Urban.org: Marla McDaniel, Tyler Woods, Eleanor Pratt, Margaret Simms
When there is evidence of racial and ethnic differences at any point in the service delivery spectrum—for example, in access to and take-up of human services, in the nature and quality of services received, or in the outcomes of services—it can be challenging to interpret what those differences mean. In particular, it can be challenging to understand whether and to what extent those differences represent disparities. Disparities mean that one group is systematically faring worse than another for reasons that are not due to the group’s needs, eligibility, or preferences.
This report helps the Administration for Children and Families (ACF) build the base of knowledge necessary to reliably identify and interpret racial and ethnic differences in relation to ACF’s human services programs. Better understanding these differences and being able to distinguish when those differences indicate disparities can help improve ACF’s program delivery. To further ACF’s understanding, this report synthesizes the existing research on racial and ethnic differences and disparities in relation to the service delivery systems of six programs, or program areas, administered by ACF:
To facilitate this synthesis, the report provides a clear definition of disparities. It also develops a conceptual framework for identifying racial and ethnic differences throughout the service delivery system and for distinguishing racial and ethnic differences from disparities. READ FULL ARTICLE
Kaiser Family Foundation
Racial and ethnic disparities in health care – whether in insurance coverage, access, or quality of care – are one of many factors producing inequalities in health status in the United States.1 Eliminating these disparities is politically sensitive and challenging in part because their causes are intertwined with a contentious history of race relations in America. Nonetheless, assuring greater equity and accountability of the health care system is important to a growing constituency base, including health plan purchasers, payers, and providers of care. To the extent that inequities in the health care system result in lost productivity or use of services at a later stage of illness, there are health and social costs that affect us all.
Why Health Care Disparities Are a Concern
One in three residents of the United States self-identify as either African American, American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, Hispanic/Latino, or multiracial. By 2050, this number is expected to increase to one in two.2
Despite significant advances in civil rights, race remains a significant factor in determining whether an individual receives care, whether an individual receives high-quality care, and in determining health outcomes.
The Institute of Medicine (IOM) landmark report, Unequal Treatment, provides compelling evidence that racial/ethnic disparities persist in medical care for a number of health conditions and services.3 Numerous efforts are underway to reduce or eliminate racial and ethnic health care disparities, and to address some of the social factors that affect health care outcomes. Yet despite these many efforts, disparities in access to quality care remain, and for some measures being tracked, gaps in care are getting larger rather than smaller.4
Key Facts on Race, Ethnicity and Health Care in the U.S.
ADDRESSING HEALTH CARE DISPARITIES
Although attention to racial/ethnic disparities in care has increased among policymakers, there is little consensus on what can or should be done to reduce these disparities. The U.S. Congress provided early leadership on the issue by legislatively mandating the IOM study on health care disparities, creating the National Center on Minority Health and Health Disparities at the National Institutes of Health, and requiring DHHS to produce the National Healthcare Disparities Report.5 This brief examines four broad policy areas for addressing racial and ethnic health care disparities: READ FULL ARTICLE
Historically, in the United States, there has been a wide gulf between whites and members of minority groups in terms of health insurance coverage and access. Proponents of the Affordable Care Act (ACA) hoped that law’s major insurance coverage expansions and reforms would begin to bridge those gaps.
Evidence suggests that uninsured rates have declined among blacks and Hispanics under the ACA,1 but have these coverage gains reduced disparities between whites and ethnic and racial minorities? This brief seeks to answer that question and to examine if disparities in access to coverage and care are different in states that expanded Medicaid and states that did not.
We compared national averages between 2013 and 2015 for white, black, and Hispanic adults on three key measures of health care access to determine the effect of the ACA’s major coverage expansions on disparities:
CDC.gov I September 15, 2017
Nationally, Americans use preventive services at about half the recommended rate. Cost-sharing such as deductibles, co-insurance, or copayments also reduce the likelihood that preventive services will be used. One study found that the rate of women getting a mammogram went up as much as 9% when cost-sharing was removed.
Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of every 10 deaths among Americans each year and account for 75% of the nation’s health spending. These chronic diseases can be largely preventable through close partnership with your healthcare team or can be detected through appropriate screenings when treatment works best.
Eating healthy, exercising regularly, avoiding tobacco, and receiving preventive services such as cancer screenings, preventive visits and vaccinations are just a few examples of ways people can stay healthy. The right preventive care at every stage of life helps all Americans stay healthy, avoid or delay the onset of disease, keep diseases they already have from becoming worse or debilitating, lead productive lives, and reduce costs.
And yet, despite the benefits of many preventive health services, too many Americans go without needed preventive care, often because of financial barriers. Even families with insurance may be deterred by copayments and deductibles from getting cancer screenings, immunizations for their children and themselves, and well-baby check-ups that they need to keep their families healthy. READ FULL ARTICLE
NEJM Catalyst I March 22, 2017
Harnessing the full potential of data requires developing an organization-wide data science strategy. Such strategies are now commonplace in most industries such as banking and retail. Banks can offer their customers targeted needs-based services and improved fraud protection because they collect and analyze transactional data. Retailers such as Amazon routinely collect data on shopping habits and preferences to profile their customers and use sophisticated predictive algorithms to tailor marketing strategies to customer demand.
Health care is a glaring exception. Individual pieces of data can have life-or-death importance, but many organizations fail to aggregate data effectively to gain insights into wider care processes. Without a data science strategy, healthcare organizations can’t draw on increasing volumes of data and medical knowledge in an organized, strategic way and individual clinicians can’t use that knowledge to improve the safety, quality, and efficiency of the care they provide.
A comprehensive data science strategy needs to address the quality of the underlying data, effective ways to analyze the data and a framework for keeping it secure. If an organization tries to aggregate and analyze poor-quality data, it may derive useless or even dangerous conclusions. An inadequate security framework may lead to unauthorized access and undermine the trust of patients and providers.
A carefully developed data science strategy will help achieve both precision medicine (helping to tailor treatments to patients) and the creation of learning health systems (helping to predict outcomes and identifying specific areas for improvement). Ideally, every decision a provider makes about a patient should be informed by the data of both that specific patient and other similar patients. In a learning health system, prior experiences improve future choices. Read Full Article