A Commonwealth Fund report released April 18 revealed health disparities between white and Black populations in Wisconsin. The Commonwealth Fund showed white Wisconsin residents rank in the 82nd percentile for health care performance, compared to Black individuals who rank in the 14th percentile for health care performance — one of the lowest rankings in the country, according to the report.
Researchers assessed health and healthcare performance by examining health outcomes, healthcare access and the use of healthcare services, according to the report.
Many historic policies still influence health disparities in Wisconsin today, University of Wisconsin Collaborative Center for Health Equity Administrative Manager Amy Filut said.
“When it comes to health disparities, there are many facets to consider,” Filut said. “A lot of different systems are informed by the biased, discriminatory and racist practices of the past.”
For example, redlining, established in the 1920s and 1930s, confined certain groups to neighborhoods with poor air quality or close to other forms of pollutants, Filut said.
It is commonly believed that health outcomes are primarily driven by healthy behaviors and clinical care, professor emeritus in the UW Department of Family Medicine and Community Health and founding director of the Wisconsin Center of Health Equity Geoffrey Swain said.
“We say if you behave yourself — that is, you exercise, you eat right, you wear sunscreen, you wear your seatbelt, et cetera — you’re going to be healthy,” Swain said. “The problem with that story is that it’s partly right, and it’s partly wrong.”
These habits account for about half of the modifiable determinants of health, Swain said. The other half is encompassed by social and economic factors like employment, reliable transit, social support and community safety, Swain said.
While healthcare is important, it only accounts for 20% of health outcomes — underscoring a clear distinction between health and healthcare, Swain said.
Expanding diversity within healthcare training could help alleviate health disparities, Filut said. Healthcare workers’ education often focuses on one demographic of patients, but it is crucial that all backgrounds are represented.
“One example is that when you look at your textbook, and you’re looking at pictures of eczema, is it showing eczema on white patients or are they including what eczema looks like on darker skin?” Filut said.
Medical studies often represent white male patients, Filut said. As such, a resulting treatment for eczema — or any other medical condition — could be effective for white male individuals, but healthcare professionals may not know its effects on people of different genders, ethnic or racial backgrounds, Filut said.
UW’s School of Medicine and Public Health was ranked the 18th most diverse medical school in the country in 2023, according to U.S. News. The rate of enrollment of students from marginalized racial and ethnic groups has increased from about 24% in the fall of 2020–21 to about 39.7% in spring 2023–24, according to the UW–Madison Enrollment Report.
The importance of healthcare workforce diversity lies partly in the necessity for patients from diverse backgrounds to trust and relate to their providers, Swain said. Diversity can also help patients and providers overcome their own unconscious biases, Swain said.
“We get to see that people who are different than us can still be just as competent,” Swain said. “[Diversity] matters on the patient experience side and it matters on the provision of care side.”
Future medical professionals can learn about the importance of health equity through the programs offered at UW SMPH, Filut said. Students can apply for the Wisconsin Partnership Program, a funding agency that supports health equity research efforts, Filut said. Additionally, the university offers three professional development programs — Advancing Diversity and Equity in Pre-doctoral Trainees, Advancing Health Equity and Diversity, and Success Together Reaching Independence, Diversity and Empowerment — geared toward improving health equity and diversity, Filut said.
Advancing medical education on diversity and equity is only one piece in reducing health disparities, Swain said. Students at any university should concern themselves with identifying which demographics experience limited access to the social and economic factors that drive health outcomes because these discrepancies affect everyone, Swain said.
Both federal and state governments incur significant costs due to health disparities, Filut said. Racial health disparities in the U.S. lead to about $93 billion in additional medical care costs and a $42 billion loss in productivity each year, according to the American Heart Association.
Students can work to improve health equity by voting in elections for candidates who will support the existing programs and initiatives that address disparities in Wisconsin, Filut said. Health inequity affects everyone regardless of the demographic it directly disadvantages, so all individuals are encouraged to strive for change, Filut said.
“In reducing health disparities, it’s not just helping a single person or single group,” Filut said. “In the end, it helps everyone. If you could play a role in supporting the health of everybody — I feel like that’s a worthwhile effort, and it’s something to be proud of.”
