Insights

The racial implications of medical debt: How moving toward universal health care and other reforms can address them

By Andre M. Perry, Joia Crear-Perry, Carl Romer, and Nana Adjeiwaa-ManuOctober 05, 2021

Higher rates of COVID-19 infection among essential and frontline workers put a spotlight on underinsured laborers. Essential workers—those who perform a range of jobs and services that are necessary for society to function well, including but not limited to occupations in health care, food service, and public transportation—are less likely to have insurance and are more likely to be underinsured than non-essential workers. However, a 2020 Brookings report found that Black essential workers are more likely to be uninsured than white essential workers. Similarly, an Urban Institute analysis found that Black workers are more likely to be essential and frontline workers (a sub-category of essential workers comprised of people who cannot work from home), and they are more likely to be underinsured. The Urban Institute study adds that the problem of not having adequate insurance is even more acute for American Indian or Alaska Native and Latino or Hispanic workers. In order to achieve equity for the lowest paid and most essential frontline workers of color, the American health insurance and health care systems need a radical restructuring.

 

 

The concentration of Black people in essential jobs did not develop through happenstance. Racism in labor markets is revealed in racial disparities in occupational concentration, employment rates, and pay. For instance, Black people in Minneapolis, as in much of the nation, are more likely to work in jobs considered essential—transit, factories, retail, health care facilities, and childcare—which increases their exposure to COVID-19. In the state of Minnesota, Black people make up 7% of the total population, and account for approximately 25% of all COVID-19 infections as of the summer of 2020, according to a University of Minneapolis study. There is a causal relationship between wealth and quality of life outcomes, including health. Wealth is the sum of all assets owned minus debt held—a person’s net worth. Occupational discrimination factors into how much wealth a family has and the resultant degree of protection a family has to withstand inevitable economic shocks.

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