新摩根健康- norc分析发现，美国人在雇主赞助的保险中存在广泛的健康差异

Washington, D.C., July 25, 2022 – Many Americans who depend on employer-sponsored health care are managing complex, 昂贵的健康状况和面临重大差距在诊断和疾病管理跨种族, ethnicity and income levels, 根据摩根健康和芝加哥大学NORC的一项新分析. Further, for employed individuals with low- and moderate-incomes, the high cost of care and insurance, including deductibles and out-of-pocket costs, forced many to forgo or delay necessary medical treatments.

超过1.5亿美国人依靠雇主赞助的医疗保险(ESI). While the national focus on health inequities has centered on the U.S. population at large, 由于历史数据的差距和分析跨种族健康结果的局限性，ESI登登者的健康状况尚未得到很好的了解, ethnicity and income.

“这些发现为商界领袖敲响了警钟，提醒他们注意全国劳动力中存在的严重健康差异,” said Dan Mendelson, Morgan Health CEO. “商界有责任理解和认识到这些差异, and more importantly, act to eliminate them. 这将需要卫生计划和提供者积极参与，以缩小差距并改善健康结果.”  

摩根健康- norc的分析反映了来自三个具有全国代表性的ESI登记者的最新数据, public surveys and national vital statistics records. 这些发现为COVID-19发病前的健康结果和差异提供了重要的快照. 一些最显著的差异似乎与收入差异有关, while others vary by race and sexual orientation, even when controlling for other factors. 

Key Findings:

• 慢性疾病的负担在不同种族之间差异很大，数据显示某些患者群体的关键疾病诊断不足.
  • Blood pressure: 60.4 percent of Black enrollees, 40.7 percent of Asian enrollees and 44.2 percent of Hispanic enrollees had high blood pressure, compared to 46.0 percent of white enrollees. After adjusting for age and sex, Black enrollees were 16.7 percentage points more likely to have high blood pressure than white enrollees. Furthermore, Black enrollees were 15.他们患高血压的可能性比白人高6个百分点.
  • Diabetes: Compared to white enrollees, Asian, Hispanic and Black enrollees were more likely to have diabetes by 6.9 percentage points, 5.6 percentage points, and 5.3 percentage points, respectively, after adjusting for age and sex. 亚洲人未确诊糖尿病的比率大约高出3个百分点, Hispanic and Black enrollees than white enrollees.
  • Obesity: 42.8 percent of enrollees were classified as obese. After adjusting for age and sex, Black enrollees were more likely to be obese than white enrollees by 13.6个百分点，而亚裔参保者肥胖的可能性比白人员工低26个百分点.2 percentage points.
• 种族间剖宫产(C-section)分娩率的广泛差异强化了ESI市场内持续存在的孕产妇健康差距. 研究表明，剖腹产可显著降低高危产妇的发病率和死亡率. However, when performed in low-risk situations, 剖腹产会增加感染和血栓的风险，并可能导致不必要的产后并发症，包括死亡.
  • The analysis showed that 20.1 percent, 17.7 percent, and 17.0 percent of low-risk deliveries among Black, Asian and Hispanic enrollees, respectively, were performed via C-section, compared to a rate of 13.6 percent among white enrollees.
  • After adjusting for differences in age, Black, 低风险怀孕的亚裔和西班牙裔参试者比白人参试者更有可能接受剖腹产.5, 3.9, and 3.4 percentage points, respectively.
• Behavioral health and substance use issues were prevalent among all enrollees, however, 对女同性恋者来说，这些问题的严重程度和相关结果有明显的不同, Gay or Bisexual enrollees. 
  • The overall rates of anxiety and depression within ESI were 13.3 percent, and 14.1 percent, respectively. After adjusting for age and sex, white enrollees were more likely than Black, Hispanic and Asian enrollees to experience serious psychological distress, by 2.0 percentage points, 1.8 percentage points, and 5.2 percentage points, respectively.
  • 报告有严重心理困扰的女同性恋、男同性恋或双性恋参保者的比例为12%.1 percentage points higher, the rate of anxiety was 16.6 percentage points higher and the rate of depression was 18.在调整了年龄和性别后，比直接参保者高出4个百分点.
  • 19.8%的参保者使用烟草制品(包括吸烟、吸电子烟、嚼烟).1 percent reported heavy alcohol use, and 18.8 percent used illicit drugs, such as marijuana, cocaine, crack, heroin, misuse of pain relievers, stimulants, and tranquilizers, to name a few. 西班牙裔参选者中酗酒人数最多，而白人参选者中吸毒人数最多.
• Despite perceptions around the robustness of coverage within ESI, enrollees experience significant barriers to accessing care, 特别是对于那些种族/少数民族背景和低收入或中等收入的个人.
  • Specifically, 6.9 percent of enrollees reported missing medical care due to cost, 9.8 percent reported missing prescriptions due to cost, and 11.9 percent reported difficulty paying medical bills. These numbers vary widely by income.
  • While nearly all enrollees (91.5 percent) reported having have a usual source of care, 分析显示急诊科(ED)使用率(护理可及性的代理指标)存在显著差异.
  • After adjusting for age and sex, Black enrollees were 4.9 percentage points more likely than white enrollees to have visited an ED; in contrast, Asian enrollees were 4.5 percentage points less likely than white enrollees to have visited an ED.
  • 在调整了年龄和性别之后，最低收入阶层(低于5万美元)的参保人数为7%.1 percentage points more likely than enrollees in the highest income bracket ($150,000 or more) to have visited an ED.
• Even with employer-sponsored coverage, 一些参保人的社会需求未得到满足，这可能进一步加剧健康结果方面的差距.
  • More than 7 percent of enrollees were food insecure. After controlling for age and sex, 黑人和西班牙裔参保者比白人参保者更有可能处于食品不安全状态.8 and 6.0 percentage points, respectively).

As part of its commitment to improving the quality, equity and affordability of employer-sponsored health care, 摩根保健公司正在开发新的负责任的保健模式和质量措施，目的是减轻任何观察到的差距. For example, 我们与Kaiser Permanente的合作将包括两家公司共同收集和报告加州澳博官方网站app员工的健康权益指标，并计划从2023年开始在某些质量指标上引入与健康权益相关的绩效保证.

To view the full report, click here. To view the Executive Summary and FAQ, click here and here.

About Morgan Health

摩根健康是澳博官方网站app的一个业务部门，专注于改善雇主赞助的医疗保健. Through its investments and the advancement of accountable care, Morgan Health is working to improve the quality, 为澳博官方网站app员工提供公平和负担得起的雇主资助的医疗保健, their families and the U.S. health system. The business is led by Dan Mendelson, CEO of Morgan Health, reporting to Peter Scher, Vice Chairman of JPMorgan Chase & Co. and a member of the firm’s Operating Committee. Morgan Health is headquartered in Washington, D.C. Visit morganhealth.com

About NORC at the University of Chicago

芝加哥大学的NORC进行决策者信任的研究和分析. 作为一个无党派的研究机构和衡量和理解世界的先驱, 80多年来，我们研究了人类经历的几乎每一个方面和每一个重大新闻事件. Today, we partner with government, corporate, 以及世界各地的非营利客户，为社会面临的关键决策提供必要的客观性和专业知识.
www.norc.org