Blog: National Partnership for Action
Posted on 12/30/2013 by J. Nadine Gracia, MD, MSCE
As 2013 comes to a close, it is with great pleasure that I share with you the U.S. Department of Health and Human Services’ (HHS) 2013 Report to Congress on Minority Health Activities . As called for under Section 10334 of the Affordable Care Act, the biennial Report to Congress on Minority Health Activities summarizes the programs, policies, and initiatives of agencies across HHS that address minority health and health disparities. This 2013 Report to Congress demonstrates our Department’s commitment to eliminating health disparities and achieving health equity. Since the inaugural 2011 Report to Congress, all of the individual Offices of Minority Health have been established, and the leadership of the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration has appointed permanent directors of their respective Offices of Minority Health. In addition, the Office of Minority Health has been elevated to the Office of the Secretary and the National Center on Minority Health and Health Disparities within the National Institutes of Health has been elevated to an Institute. Together, the directors of the Offices of Minority Health and the National Institute on Minority Health and Health Disparities, along with the HHS Health Disparities Council, are providing strategic coordination of HHS efforts in disparities reduction and health equity. Furthermore, under the leadership of our Secretary of Health and Human Services Kathleen Sebelius, HHS released its first-ever Action Plan to Reduce Racial and Ethnic Health Disparities in 2011. The HHS Disparities Action Plan is the most comprehensive federal commitment to reducing health disparities and charges all HHS agencies and offices to heighten the impact of their policies and programs to reduce health disparities. This strategic action plan builds on the foundation of the Affordable Care Act with the goals of transforming health care, strengthening the nation’s health and human services infrastructure and workforce, advancing the health, safety and well-being of the American people, advancing scientific knowledge and innovation, and increasing the efficiency, transparency, and accountability of HHS programs. It represents an unprecedented time of coordination and collaboration across the Department and with our partners to achieve the vision of “a nation free of disparities in health and health care”. In this time of historic transformation of health and health care in our nation, we face a remarkable moment of opportunity to end health disparities that have impacted minority communities for far too long and to ensure that everyone has the opportunity to reach their full potential for health. To read the 2013 Report to Congress on Minority Health Activities, please click here.
Posted in: NPA Reports Minority Populations Health Disparities | Comments | Add a Comment | Comment Policy | Permalink
Posted on 12/18/2013 by Kiran Ahuja
Over the last four years at the White House Initiative on Asian Americans and Pacific Islanders (WHIAAPI), we have been working with federal agencies across the board to improve data collection, analysis, and dissemination of findings and reports on Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs). We have been particularly focused on NHPIs, who, according to the 2010 U.S. Census, comprise just 0.4 percent of the total U.S. population, making it difficult to include them in sufficient numbers in most national population-based health surveys. The lack of reliable health data for this population has made it difficult to assess their health status and health care utilization. However, the available data for this population indicates that Native Hawaiians and Pacific Islanders experience significant health disparities when compared to other groups, such as lower utilization of health care services and higher rates of chronic diseases, such as diabetes and obesity.
That's why we welcome the announcement made today that the U.S. Department of Health and Human Services (HHS) will launch the first-ever, large-scale national health survey to collect detailed health information on NHPI households – the Native Hawaiian/Pacific Islander National Health Interview Survey. This information will be collected through HHS' National Health Interview Survey, the nation's largest in-person, household health survey. Never before has there been a study of this scale to assess the health needs of NHPIs, and this type of survey has long been called for by the NHPI community. This important effort will help improve our understanding of the health concerns – from access to health care to health insurance coverage to rates of chronic diseases like diabetes or heart disease – faced by this community and to identify areas of opportunity for federal government to better address these concerns.
WHIAAPI encourages advocates and organizations across the country to join us in spreading the word about this landmark survey. We hope you can continue the conversation with us on Twitter using #NHPI.
Our hope is that the results of this study will provide researchers, policymakers, and community leaders with the data they need to understand and address disparities in health and health care, and provide lessons for data collection and analysis focused on small populations.
The Native Hawaiian/Pacific Islander National Health Interview Survey will begin early next year, and the results will become available summer 2015.
Posted in: Health Minority Populations HHS Health Disparities Federal Asian American Data & Statistics Health Care Health Equity Minority Health Native Hawaiian Pacific Islander Research & Evaluation | Comments | Add a Comment | Comment Policy | Permalink
Posted on 9/27/2013 by Coleen A. Boyle, PhD, MSHyg, and J. Nadine Gracia, MD, MSCE.
A generation ago, almost 15 percent of children in the United States born with sickle cell disease died before the age of two. Many more died in their teens. 1
Today, babies born with sickle cell disease face a far more promising future. Children and adults can benefit from treatment options that help mediate complications of the disease. According to data from CDC's National Vital Statistics System, the proportion of deaths from sickle cell disease among children decreased from 12 percent in 1979 to approximately 3 percent in 2006. Since the signing of the National Sickle Cell Anemia Control Act 41 years ago, considerable progress has been made in biomedical research, disease surveillance, and care coordination.
But as patients and families know all too well, barriers to care and quality treatment persist. Between 90,000 and 100,000 people in the U.S. currently live with sickle cell disease, making it the most common inherited blood disorder in the country. Minorities bear a disproportionate burden, with the disease occurring in roughly one out of every 500 African American births and one out of every 36,000 Hispanic American births. And far too many have struggled to access the quality care that they need to manage the disease and live a healthy life.
That began to change three years ago, with the passage of the Affordable Care Act.
By directly addressing barriers to care and coverage, the Affordable Care Act has created new opportunities for those living with sickle disease to access affordable, high-quality health insurance and medical services – opportunities that many may never have had before.
Because of the law, sickle cell disease and other pre-existing conditions can no longer be grounds for denial of coverage from health insurers – a provision of the law that would provide security to 129 million Americans with pre-existing conditions.
Young adults living with sickle cell disease can now stay on their parents' health insurance until the age of 26, ensuring smoother transitions from pediatric care to adult care.
In addition, screening for sickle cell disease among newborns is now one of the preventive services covered at no cost under the Affordable Care Act. Thanks to the law, approximately 71 million Americans can now access these screenings and other important preventive services without having to pay a co-pay or deductible.
The law is also helping community health teams to explore new opportunities for improved disease management through the Centers for Medicare & Medicaid Services' (CMS) Innovation Center – and expanding access to care through investments in community health centers, where nearly two-thirds of patients served are people of color.
Meanwhile, agencies across the Department of Health and Human Services are working to make the most of these opportunities. At the Centers for Disease Control and Prevention (CDC), researchers are studying how sickle cell disease is managed at the community level through a state-based project called PHRESH (Public Health Research Epidemiology and Surveillance of Hemoglobinopathies). Using data collected from the program, CDC is helping states build capacity to monitor health system changes stemming from the Affordable Care Act – giving them the tools they need to identify the most effective interventions, highlight quality measures, and zero in on the "hotspots" of chronic conditions where they are needed most.
At the Office of Minority Health, one of the office's strategic priorities – leading the implementation of the first-ever HHS Action Plan to Reduce Racial and Ethnic Health Disparities – includes strengthening the cultural and linguistic competency of the health and health care workforce to improve health care quality and reduce health disparities. And as implementation of the Affordable Care Act continues, the Office of Minority Health's outreach and education efforts in minority communities are helping to reach those living with sickle cell disease and others who stand to benefit most from the health care law.
Three years after its passage, the Affordable Care Act has touched the lives of millions of Americans – including the thousands living with sickle cell disease. And this is just the beginning. On October 1, millions of Americans will have a chance to enroll in affordable health insurance coverage through the new Health Insurance Marketplace, with coverage beginning as early as January 1, 2014. While the fight against sickle cell disease continues, the health care law is giving patients and families affected by sickle disease unprecedented opportunities for improved care and expanded coverage – and new hope for a healthier future.
Learn more about the Affordable Care Act and the Health Insurance Marketplace at www.healthcare.gov.
Posted in: Health Minority Populations OMH Promising Practices HHS Health Disparities Partnership Federal Prevention Affordable Care Act/Health Care Law African American Asian American Health Care Health Equity Hispanic/Latino Promotores/Community Health Workers Research & Evaluation Youth | Comments | Add a Comment | Comment Policy | Permalink
Posted on 9/18/2013 by Amirah Abdullah
A world free of disparities in health and health care, where all people are able to attain the highest level of health, may appear utopic. However, this is the vision of the Southeastern Health Equity Council (SHEC) for the states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee. These states are comprised of a diverse population, with some groups demonstrating an increased risk of adverse health outcomes, and many residing in rural locations that restrict access to care.
To achieve its vision of health equity, the SHEC is collecting and utilizing data to outline the challenges and opportunities facing the region. Data is a powerful tool that can illuminate issues, inform decisions, and portray the impacts of such decisions.
As an intern working with the SHEC, I have had the opportunity to contribute to their latest efforts to improve the health of the population by increasing awareness on state-level policies and practices related to health care access, healthy food choices, and cultural competency. From June through August 2013, I researched data in 12 domains using 19 indicators to help answer questions about the physical environment, food choices, health behaviors, diversity in the health care workforce, and health care coverage affect an individuals’ lifespan, with the intent to generate a regional health equity report card.
This report card, which will be available this fall, will present detailed data by race, ethnicity, gender, sexual orientation, urban/rural location, and disability, which will be used by the SHEC for the first time to inform local policy makers. It will allow a look at several domains across multiple demographic measures at the same time, to generate a much needed holistic response to resolving health disparity issues. The SHEC will emphasize health disparity indicators and gaps in existing data to illustrate the importance of collecting data from minority groups. The SHEC developed the report card using Healthy People 2020 goals (where available), year comparisons, and national comparisons to grade each indicator.
Although the SHEC region is known to have some of the poorest performing states in the nation, the data never cease to provide compelling evidence of unequal burdens of disease in our communities. The Southeast represents 19 percent of the total population in the country. Yet in 2010, this region accounted for 21 percent of heart disease mortality nationally, with factors such as obesity, diabetes, and hypertension affecting this population at a substantially higher rate than other areas of the country.
A health equity report card could not come at a more opportune time, with the ongoing national discourse about health care access and reducing the costs of health care. In spotlighting the disparities in the Southeastern region of the country, we create a unique opportunity to educate local and national policy makers, and generate discourse that can influence health outcomes in the region for the better.
We can effectively point policy makers toward decisions that improve healthy food choices, enhance health care access and promote well-being. We also create the opportunity to specify populations and issues that merit the attention of state and local policy makers and communities. Over time, we have a real opportunity to look back in time and ask – “did we make the grade?”
The development of the SHEC health equity report card is an exciting first step in making this vision a reality. However, it is important to remember that we must all play our parts in making the states in the Southeast a healthier place to live.
How do you grade progress on health disparities indicators in your state or region? Let us know by commenting below.
Posted in: Minority Populations NPA Partners Promising Practices Health Disparities Federal Prevention Data & Statistics Health Equity Minority Health | Comments | Add a Comment | Comment Policy | Permalink
Posted on 9/11/2013 by Pamela Ascon
You are in a foreign country and your child is feeling sick. You rush her to the hospital and want to quickly speak to a doctor. Instead, you are given a long form asking many questions in a complete different language. You ask for help, but no one seems to comprehend your heavy accent.
This is the reality that my family and I encountered when visiting medical facilities for many years. As a child who had recently arrived to America, I attempted to act as a translator between the doctor and my mother with the few vocabulary words that I had learned so far in school. I remember my mother’s face emanating discomfort with her inability to fully express her feelings and concerns.
I now understand that the helpless look on my mother’s face was a true reflection of the challenges consistently encountered by many minority populations.
Some of the most significant barriers between healthcare providers and patients are language and cultural differences, which can play a crucial role in patient health outcome. If patients have a hard time communicating with their healthcare provider, this can lead to errors in diagnosis or treatment. With the ample range of cultures in the United States, patients’ cultural beliefs are of equal importance. If a patient’s belief interferes with their treatment option, the clinician should respectfully accommodate the patient while ensuring that they have a successful health outcome.
In 2050, it is estimated that the minority population will account for almost half of the U.S population [PDF | 283KB], underscoring the necessity of culturally and linguistically appropriate approaches. To inform these approaches, the U.S Department of Health and Human Services has recently released the Enhanced National Standards for Culturally and Linguistically Appropriate Services in health and health care, also known as the CLAS Standards. This blueprint guides implementation to advance and sustain culturally and linguistically appropriate health services. It also highlights the importance of providing quality and equal health services to minorities.
Currently, CLAS Standards are being utilized to improve operational functions within the workplace by equipping culturally and linguistically competent staff to serve the needs of the populations that they serve. CLAS Standards improve quality of care and patient safety while decreasing the liability risk for health care providers. They will ultimately prepare health and healthcare organizations to meet the needs of minorities while improving health care quality.
Therefore, I encourage health and health care organizations to adopt and implement CLAS Standards. Working as a team, we can narrow the cultural and language gaps within the health care system and eliminate a major barrier to achieving health equity in the nation.
Posted in: Health Minority Populations Promising Practices Health Disparities Federal CLAS Cultural & Linguistic Competency Health Care Minority Health | Comments | Add a Comment | Comment Policy | Permalink
Top 5 recent blog topics are shown on this page. Please use search feature for other blog topics.
About the Blog
The NPA works to achieve health equity -- the highest level of health for all people. This blog is a venue for professionals from all fields and sectors to share their thoughts on pressing issues, news and events pertaining to health equity. Follow and participate in this candid discussion.
Recent Blog Posts
→ Changing the Prognosis for Sickle Cell Disease through the Affordable Care Act
→ Winning the battle against health disparities through new technology
→ Improving Data Collection on Native Hawaiian and Pacific Islander Health
→ 2013 Report to Congress on Minority Health Activities
→ The Celebration Continues: Three Kings Day and the Health Insurance Marketplace