For the last couple weeks, we’ve been covering racial bias in AI on the podcast, and today I wanted to broaden out Research Corner to focus on some other aspects of racial disparities in health care. As always, if you’ve got feedback or ideas for other studies to feature, email me at  sshah@tradeoffs.org.

New Insights into Racial and Ethnic Health Disparities​

Health researchers in this country pay significant attention to race and ethnicity, with good reason. From deadly childbirth outcomes occurring more often among Black mothers to higher infection rates among Hispanic dialysis patients, there’s broad proof of disparities in health and outcomes.

Last month, economists Jevay Grooms and Hannes Schwandt added to the conversation when they hosted the 2023 Racial and Ethnic Health Disparities conference for the National Bureau of Economic Research (NBER). The convening touched on a wide range of topics including kidney transplants, technology adoption, law enforcement and more.

I wanted Tradeoffs readers to hear from Jevay about some of the emerging research and other discussion topics that came out of the conference.

Shah: Among the papers presented, are there any studies that you’re still thinking about weeks after the meeting ended?

Grooms: A couple really stood out. One early unpublished analysis by David Cutler and others looked at how health outcomes in the U.S. have changed among and within different racial groups – including Black, white and Hispanic Americans. 

They used a measure of life expectancy called a ‘QALE’ that considers quality of life and found that the gap in QALE between white and Black Americans shrunk [by almost 30 percent from 2000 to 2019.] The researchers’ early analysis suggests one big reason for this shift could be improvements in educational access across the U.S.

The authors said they next plan to break some of these trends down by gender as well.

Another great working paper by Amy Finkelstein and colleagues found differences in living arrangements [e.g., apartment, single family home] and the nature of work [e.g., occupation, ability to work from home] explained 15 percent of the difference in death rates between Hispanic and white Americans during the COVID pandemic. 

Shah: Economics as a field has notoriously struggled with diversity. For example, in 2021, only 3 percent of economics PhD recipients were Black. Did the meeting address the diversity of the researchers themselves who study health disparities?

Grooms: Something that Hannes and I really pushed for at this conference — and that the NBER supported — was to invite current PhD students from underrepresented racial and ethnic backgrounds.

We had 15 to 20 PhD students who attended in person through the American Economics Association Mentoring Program, which helps increase diversity in the academic pipeline.

We also brought people from other disciplines in — sociology, public health, global health — to offer a different perspective and ensure we’re framing race and ethnicity properly. Because as economists, we’re often not trained on racial disparities, yet we do that work.

Shah: If you had a “call to action” for your colleagues to research one or two major, unanswered questions around the topic of health disparities, what would they be? 

Grooms: I think there’s so many — whether we’re talking about substance use and mental health, which I work on, or maternal mortality among Black and white women. 

As we wrapped up, Jevay also told me about another insight  from the conference: a featured study by Itzik Fadlon and colleagues showing that Black and Hispanic patients were much less likely to use a specific heart monitoring technology.

It underlines the need to investigate what drives low technology adoption for these groups. Without those insights, as policymakers and payers begin to make rules around telehealth and other pandemic-era technologies permanent, they risk exacerbating disparities rather than improving them.