Despite Gov. Gretchen Whitmer’s best efforts, racial disparities in Michigan’s health care system persist and are among the worst in the country.

The Commonwealth Fund 2024 State Health Disparities Report released Thursday ranks Michigan 29th out of 39 states analyzed for health care received by Black residents. When Whitmer took office, The Commonwealth Fund’s 2019 scorecard ranked the state 26th out of 51 states and the District of Columbia for health care disparities, suggesting things have gone from bad to worse for Black Michiganders during her tenure.

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The 2024 report shows health system performance for white residents was also “worse than average,” while the best performance in Michigan was for Asian Americans/Native Hawaiians/Pacific Islanders, which scored in the 84th percentile among population groups in the U.S., the Detroit Free Press reports.

“Compared to other states in the Great Lakes region, Michigan has more severe racial and ethnic health disparities,” the report read.

Michigan has one of the highest rates nationally for premature deaths from avoidable causes for Black residents at 647.8 per 100,000, behind only Mississippi, Wisconsin, and the District of Columbia, according to the 2024 report.

Michigan also has the second highest rate of Black Medicare beneficiaries admitted to a hospital for conditions “that can typically be managed through good primary care,” according to The Commonwealth Fund. That rate was 65.7 per 1,000 Black Medicare beneficiaries. Only Indiana’s rate of 75.2 per 1,000 is higher.

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It’s a similar deal for avoidable emergency department visits, with Michigan’s rate of 225.1 out of every 1,000 Black Medicare beneficiaries the 12th worst in the nation.

“This report demonstrates that if you don’t look under the hood, you won’t identify where you’re failing people and where you’re leaving people behind,” said Joseph Betancourt, president of the Commonwealth Fund, told the Free Press.

Instead of delving into the root issues involved, the Whitmer administration has focused on mandating annual implicit bias training for medical licenses, a move some health professionals and academics argued would do little to change the dynamic.

“The evidence shows that training in implicit bias can make a positive difference, so today we are taking action to help improve racial equity across Michigan’s health care system,” Whitmer said when she issued an executive directive in 2020 that required the training for all health professionals.

Herbert Smitherman, a professor of internal medicine at Wayne State University, offered a different assessment at the time in comments to the Detroit Free Press.

“We’re dealing with explicit structural and systematic racism. You don’t deal with explicit bias within society with implicit bias training and believe that that’s going to solve anything because the disparities — health, social and economic — within the American society over the last 30 to 40 years have continued to increase between Blacks and whites,” he said. “It is increasing as we’re doing implicit bias training.”

“Education and training never hurts,” he said. “But if you’re asking me whether it’s going to improve the structural racism, the systemic integrated policies or social policies that are impacting Black people and brown people all over the state of Michigan and the country, I don’t think it is going to do a lot.”

Others in the medical community have spoken out about the underlying premise of implicit bias training: that racist white professionals treat Black patients differently others.

“The idea of implicit bias is grounded in the belief that white people treat those who aren’t white worse than those who are. It’s part of the woke assumption that society, including healthcare, suffers from ‘systemic racism,’” Laura Morgan, an RN who quit her 39-year career over mandated implicit bias training, wrote in a 2022 column for the Wall Street Journal.

“Policy makers don’t seem to be considering the unintended consequences of these mandates,” she wrote. “Accusing my peers and me of racism will contribute to soaring levels of burnout, causing many to leave the medical profession. Some, like me, will surely be forced out. Patients, especially minorities, will experience the most harm.”