Elimination of Health Disparities

Vision A 21st Century Intelligent Health System with best outcomes for all. Need There are three principal areas of health disparities: ethnicity, geographic location, and socioeconomic status.

Laura Linn Project Director

• The Institute of Medicine, in Unequal Treatment, summarizes that racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities, even when access-related factors, such as patients’ insurance status and income, are controlled. The sources of these disparities involve many participants at several levels, including health systems, their administrative and bureaucratic processes, utilization managers, healthcare professionals, and patients.
• In an article appearing in Health Affairs, “What if We Were Equal? A Comparison of the Black-White Mortality Gap In 1960 and 2000,” it was stated that an estimated 83,570 excess deaths each year could be prevented in the United States if the black-white mortality gap could be eliminated.
• Increased disparities are found in cancer, cardiovascular disease, diabetes and infant mortality.
• Principal findings of the 2006 National Health Disparities Reports:
  • The 2006 report finds that disparities related to race, ethnicity, and socioeconomic status still pervade the American health care system. Although varying in magnitude by condition and population, disparities are observed in almost all aspects of health care, including:
  • Across all dimensions of quality of health care including: effectiveness, patient safety, timeliness, and patient centeredness.
  • Across all dimensions of access to care including: facilitators and barriers to care and health care utilization.
  • Across many levels and types of care including: preventive care, treatment of acute conditions, and management of chronic diseases
  • Across many clinical conditions including: cancer, diabetes, end stage renal disease (ESRD), heart disease, HIV disease, mental health and substance abuse, and respiratory diseases.
  • Across many care settings including: primary care, home health care, hospice care, emergency departments, hospitals, and nursing homes.
  • Within many subpopulations including: women, children, elderly, residents of rural areas, and individuals with disabilities and other special health care needs.

Mission

The Center believes that health disparities are another result of a broken health care system; a system that must be transformed into a 21st Century Intelligent Health System free of health disparities, a system that provides quality health and health care for all resulting in the best outcomes for all.

Project Objectives

1. Develop and advocate solutions to eliminate health disparities.
2. Work with the Healthy Georgia Diabetes and Obesity Project to:
3. Identify health disparities at the local level using zip code data
4. Target intervention [for example, most black patients are seen by a relatively small fraction of providers, intervention focused on this set of providers could greatly decrease health disparities in this population]
5. Improve access to care by linking community health screenings with physician practice and health center referral, as a strategy for early detection, prevention, and treatment of diabetes.
6. Expand Bridges to Excellence and promote other pay for performance programs in areas of increased health disparities.
7. Integrate a minority health component into the Center’s Cancer and Diabetes projects.
8. Identify ideal legislation for eliminating health disparities
9. Develop a replicable model of eliminating health disparities at the community level.

Key Initiatives

• Increasing awareness of health disparities through partnership with the National Minority Quality Forum
• Building models to decrease health disparities through community projects in Georgia:
  • Diabetes screening in high risk groups
  • Increasing awareness of diabetes in high risk groups
  • Partnership with the Morehouse Community Physician Network to build models for decreasing health disparities
  • Medicare Diabetes Screening initiative
• Launching a Women’s Health Project in 2008