Health inequities span from the cradle to the grave, in the form of higher rates of infant mortality, chronic disease, disability and premature death among many racial and ethnic minority groups. A large volume of research demonstrates that these inequities persist even after socioeconomic factors — such as income and education levels — are considered. For example, African American mothers with a college degree experience infant mortality at rates higher than white mothers who have less than a high school education.

Many affected populations also face barriers to health care services, which further increases risks born by segregation and poverty concentration. These circumstances include poor geographic access to full-service grocery stores; higher rates of exposure to fast food; environmental degradation; crime and violence; and the stresses associated with these examples, as well as many others.

The Affordable Care Act, signed into law by President Barack Obama just over a year ago, is an important first step toward eliminating these inequities. Every credible analysis shows that this measure will improve access to health care and stimulate public health strategies to keep communities healthy, which have the greatest potential to reduce health inequities. It will expand access to health insurance, improve the distribution of health care resources in underserved communities and stimulate federal research on health inequities — among many other provisions that help ensure that all Americans have an opportunity to live healthy lives. 

But the law is only one element of what must be a multi-faceted solution. Success will require  public-private partnerships, a reality that received a big shot in the arm when the Obama administration released, for the first time in federal government history, a national strategy — the —  to eliminate health inequities.

At the same time, the Department of Health and Human Services released an , that coordinates the department’s goals and actions to reduce health inequities. This plan is aligned with the national strategy to expand its impact.

Their release was particularly significant given that the month’s dominant health policy news story was the House Republican plan to slash Medicaid and other federal health programs, many of which disproportionately help racial and ethnic minorities.

The administration’s national strategy, which was released by the HHS Office of Minority Health, outlines a common set of goals for public and private sector initiatives to achieve health equity. It is a product of the National Partnership for Action, and incorporates ideas generated from thousands of individuals and organizations across the country to transform health care and expand health care access; improve the diversity and distribution of the health care workforce; expand the cultural and linguistic competence of health care systems; and improve neighborhood conditions that shape health, among many other objectives.

The HHS action plan outlines strategies and actions to reduce health disparities in five overarching areas, including health care; the health and human services workforce; prevention; scientific knowledge and innovation; and HHS programs. This plan was developed in response to the stakeholder strategy and is intended to amplify its impact.

Some might argue that such an agenda and coordinated federal effort is late in coming, given the fact that over 25 years ago the release of a major report on health disparities among racial and ethnic groups — the so-called Heckler Report, after President Ronald Reagan’s HHS Secretary Margaret Heckler — first called federal attention to the problem of the health gap.

Others will argue that there is no time like the present to take significant steps to eliminate health inequities. If they are correct, April 2011 may prove to be a pivotal month.

Brian D. Smedley, Ph.D., is vice president and director of the Joint Center for Political and Economic Studies Health Policy Institute.ÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌý

This <a target="_blank" href="/news/050211smedley/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

When President Barack Obama met with the nation’s governors last month and offered to allow states to establish their own plans to reform health care in place of the Patient Protection and Affordable Care Act, he insisted that states meet or exceed the same goals established in the health overhaul to expand insurance coverage, improve the quality of care and contain rapidly escalating healthcare costs.

The president might also insist that states show progress toward eliminating health inequities — differences in the opportunity to have good health that exist between rich and poor Americans, and whites relative to most non-whites.

These health inequities exist literally from the cradle to the grave, in the form of higher rates of infant mortality; disease and disability; and earlier death for many people of color and the poor relative to whites and higher-income groups.

While a large share of Americans would undoubtedly be saddened by these statistics, few understand how health inequities hurt all of us. They have a tremendous human toll, to be sure. Too many families are robbed of loved ones prematurely or suffer as a result of unnecessary disease or disability. But they also carry a significant economic burden for the nation. A released by the Joint Center for Political and Economic Studies found that between 2003 and 2006, health and health care inequalities cost the nation $1.24 trillion in health care expenses as well as economic impacts, such as lost wages and productivity.

States have significant power under the federal health law to shape how health care is financed and delivered. For example, many states will set up health insurance exchanges, which, if done right, should help people purchase insurance in an open market; but also spread risk as broadly as possible, ensure adequate consumer input and oversight, and utilize culturally- and linguistically-fluent navigators to connect people to the insurance products they need.

State health agencies can also apply for flexible funding to support state and community efforts to fight obesity, increase HIV testing, reduce tobacco use, and expand mental health and substance abuse programs through the measure’s Community Prevention and Public Health Fund. States may also receive Community Transformation Grants, which, if funded by congressional appropriators, can be used to improve neighborhood conditions to promote good health. Many public health experts believe that these provisions of the health law have the greatest potential to help eliminate health inequities because they target resources to strategies that promote good health for large populations, rather than individuals, and are effective in helping people to stay healthy in the first place.

But several states are clamoring for greater flexibility, including creating federal block grant funding for Medicaid, the nation’s most important source of insurance for those with low incomes. Unfortunately, such a strategy is unlikely to help meet growing needs for insurance coverage. Medicaid block grants would force states to compete for increasingly limited federal resources and would solidify already stringent eligibility requirements in many states, such as Alabama, which covers working parents only up to 24 percent of the poverty line, or an annual income of $4,450 for a family of three.

Obama is correct to allow states to develop their own strategies for health care reform. But, unfortunately, some states are motivated to act more by budget-balancing pressures than by a desire to improve their residents’ health and eliminate health inequities. As the joint center’s research on the economic consequences of health inequalities demonstrates, however, there is a steep price to be paid for inaction in the face of need.

Given that the share of people of color in the U.S. population is expected to increase to at least half by 2042, it behooves states to take seriously the need to ensure that all Americans can enjoy the opportunity to achieve good health.

This <a target="_blank" href="/news/031811smedley/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

Health inequities span from the cradle to the grave, in the form of higher rates of infant mortality, chronic disease, disability and premature death among many racial and ethnic minority groups. A large volume of research demonstrates that these inequities persist even after socioeconomic factors — such as income and education levels — are considered. For example, African American mothers with a college degree experience infant mortality at rates higher than white mothers who have less than a high school education.

Many affected populations also face barriers to health care services, which further increases risks born by segregation and poverty concentration. These circumstances include poor geographic access to full-service grocery stores; higher rates of exposure to fast food; environmental degradation; crime and violence; and the stresses associated with these examples, as well as many others.

The Affordable Care Act, signed into law by President Barack Obama just over a year ago, is an important first step toward eliminating these inequities. Every credible analysis shows that this measure will improve access to health care and stimulate public health strategies to keep communities healthy, which have the greatest potential to reduce health inequities. It will expand access to health insurance, improve the distribution of health care resources in underserved communities and stimulate federal research on health inequities — among many other provisions that help ensure that all Americans have an opportunity to live healthy lives. 

But the law is only one element of what must be a multi-faceted solution. Success will require  public-private partnerships, a reality that received a big shot in the arm when the Obama administration released, for the first time in federal government history, a national strategy — the —  to eliminate health inequities.

At the same time, the Department of Health and Human Services released an , that coordinates the department’s goals and actions to reduce health inequities. This plan is aligned with the national strategy to expand its impact.

Their release was particularly significant given that the month’s dominant health policy news story was the House Republican plan to slash Medicaid and other federal health programs, many of which disproportionately help racial and ethnic minorities.

The administration’s national strategy, which was released by the HHS Office of Minority Health, outlines a common set of goals for public and private sector initiatives to achieve health equity. It is a product of the National Partnership for Action, and incorporates ideas generated from thousands of individuals and organizations across the country to transform health care and expand health care access; improve the diversity and distribution of the health care workforce; expand the cultural and linguistic competence of health care systems; and improve neighborhood conditions that shape health, among many other objectives.

The HHS action plan outlines strategies and actions to reduce health disparities in five overarching areas, including health care; the health and human services workforce; prevention; scientific knowledge and innovation; and HHS programs. This plan was developed in response to the stakeholder strategy and is intended to amplify its impact.

Some might argue that such an agenda and coordinated federal effort is late in coming, given the fact that over 25 years ago the release of a major report on health disparities among racial and ethnic groups — the so-called Heckler Report, after President Ronald Reagan’s HHS Secretary Margaret Heckler — first called federal attention to the problem of the health gap.

Others will argue that there is no time like the present to take significant steps to eliminate health inequities. If they are correct, April 2011 may prove to be a pivotal month.

Brian D. Smedley, Ph.D., is vice president and director of the Joint Center for Political and Economic Studies Health Policy Institute.ÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌýÌý

This <a target="_blank" href="/news/050211smedley/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

When President Barack Obama met with the nation’s governors last month and offered to allow states to establish their own plans to reform health care in place of the Patient Protection and Affordable Care Act, he insisted that states meet or exceed the same goals established in the health overhaul to expand insurance coverage, improve the quality of care and contain rapidly escalating healthcare costs.

The president might also insist that states show progress toward eliminating health inequities — differences in the opportunity to have good health that exist between rich and poor Americans, and whites relative to most non-whites.

These health inequities exist literally from the cradle to the grave, in the form of higher rates of infant mortality; disease and disability; and earlier death for many people of color and the poor relative to whites and higher-income groups.

While a large share of Americans would undoubtedly be saddened by these statistics, few understand how health inequities hurt all of us. They have a tremendous human toll, to be sure. Too many families are robbed of loved ones prematurely or suffer as a result of unnecessary disease or disability. But they also carry a significant economic burden for the nation. A released by the Joint Center for Political and Economic Studies found that between 2003 and 2006, health and health care inequalities cost the nation $1.24 trillion in health care expenses as well as economic impacts, such as lost wages and productivity.

States have significant power under the federal health law to shape how health care is financed and delivered. For example, many states will set up health insurance exchanges, which, if done right, should help people purchase insurance in an open market; but also spread risk as broadly as possible, ensure adequate consumer input and oversight, and utilize culturally- and linguistically-fluent navigators to connect people to the insurance products they need.

State health agencies can also apply for flexible funding to support state and community efforts to fight obesity, increase HIV testing, reduce tobacco use, and expand mental health and substance abuse programs through the measure’s Community Prevention and Public Health Fund. States may also receive Community Transformation Grants, which, if funded by congressional appropriators, can be used to improve neighborhood conditions to promote good health. Many public health experts believe that these provisions of the health law have the greatest potential to help eliminate health inequities because they target resources to strategies that promote good health for large populations, rather than individuals, and are effective in helping people to stay healthy in the first place.

But several states are clamoring for greater flexibility, including creating federal block grant funding for Medicaid, the nation’s most important source of insurance for those with low incomes. Unfortunately, such a strategy is unlikely to help meet growing needs for insurance coverage. Medicaid block grants would force states to compete for increasingly limited federal resources and would solidify already stringent eligibility requirements in many states, such as Alabama, which covers working parents only up to 24 percent of the poverty line, or an annual income of $4,450 for a family of three.

Obama is correct to allow states to develop their own strategies for health care reform. But, unfortunately, some states are motivated to act more by budget-balancing pressures than by a desire to improve their residents’ health and eliminate health inequities. As the joint center’s research on the economic consequences of health inequalities demonstrates, however, there is a steep price to be paid for inaction in the face of need.

Given that the share of people of color in the U.S. population is expected to increase to at least half by 2042, it behooves states to take seriously the need to ensure that all Americans can enjoy the opportunity to achieve good health.

This <a target="_blank" href="/news/031811smedley/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">