BCBST Report Reveals Racial Care Disparities Among TN Residents

BlueCross BlueShield of Tennessee (BCBST) has published its first health equity report, revealing the racial care disparities that Tennessee residents face in behavioral healthcare, maternal healthcare, cancer care, and more.

The payer analyzed data from publicly available sources and BlueCross members who receive coverage through their jobs, independently, or through the state Medicaid plan. The report focuses on how racial and social factors influence health outcomes in six areas: behavioral health, cancer, child and adolescent well-care, chronic condition management, COVID-19, and maternal health.

“We wanted to get a better picture of the health issues and barriers to care faced by our members and Tennesseans as a whole, so that we could more effectively partner with healthcare providers to address those issues,” Andrea Willis, MD, chief medical officer of BCBST, said in the press release.

“Understanding this data helps support progress that will ultimately deliver better health for everyone, regardless of their background.”

The report found stark racial care disparities in all focus areas.

Since 2014, the drug overdose rate among Black adults has risen by 270 percent, compared to 58 percent for White Tennesseans. Additionally, Indigenous residents reported 10 days per month of poor mental health, which is more than any other racial or ethnic group.

Black women in Tennessee have the ninth highest death rate from breast cancer in the US, and only 63 percent of Black Tennesseans ages 50 and older were screened for colorectal cancer.

In addition, Black Tennesseans are three times as likely to die of cervical cancer compared to their White counterparts, and Hispanic individuals are twice as likely as non-Hispanics to die.

Screening rates for colorectal, breast, and cervical cancers were generally lower among those who receive coverage through TennCare, the state’s Medicaid program, compared to commercial plan members, the report noted. This difference was consistent across all racial and ethnic groups.

Black children and teens are twice as likely to die than White children and teens in Tennessee. Further, Black children were 40 percent less likely than White children to be vaccinated against the flu in 2021.

Tennesseans face disparities in maternal health as well. Mental health contributed to 27 percent of all pregnancy-related deaths. Similarly, substance abuse contributed to 26 percent of deaths and obesity contributed to 24 percent of deaths.

What’s more, Black patients were two and a half times more likely to have a pregnancy-related death than White patients.

The report found that Black women in Tennessee are twice as likely to die from diabetes than White women. Black adults are also 40 percent more likely to have high blood pressure and less likely to have it under control than White adults.

The COVID-19 pandemic unearthed significant care disparities across the country, and Tennessee was not immune to these disparities.

Black Tennesseans accounted for nearly 30 percent of COVID-19 deaths among residents 50 years and younger. They also accounted for 21 percent of COVID-19 hospitalizations. Additionally, only 46 percent of Black residents are vaccinated—the lowest rate among any demographic category in the state.

Hispanic Tennesseans accounted for 8 percent of COVID-19 deaths among residents 40 years and younger.

Data from NORC at the University of Chicago revealed that employer-sponsored health plans, in particular, lack health equity. Employees experienced care disparities in chronic conditions, maternal health, and behavioral health.

Payers have worked to reduce care disparities and improve health equity among their member populations.

For example, Humana recently dedicated funding to community-centered organizations and evidence-based programs that aim to eliminate healthcare barriers for seniors, veterans, and children. Specifically, the payer’s initiative focuses on reducing food insecurity.