By Dr. Joseph Webb

Thirty million Americans live in “healthcare deserts,” with eight in ten U.S. counties lacking the ability to provide basic health services to their populations. When it comes to health equity, the problem is even more significant. According to the Commonwealth Fund’s Scorecard on State Health System Performance, every state in the U.S. is falling short in the area of racial and ethnic health equity: “Mirroring the nation as a whole, substantial health and health care disparities exist between white and Black, Hispanic, and AIAN communities in nearly all states.”

For individuals who lack access to basic and preventative care, whether from a lack of insurance, living in a healthcare desert or another socioeconomic factor, the result is the same: Poor outcomes. Across the nation, people of color are more often impacted than Whites. According to the Department of Health and Human Services Office of Minority Health, Black Americans are at greater risk for “COVID-19, heart disease, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide” than White Americans. Life expectancy from birth for Black men is 66.7 years versus 73.7 for White men and 74.8 for Black women versus 79.2 for White women.

Health equity in Tennessee
Tennessee ranked 44th in the nation for overall health in 2023, and 15th for the number of counties designated as healthcare deserts, with 23 of our state’s 95 counties included. This number represents more than a third of Tennessee’s population or 2.5 million individuals.

Across the state, 17.6% of Black Tennesseans have diabetes compared to 13.7% of Whites. According to TN.gov, diabetes is the fourth leading killer of Black Tennesseans, who are also more likely to experience hospitalization and complications like “heart disease, stroke, blindness, lower limb amputations and severe kidney disease” than are White Tennesseans. The same is true here in Nashville, where Black Americans have higher rates of chronic conditions like diabetes, hypertension, respiratory issues, and obesity compared to White Americans.

Non-Hispanic Black women in our state are 2.3 times more likely to die from pregnancy-related causes than White women. Between 2017 and 2021, non-Hispanic Black women experienced 78.2 pregnancy-related deaths for every 100,000 live births, while White women experienced 32.9. Non-Hispanic Black infants are nearly four times more likely to die from low birthweight and other complications and 2.9 times more likely to die of sudden infant death syndrome than non-Hispanic whites.

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