Advancing Racial Equity in U.S. Health Care: The Commonwealth Fund 2024 State Health Disparities Report

For nearly two decades, the Commonwealth Fund has tracked health and health care in each state, seeking both to understand how the policy choices we make affect people’s health outcomes and to motivate the change needed to improve the health of all communities across the United States. But assessing how well a state performs on average can mask the profound inequities that many people experience.

This report evaluates disparities in health and health care across racial and ethnic groups, both within states and between U.S. states. We collected data for 25 indicators of health system performance, specifically focusing on health outcomes, access to health care, and quality and use of health care services for Black, white, Hispanic, American Indian and Alaska Native (AIAN), and Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations. We then produced a health system performance “score” for each of the five racial and ethnic groups in every state where we were able to make direct comparisons between those groups and between groups in other states. (For complete details on our methods, see How We Measure Performance of States’ Health Care Systems for Racial and Ethnic Groups.)

Our hope is that policymakers, health system leaders, and community stakeholders will use this tool to investigate the impact of current and past health policies on different racial and ethnic groups and to take steps to ensure an equitable health care system for the future.