Tennessee health equity report focuses on racial disparities in outcomes

Staff photo / Alexandria Montgomery and La'Nita Montgomery get their photo taken at a booth during a breast cancer awareness event at Hamilton Place mall in Chattanooga in 2018.

A new health equity report from BlueCross BlueShield of Tennessee details how race and social factors impact six areas of health ranging from maternal health and cancer to mental health and COVID-19.

Data in the report came from a combination of public data sources and de-identified population data from about 2 million people insured through BlueCross BlueShield of Tennessee, which is the state's largest health insurer.

Some of the key findings include wide disparities in pregnancy-related deaths and breast cancer mortality between Black and white women and that Indigenous people in the state experience more poor mental health days than any other racial group.

The report also found Black adults in Tennessee are 40% more likely to have high blood pressure and less likely to have it under control than white adults and Hispanic people accounted for 8% of COVID-19 deaths among Tennesseans 40 years and younger.

"We definitely saw health disparities exacerbated during the COVID-19 crisis, and we felt a call to really do something about that ourselves," Dr. Andrea Willis, chief medical officer for BlueCross BlueShield of Tennessee, said via phone. "So we wanted to just lay bare the data that we had in house that shows how we're tracking and across the metrics, but it also shows opportunities where we can all come together to close gaps in care."

Sherri Zink, chief data and engagement officer for BlueCross BlueShield of Tennessee, said maternal health and ensuring that pregnant women are receiving the right pre- and post-natal care is one aspect of the report currently receiving a lot of attention.

(READ MORE: Tennessee among worst states for maternal health before abortion ban enacted)

  photo  Staff photo / LaQuisha Cousin is shown a scavenger hunt map by Catharine Wells, the director of corporate marketing at CBL, during a breast cancer awareness event at Hamilton Place mall in 2018.

The report found that for pregnancy-related deaths, mental health contributed to 27% of deaths, substance use contributed to 26% and obesity contributed to 24%.

"So we definitely are connecting into that and really looking at how we move the needle on those maternal health metrics," Zink said.

In terms of cancer, Black women in Tennessee have the ninth highest rate of death from breast cancer in the nation, according to the report. Black Tennesseans are also three times more likely than white people to die due to cervical cancer, while Hispanic people are twice as likely to die.

After digging more into the data, Willis said it was interesting to see that even though certain groups were undergoing a fair amount of screening for various diseases -- such as cancer or diabetes -- that didn't always result in better outcomes.

"Sometimes we may see screening that looks OK, but then when you look at the big picture -- the health outcomes -- you still see those disparities," she said. "So I think this will help us focus in -- first of all, we want everybody to get to screening -- but what happens between screening and the care that people receive?"

The need to increase childhood vaccination rates is another area highlighted by the report that Willis said needs extra focus.

Data in the report is based primarily on the calendar year 2021, and the plan is to continue releasing these reports on an annual basis, Zink said.

"We have gotten a lot of inquiries about looking at this from a regional perspective within the state of Tennessee. We're still exploring that opportunity," she said.

Overall, Willis said she hopes the report helps shed light not only on areas of focus to improve the health of Tennesseans but the role that health insurers and other stakeholders have in public health.

"I think that we have to expand the definition of who public health entities are," she said. "It's not just the health departments -- it's really every stakeholder that should be around the table to improve the public's health.

"So we're sharing our data that's unique to us. It's data that we uniquely collect," Willis said. "We want that part of the data to be a part of the bigger picture."

Contact Elizabeth Fite at efite@timesfreepress.com or 423-757-6673.