Arkansas ranks worst in the nation on health system performance for Hispanic residents, according to a new report that found existing racial and ethnic health disparities are likely to worsen in every state under recent federal policy changes.
About half of Hispanic children in Arkansas received timely preventive medical and dental care, according to the report, released Wednesday by The Commonwealth Fund, a private foundation that promotes a high-performing healthcare system. By comparison, more than nine in 10 Hispanic children in states like Vermont received timely care.
Dr. Joseph Betancourt, president of The Commonwealth Fund, said the report is being released at a time when efforts are underway to limit the collection of data by race and ethnicity.
“We know you cannot fix what you cannot measure, and without this data we lose our ability to identify who’s being left behind and then be able to direct resources where they will have the greatest impact to eliminate gaps,” Betancourt told reporters Tuesday. “This is a basic tenet of quality of care.”
The report used 24 measures to evaluate healthcare access, quality, use of services and health outcomes for Asian American, Native Hawaiian and Pacific Islander, American Indian and Alaska Native, Black, Hispanic and white populations.
Arkansas ranked 48th among states on health system performance for its white population.
The disparities identified in the report “are longstanding and persistent,” Betancourt said.
“To understand why this is the case, we must recognize that disparities are multifactorial, rooted in coverage differences, differences in the quality of care people receive, and also different experiences of the conditions that shape health long before someone ever walks into a hospital or doctor’s office,” he said.
The study uses data from 2023 and 2024 and does not reflect recent shifts in federal policy, including Medicaid funding cuts and tightened eligibility, restrictions barring most legal immigrants and asylees from marketplace and Medicaid coverage, and the expiration of enhanced premium tax credits in the marketplaces.
It’s likely these changes have worsened existing disparities and will widen them, according to the report.
Nationwide, rates of people skipping needed care because of costs hit record lows in 2021 and 2022 but are rising again, with Hispanic and American Indian and Alaska Native communities seeing the steepest increases.
Kristen Kolb, a research associate and report author, said this is the result of a pandemic-era Medicaid policy that kept beneficiaries continuously enrolled and other coverage enhancements at that time. Those gains have declined as those coverage expansions have been pulled back in recent years, she said.
In 43 of 50 states where data is available, Hispanic adults were the most likely to go without care they couldn’t afford, according to the report. In most states, they were also the most likely to lack a regular source of care.
“Having a usual source of care is associated with the use of preventative health services and better health outcomes,” Kolb said. “These findings reflect the intertwined relationship of insurance coverage, affordability and access to care.”
Health systems in Arkansas, Mississippi, Oklahoma and West Virginia performed poorly across all groups measured. Compared to other Southeast states, Arkansas has more severe racial and ethnic health disparities.
The report found that health system investments and state policy decisions, including whether to expand coverage, are linked to how large disparities are and whether they are narrowing or widening.
The report’s authors suggested that policymakers consider steps in five areas to improve their state’s health systems:
- Devote resources to address health-related social needs such as housing, economic stability and paid family leave
- Ensure affordable, accessible and equitable healthcare coverage for all
- Strengthen primary care and improve care delivery in communities with fewer healthcare providers
- Protect access to preventive services
- Ensure digital health tools and artificial intelligence are designed and deployed equitably
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