Earlier this month the Atlas Project at the Dartmouth Institute for Health Policy and Clinical Practice released a report documenting the state of health inequalities in the United States. The report (which was previously mentioned in a post on The State of Opportunity blog) titled “Disparities in Health and Health Care among Medicare Beneficiaries” can be accessed here.
The report calls attention to the fact that health care reform is not only about expanding insurance coverage and improving efficiency standards for health spending – it is also about addressing the unequal access to and the quality of health care in the U.S. As the Dartmouth report articulates, health disparities are widespread and extensive. There are higher rates of obesity and smoking among African Americans than there are among whites; this leads to blacks experiencing higher rates of diabetes and cardiovascular disease than whites do. Blacks have poorer access to primary and specialty care, and this limits their ability to manage any chronic illnesses they might have. Blacks also have poorer access to advanced surgical solutions, and are more likely to face unfavorable, last resort treatments like leg amputation for diabetes.
Dr. Nancy Bennett, director of the Center for Community Health at the University of Rochester, and Dr. Wade Norwood, director of community engagement at Finger Lakes Health Systems Agency, recently wrote an op-ed addressing what local communities are doing to address health disparities in their areas. They describe the problem as follows:
Although these [disparities] may be related to the adequacy of insurance, studies have shown that differences remain even when coverage is equal. We need to understand, through public health and health services research, the complexities of this pathway so that we can eliminate inequalities.
If the federal government is unable to address problems of unequal access and quality of health care in the U.S., local community organizations must take it upon themselves to deal with these issues. The Finger Lakes Health Systems Agency has established a number of African American and Latino health coalitions to prioritize improving health equity in New York. They have already made significant progress:
More people had access to primary care in 2006 compared with 2000, more received annual mammograms and fewer were admitted to the hospital for complications of chronic disease. We know from our own local health data that we have almost eliminated racial and ethnic disparities in immunization rates for both children and adults, and in mammography and cervical cancer screening. Much of this success can be attributed to specific, targeted programs that improve our overall measures while reducing racial disparities.
The Opportunity Agenda has written numerous reports on the prevalence of health disparities in the U.S., as well as how these inequalities inhibit people’s ability to achieve their full potential. In New York, The Opportunity Agenda has been part of various efforts to improve health equality through empowering communities. The Coalition for Community Health Planning, a group that The Opportunity Agenda is an active member of, has been pushing the state and city governments to commit to investing in community health planning programs and to facilitating community involvement in health care.
To learn more about health inequalities in New York, read our report: Dangerous and Unlawful: Why Our Health Care System is Failing New York Communities and How To Fix It. Also, visit our Google Maps mashup Health Care That Works to see how recent hospital closures have had a disproportionate impact on communities of color.
