregon-specific findings:

• While it lags its peer states in the West, on a national level healthcare outcomes in Oregon are better-than-average for Asian-American-Native-Hawaiian-Pacific-Islander, Black, Hispanic and white residents. Again, it rates much worse than the national average for Native American residents. (White people make up about 70 percent of the state’s population, while Hispanic Oregonians, the next-largest group, amount to about 16 percent of the state’s residents. Indigenous people amount to less than 1 percent.)
• Despite the generally better-than-average performance, some critical measures of healthcare outcomes trail national averages. For example, Asian-American, Native American, Black and white people in Oregon all have higher-than-peer-average rates of preventable deaths before the age of 75. Only Hispanic residents, with 132 deaths per 100,000 population, outperform the national average among Hispanic people.
• Among adults aged 19-64, Oregon has a better-than-average rate of people covered by health insurance. Yet the percentages of people who went without healthcare because of its cost is roughly equivalent to the nationwide figures.

“Yes, Oregon has good coverage rates overall, but people can be insured and still be underinsured,” Radley said. “They could be insured but have a deductible that puts healthcare services out of reach.”

Commonwealth Fund officials sounded an alarm about how well researchers will be able to collect and analyze future ethnic and racial data. They noted that federal support for data collection and research is in decline, particularly for measures of race and ethnicity. Staff cuts in the Department of Health & Human Services and other agencies raise questions about how well they will be able to monitor future measures of health outcomes, access and quality data. Without good data, the researchers said, disparities will be obscured and accountability will be at risk.

“You cannot fix what you cannot measure,” said Betancourt.

This republished story is part of OPB’s broader effort to ensure that everyone in our region has access to quality journalism that informs, entertains and enriches their lives. To learn more, visit opb.org/partnerships.