From a health equity standpoint, one of the most important provisions of the Affordable Care Act is the requirement that all health and health care institutions that receive federal funds must collect data on the race, ethnicity, and primary language of the patients they serve.  Having this information will allow policymakers, researchers, and advocates understand when, where, and under what circumstances health and health care inequities may occur.  There is disagreement in the field, however, about how to collect this data, and even about what the terms "race" and "ethnicity" mean.
 
In response to the U.S. Department of Health and Human Services' call for comments, the Joint Center prepared a letter to Secretary Kathleen Sebelius outlining some considerations for the collection of race and ethnicity data, available here.

Recent efforts to sharply cut back funding and support for Medicaid go beyond Washington politics—they threaten the health of millions of Americans. For the past 45 years, Medicaid has been a largely successful program that delivers essential health services to a large segment of the population. Our country‟s most vulnerable citizens, including children, low-income parents, pregnant women, seniors and those with disabilities have all benefited from this social service jointly administered by federal and state governments, as well as the Children‟s Health Insurance Program (CHIP). By expanding coverage and access - as well as financial protection - to many Americans, Medicaid has proved itself to be an effective program that delivers substantial value to the nation at large by improving health outcomes among people who otherwise would not be able to afford basic and necessary health care.

Improving health inequity was a key focus of many of the sessions at the recent American Public Health Association Midyear Meeting.

NewPublicHealth spoke with Brian Smedley, Ph.D., director of the Health Policy Institute at the Joint Center for Political and Economic Studies in Washington, D.C. Dr. Smedley spoke about health equity during the meeting.

Read more at the Robert Wood Johnson Foundation.

It's well documented that African Americans and other ethnic minorities have disproportionately higher rates of poor health, including infant mortality and most chronic conditions — heart disease, stroke, cancer, HIV/AIDS, asthma and diabetes, among others. Racial differences in health have persisted for so long that they're largely seen as a standard fact of life, even though, truth is, these differences are avoidable. So when President Barack Obama tasked Congress with sending a health care reform bill to his desk in 2009, the Congressional Black Caucus saw a huge opportunity.

"We'd already introduced a bill called the Health Equity and Accountability Act for the past several Congresses, so our work on this issue started long before the health care reform debate started," Virgin Islands Rep. Donna Christensen told The Root. In response to the president's charge, the CBC members promptly accelerated their efforts to tackle health disparities. They conferred with the National Medical Association and other black health groups, developed benchmarks that they wanted to see in the bill, formed a united front with other ethnic congressional caucuses and met on three occasions with President Obama.

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While the health care reform law achieves a number of important steps to start eliminating racial difference in health quality, it also falls short, say policy experts. Brian Smedley, vice president for the Health Policy Institute at the Joint Center for Political and Economic Studies, underscores Christensen's argument that ZIP code determines a person's health more than genetic code. He argues that the law doesn't put enough resources behind community-based prevention to tackle the reasons that African Americans get so sick in the first place.

"Health care coverage and clinical prevention screenings are important, but they're not the root causes of health inequities. When you look across the gamut of diseases that people of color disproportionately suffer from, at their root are inequitable neighborhood conditions," Smedley told The Root, echoing the problems of abundant fast-food retailers, environmental injustice and a lack of access to outdoor recreational facilities in many low-income neighborhoods of color. He proposes that federal agencies, such as the Environmental Protection Agency and the Department of Housing and Urban Development, collaborate to make neighborhoods healthier.

Read more at National Public Radio.

Healthcare is one of the nation’s largest industries, providing 14.3 million jobs. Health careers offer rewarding, prestigious and well-paying jobs in a stable sector even in harsh economic times. Accordingly, the strength and quality of our health workforce is not only central to the capacity and effectiveness of our healthcare system, but it is also a crucial component of the nation's economic infrastructure and ongoing economic security.

The Joint Center's Health Policy Institute, recently released a report entitled "Following the Money: Tracking Federal AIDS Appropriations to Address Disparities in HIV and AIDS Treatment in the United States", which explores the path of federal funding in HIV and AIDS prevention. The Report finds that HIV/AIDS is not one epidemic in the United States but rather has become multiple epidemics affecting different communites at different rates and through different vectors of transmission. Tragically, some of the communities least prepared to deal with the spread of HIV are communities that are most vulnerable and have received the least federal resources to combat the disease. There are several strategies needed to ensure the resources flow to communities proportionate to need.

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A new assessment that measures the healthiness of states shows a
decline in the overall health of the nation. The American Public
Health Association and Partnership for Prevention collaborated
with the United Health Foundation to produce the 18th annual edition
of America’s Health Rankings: A Call to Action for People & Their
Communities.

The report found that the overall health of the nation fell by a rate of 0.3
percent between 2006 and 2007. By contrast, the nation’s average annual
improvement was 1.5 percent between 1990 and 2000. Even reductions in
the rates of cancer and cardiovascular mortality could not offset growing
rates of obesity, an increase in the number of uninsured and persistent risks
such as tobacco use and violent crime.

The report ranked Vermont, Minnesota, Hawaii, New Hampshire and
Connecticut as the five healthiest states. The least healthy states are
Mississippi, Louisiana, Arkansas, Oklahoma and Tennessee.
Reed Tuckson, M.D., a member of the board of the United Health
Foundation, discussed the report and the problems it highlights with
FOCUS. The entire report can be viewed at www.americashealthrankings.
org or www.unitedhealthfoundation.org.

The Director of the Joint Center’s Health Policy Institute, Dr. Brian D. Smedley, discusses the health implications of an Obama administration and the challenges to health care reform in trying economic times.

During the only televised debate of the major vice-presidential candidates in the 2004 election cycle, moderator Gwen Ifill asked Dick Cheney and John Edwards about the crisis among African-American women, and what they-if elected-would do about it.

This issue brief identifies, analyzes and compares provisions which explicitly address the health and health care needs of racial and ethnic minorities within the two leading Congressional health care reform proposals: The Affordable Health Choices Act of 2009 (H.R. 3962) passed in the House of Representatives on November 7, 2009; and The Patient Protection and Affordable Care Act of 2009 (H.R. 3590) introduced in the Senate on November 18, 2009, as a merged version of the Senate Finance Committee’s America’s Health Future Act (S.1796) and Senate Committee on Health, Education, Labor, and Pensions’ (HELP) Affordable Health Choices Act (S. 1697). Additionally, this issue brief explores the potential implications of broad health care reforms for racial and ethnic minorities. Also discussed is how each bill could decrease disparities and improve minority health, where each falls short in advancing these goals, as well as the transitional challenges and questions for the future should health care reform legislation be enacted.

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