New BlueCross Tennessee health equity report highlights disparities in maternal care, childhood vaccines

New BlueCross Tennessee health equity report highlights disparities in maternal care, childhood vaccines

BlueCross BlueShield Tennessee’s latest health equity report shows that racial and social factors continue to impact health outcomes for many Tennesseans, particularly in areas such as childhood immunizations and maternal care.

“A lot of health care actually happens outside of the clinic,” BlueCross Chief Medical Officer Dr. Andrea Willis said at Thursday’s Chattanooga Rotary Club meeting. “You go home. Place, who you live with, where you work, your community — all of those things have an impact.”

At Thursday’s meeting, Willis and other BlueCross officials presented findings from the insurer’s second annual health equity report. Sherri Zink, chief data and engagement officer at BlueCross, said the report aims to leverage BlueCross’ vast trove of member data to uncover disparities in care, identify barriers to care and focus interventions by providers or other stakeholders.

“From a data perspective, when we address a person’s health care needs, we’re looking at them from the perspective of the whole person,” she said. “In order for us to truly understand where we can step in and help individuals, we have to understand that information and get it to the right parties.”

(READ MORE: Tennessee Kindergarten Vaccination Rate Hits New Low, Needs Action, Report Says)

Last year’s report showed a decline in childhood immunization rates, and Zinke said that continued in this year’s report despite growing focus on reversing the trend.

For business members, Asian children were 59.3% more likely to be vaccinated as children, followed by white children (54%), Hispanic children (48.7%) and black children (44.6%), the report said.

For BlueCare plan members, BlueCross’ Medicaid plan, those numbers are lower. Among these members, Hispanic children were 41.3% more likely to receive routine vaccines, followed by Asian children (40.5%), white children (27.5%) and black children (18.7%).

(Read more: COVID-19 makes racial health disparities more stark in Chattanooga, U.S.)

Willis noted that BlueCross’ data is based on the number of claims the insurance company receives for health care services and that there are other ways for children to get vaccinated, such as through local health departments.

“But based on what we’re saying, it leads us to believe that kids are not getting as much routine immunization as they used to,” she said, adding that the drop in vaccinations begs the question: “What’s going on?”

For example, maybe providers aren’t promoting vaccines in the same way or practicing “culturally competent care” — a term used to describe culturally sensitive and equitable health care — she said.

“Because, a lot of times, if people don’t feel respected in the health care system, in the provider’s office, then they’re not going to continue to show up,” Willis said. “When we don’t see claims, we need to ask questions. We can’t assume it’s just patients not pursuing claims. What is the provider community doing as well?”

Maternal health is another area of ​​focus when it comes to improving disparities, especially among the Medicaid population, Zinke said.

For BlueCross Medicaid members, black, Asian and Hispanic women were all less likely to receive prenatal care in the first trimester than white women, the report said. In terms of postpartum care, 78% of Asian members, 74.3% of Hispanic members, 68.1% of black members and 68.1% of white members received care within 90 days of delivery.

Other BlueCross findings:

— Pregnant black patients are 2.3 times more likely to die than white patients.

— 27% of pregnancy-related deaths are attributable to mental health.

— Drug use causes 39% of all pregnancy-related deaths.

— In Tennessee, members of Hispanics are the least likely of all racial groups to receive colorectal cancer screening at the recommended age.

— Members with disabilities are 60% more likely to experience transportation-related problems.

— Black members are four times more likely to be at risk of debt burden than white members.

— Black members are 2.5 times more likely to experience risks associated with unreliable transportation.

Contact Elizabeth Fite at [email protected] or 423-757-6673.

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