Kentucky residents of color continue to face significantly worse health outcomes than their white neighbors, according to a new Commonwealth Fund report released Wednesday. The Commonwealth Fund 2026 State Health Disparities Report shows Kentucky trailing the nation in multiple health metrics across racial and ethnic groups.

Black babies in Kentucky die at rates more than twice those of white infants, with 10.4 deaths per 1,000 live births compared to 5.5 for white Kentucky babies. Hispanic infant mortality stands at 7.2 per 1,000 live births, exceeding the national rate of 5. These disparities stem from social determinants of health, structural racism and provider bias, experts say.

"Maternal mortality and the disparities we see are one of the starkest examples of the inequities, and also the one that shows, I think, the most promising opportunity to resolve," said Dr. Laurie Zephyrin, senior vice president for achieving equitable outcomes with the Commonwealth Fund.

The report identifies additional troubling gaps across Kentucky. Black Kentuckians experience 262 potentially avoidable emergency department visits per 1,000 people ages 65 and older, compared to 176 for white residents—both above national averages. Hospital readmission rates within 30 days also show stark disparities: 51 per 1,000 for Black patients versus 33 for white patients.

Insurance coverage remains a critical barrier. Hispanic Kentuckians face the highest uninsured rates, with 34% of Hispanic adults and 11% of Hispanic children lacking coverage, compared to 8% and 4% respectively for white Kentuckians. Nationally, rates are 23% for Hispanic adults and 10% for Hispanic children.

Kentucky's health challenges extend beyond insurance access. Flu vaccination rates vary by race, with 42% of white Kentuckians receiving recent shots, 40% of Black residents, 37% for Asian Americans and Pacific Islanders, and just 29% for Hispanic Kentuckians. Smoking rates also exceed national averages, with 17% of white Kentucky adults and 16% of Black adults smoking, compared to national rates of 12% for both groups.

Dr. Joseph Betancourt, president of the Commonwealth Fund, warned that federal policy changes threaten to worsen disparities. Affordable Care Act subsidies expired at year's end 2025, and Kentucky's ACA enrollment has dropped to approximately 89,000 for 2026, down from 97,000 the previous year.

Congressional action has also strained Medicaid, which covers nearly one in three Kentuckians. Congress cut Medicaid spending by $880 billion over 10 years in 2025, threatening coverage for vulnerable populations. Betancourt emphasized that addressing these disparities requires robust data collection. "We know you cannot fix what you cannot measure," he said, noting efforts to limit race and ethnicity data collection "will further disenfranchise vulnerable communities."

Solutions exist, experts agree. Ensuring access to midwifery services and doulas, expanding health coverage, and ensuring consistent quality care delivery across racial groups are critical steps. Zephyrin called for systemic commitment: "We know what to do. We know how to do it. We just need to do it the same for everybody."