Unequal Health Outcomes in the United States: A Report to the U.N. Committee on the Elimination of Racial Discrimination, National Health Law Program (2008)

This report provides an in-depth analysis of the overwhelming racial disparities in health care access and treatment in the United States, and approaches the problem as a human right violation. The report describes the massive health care disparities in general health as well as areas such as HIV, reproductive health, and infant mortality. For example, the age-adjusted death rate for cancer was 25% higher for African Americans than white Americans in 2001; African-American women are our times more likely to die in childbirth than white women; and African-American women are infected with HIV at a rate 23 times that of white women and comprised 66% of new HIV infections among women in 2005.

The report analyzes contributing factors to these disparities—such as discrimination, health-care providers’ attitudes, lack of access to health care, pollution and toxic waste, social and economic barriers, and the criminal justice system—and the government policies that create and maintain these factors—including Medicare and Medicaid policies, interpretations of Civil Rights statutes to limit remedies, welfare reform policies, and the underfunding of programs intended to assist the poor and minorities to obtain health care. The report argues that these policies violate the United States’ obligation under the Convention on the Elimination of all Forms of Racial Discrimination (CERD) to undertake to prohibit and eliminate racial discrimination in all its forms in the right to public health and medical care, including the underlying determinants of health. The report outlines specific policy steps that the United States must take in order to address these disparities and comply with its obligations under CERD.