State health reform efforts may help resolve disparity issues

Improvements in health care access and quality could also help address the problem.

By Susan J. Landers — Posted June 2, 2008

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With about half of the states exploring health system reform, now also is the time to address health care disparities, said researchers at a May 12 Capitol Hill briefing.

The event was sponsored by the Alliance for Health Reform, a nonprofit, nonpartisan group in Washington, D.C., and the Commonwealth Fund, a private foundation in New York City.

Inequities in the quality of care provided to minority patients have long been recognized. These differences were documented in two Institute of Medicine reports, "Crossing the Quality Chasm: A New Health System for the 21st Century," published in 2001, and "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," in 2002.

Since then, the elimination of these disparities has been the goal of several medical groups, including the AMA, which heads the Commission to End Health Care Disparities with the National Medical Assn.

Ensuring full access to health care means promoting the concept of a medical home, streamlining enrollment for public health insurance programs, promoting diversity among health care professionals and cultural and linguistic competence in health systems, said Brian D. Smedley, PhD, research director and co-founder of the Opportunity Agenda, an organization that addresses barriers to care. He was also the study director for the "Unequal Treatment" report.

Anne Beal, MD, MPH, assistant vice president of the Commonwealth Fund's Program on Quality of Care for Underserved Populations, noted that there are many causes of disparities, including genetic predispositions to diseases and patients who fail to follow treatment instructions. However, the "biggest bang for the buck" toward reducing disparities would be achieved if access to care is improved, adequate insurance coverage provided and the quality of care bolstered.

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