Focusing unprecedented federal attention on the barriers to good health for people of color, the US Department of Health and Human Services unveiled a two-part plan today of federal and community strategies designed to move the nation toward health equity. The plans mark an important step forward. The impact will depend on how strategies are implemented on the ground.
The goal is to reduce health disparities such as the fact that black babies are twice as likely to die in their first year as white babies, Hispanics die of diabetes at 1.4 times the rate of whites, and Asian-Americans are far more likely to contract Hepatitis A than whites. The causes of these problems run deep, far beyond access to insurance coverage or health care. They include the jobs we get, the places we live and the quality of schools for our children.
Part one is HHS Action Plan to Reduce Racial and Ethnic Health Disparities , which coordinates health equity measures in the Affordable Care Act, Healthy People 2020 and other existing federal initiatives. It sets out five broad goals, ranging from expanding access to health care to diversifying the health workforce. Specific steps include implementing the long-awaited Community Transformation Grants, creating an online registry of medical interpreters for patients who don't speak English, expanding the use of community health workers in the Medicaid program, and expanding preventive dental care for children.
HHS Assistant Secretary Howard Koh called it "the most comprehensive federal effort ever to address racial and ethnic disparities."
Part 2 is the National Stakeholder Strategy for Achieving Health Equity, which provides a second set of goals and strategies for initiatives and partnerships designed to foster community-level engagement. This strategy was developed over several years through local, regional and national meetings called the National Partnership for Action. The document details 20 strategies ranging from training youth to be health leaders to ensuring the availability of health data on underserved populations. It calls for the formation of 10 regional health equity councils to coordinate and galvanize the work, and promises to provide local communities with technical assistance and tool kits to move forward.
Given the bruising budget battles underway in Washington, no new money is attached to the plans. The federal work will draw on existing funding, including money currently under siege from the Affordable Care Act – another reason to defend that funding. For the most part, the local initiatives will need to find their own resources. Fortunately, the stakeholder strategy lays out hundreds of objectives which could be the basis for local organizing and could be attractive to local funders.
-- Alice Dembner, Deputy Policy Director