Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Translating the Diabetes Prevention Program Into an Urban Medically Underserved Community(2008) Seidel, Miriam; Powell, Robert; Zgibor, Janice; Siminerio, Linda; Piatt, GretchenItem Translating the Diabetes Prevention Program Into an Urban Medically Undeserved Community(2008) Seidel, Miriam; Powell, Robert; Zgibor, Janice; Siminerio, Linda; Piatt, GretchenItem PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010: Advancing Health Equity for Racially and Ethnically Diverse Populations(Joint Center for Political and Economic Studies, 2010) Andrulis, Dennis P.; Siddiqui, Nadia J.; PURTLE, Jonathan; Duchon, LisaRacial/ethnic disparities in health and health care in the United States are persistent and well documented. Communities of color fare far worse than their white counterparts across a range of health indicators: life expectancy, infant mortality, prevalence of chronic diseases, self-rated health status, insurance coverage, and many others.1 As the nation’s population continues to become increasingly diverse—people of color are projected to comprise 54% of the U.S. population by 2050 and more than half of U.S. children by 20232— these disparities are likely to grow if left unaddressed. Recent health care reform legislation, while not a panacea for eliminating health disparities, off ers an important fi rst step and an unprecedented opportunity to improve health equity in the United States. Reforming the nation’s health care system was President Obama’s top domestic priority when he was sworn into offi ce in January 2009. Th e road to reform was complex and unoffi cially started in summer of 2009 when House and Senate committees began to draft legislation. On November 7, 2009, the House of Representatives passed its health care reform proposal, Th e Aff ordable Health Choices Act of 2009 (H.R. 3962). On December 24, 2009, the Senate passed its own proposal for health care reform, Th e Patient Protection and Aff ordable Care Act (H.R. 3590)*, which was a merged version of the Senate Finance Committee’s America’s Health Future Act (S.1796) and the Senate Committee on Health, Education, Labor, and Pensions’ Aff ordable Health Choices Act (S. 1697).† Eff orts to reconcile diff erences between the Senate and House bills were stymied by the death of Senator Edward Kennedy (D-MA), a lifelong proponent of health care reform and critical force in securing a proposal’s passage in the Senate. Faced with limited options and expecting that a compromise bill could not get Senate support, the House passed the Senate’s proposal and Th e Patient Protection and Aff ordable Care Act (ACA) was signed into law by President Obama on March 23, 2010 (Pub. L. No. 111-148).‡ On March 30, 2010, the ACA was amended by Th e Health Care and Education Reconciliation Act of 2010 (H.R. 4872). According to Congressional Budget Offi ce (CBO) estimates, the ACA, as reconciled by H.R. 4872, will reduce the defi cit by $143 billion over the next decade and decrease the number of non-elderly uninsured by 32 million, leaving 23 million uninsured— approximately one-third of whom would be undocumented immigrants.3 Th is report provides a comprehensive review of general and specifi c ACA provisions with the potential to signifi cantly improve health and health care for millions of diverse populations and their communities. Th e narrative that follows identifi es these provisions, discusses why they are important, and considers challenges that may lie ahead in implementing them. We have organized this presentation in three major sections. Th e next section discusses provisions that explicitly address health disparities, such as those concerning data collection by race/ethnicity, workforce diversity, cultural competence, health disparities research, health disparities initiatives in prevention, and health equity in health insurance reform, and discusses their implications for racially and ethnically diverse communities. Section III describes general provisions, including health insurance reforms, access to care, quality improvement, cost containment, public health and social determinants of health, all of which are likely to have major implications for diverse communities. An accompanying appendix identifi es these provisions, provides a timetable and, where identifi ed in the legislation, the federal agencies responsible for implementation, as well as allocations as of June 30, 2010. Section IV discusses issues that will be critical in realizing the full potential of health care reform and highlights questions and directions for the future, particularly in context of important priorities for reducing racial/ethnic health disparities that were left unaddressed.Item Disparities in Nursing Home Quality Selected Measures - United States 2011(2014) UNSPECIFIEDWhile the health care quality improvement community has prioritized health disparities in acute care settings, such as hospital inpatient and ambulatory care, less attention was given to disparities in long-term care. This is despite the fact that a growing body of evidence documents pervasive racial, ethnic, and class disparities in long-term care in the United States.5-10 Furthermore, in the past decade, nursing homes have instituted various quality improvement programs and collaboratives, but it is unclear what effect they might have had on disparities. To determine what effect quality improvement efforts have had on disparities, we conducted analyses of the prevalence of selected nursing home clinical measures among long-stay nursing home residents.Item Does Health Care Save Lives? Avoidable Mortality Revisited(The Nuffield Trust, 2004) Nolte, Ellen; McKee, MartinItem Best Care at Lower Cost: The Path to Continuously Learning Health Care in America(The National Academies Press, 2012) Smith, Mark; Saunders, Robert; Stuckhardt, Leigh; McGinnis, J. MichaelItem Developing a Model for Measuring the Efficiency of the Health System in Canada(2012) UNSPECIFIEDHealth system policy- and decision-makers have a responsibility to ensure that scarce health system resources are used wisely to provide the best possible health services to the public while containing current and future costs. Measuring variations in health system efficiency and learning from them could be a helpful approach for policy- and decision-makers in this regard as it could inform policies and interventions maximizing health outcomes from scarce public resources. The goal of this project is to develop an approach for measuring the technical efficiency of the health system in a manner that is relevant to federal, provincial, territorial and regional policy- and decision-makers. Consultations with health system stakeholders at federal, provincial and territorial levels were the most significant contributions in defining this approach. A review of health system data available in Canada at the provincial, territorial and regional levels helped assess the feasibility of the health system efficiency measurement model proposed. The report provides an overview of the methods used to develop the approach, describes the main decision points and concludes with a presentation of an approach to health system efficiency measurement at the provincial and regional levels. The next steps in the project are as follows: test the model, using available data to produce preliminary results of the health system efficiency measure; engage with policy-makers and health system managers at the regional level to explore possible factors leading to inefficiencies; and identify successful policies that can serve as a learning opportunity for Canadian jurisdictions.Item Health Reform Interrupted: The Unraveling Of The Oregon Health Plan(2007) Oberlander, J.The Oregon Health Plan (OHP) has received national and international attention for rationing medical care based on explicit priorities. However, in recent years OHP has lost substantial enrollment and struggled to live up to its core principles. This paper explores what went wrong in OHP and the implications of Oregon’s experience for state-led health reform.Item Virginia Health Equity Report 2012(2012) UNSPECIFIEDThe 2012 Virginia Health Equity Report draws attention to health inequities among Virginians of varying socioeconomic, racial/ethnic, and urban/rural backgrounds. It recommends various inter-sectoral strategies and collaboration, for promoting health equity in Virginia. It provides a foundation on which partners and stakeholders can develop new plans/strategies and also receive/provide education on the Social Determinants of Health (SDOH), with the goal of shaping policy and decision-making that promotes health equity in Virginia.