Lots of people in this country don’t have access to quality medical care or mental health care. And those inequities are expensive for society.

According to a new report from Deloitte and the Meharry School of Global Health, inequities in mental health will cost the U.S. more than $477 billion this year. And that number could rise to almost $1.3 trillion a year by 2040. 

People of color, women and low-income people face the biggest inequities when it comes to mental health and accessing mental health care. That can, in turn, affect their physical health.

“Those with mental health conditions have a more difficult time managing chronic conditions,” said Dr. Jay Bhatt with the Deloitte Center for Health Solutions and Health Equity Institute. “And that can spiral out of control if the mental health condition isn’t treated.”

When conditions spiral out of control, people often end up sicker and their health care costs more.

Excess medical care is just one part of the economic cost of mental health inequities, said Darrell Gaskin at the Johns Hopkins Bloomberg School of Public Health.

“But also, illness and sickness hinders their ability to work,” he said.

So, lost productivity in the labor market is another cost. “And then the last part is premature death. And death is expensive,” said Gaskin.

Add up those three things and you get that $477 billion.

The biggest factors in determining someone’s health outcomes have to do with where they live. Investing in things like housing, education, food and medical care makes a big difference, per Thomas LaVeist at the Tulane School of Public Health and Tropical Medicine.

“Whenever we talk about addressing inequities in health, the response is always, ‘Well that costs money,'” he said.

But, LaVeist added, doing nothing costs a lot too.