Addressing Health Care Disparities

State Perspectives

Participants agreed that the release of the National Healthcare Disparities Report (NHDR) will draw much needed attention to the issue of health care disparities and would generate increased pressure for all levels of government, as well as private sector health care providers, purchasers, and community organizations to take steps to address this problem.

A number of States have focused attention on racial and ethnic health status disparities, including the development and publication of State-level reports on health status disparities. Many of the State efforts specifically designed to address health care disparities have focused on seeking to purchase services from culturally competent health care providers and delivery systems for their Medicaid and State Children's Health Insurance Program (SCHIP) populations.

Gregory Franklin from the State of California noted that his State requires organizations bidding on State health care contracts to describe specific aspects of their approaches that will address health disparities. This information is then used as part of the State's proposal review process.

Other efforts at the State level focused on meeting the needs of low-income and/or vulnerable populations (e.g., Medicaid eligibility expansions) also can help address the problem of racial and ethnic health care disparities.

Participants also discussed whether efforts to address disparities would find broader support if, rather than being presented as benefiting only certain segments of the population, they were instead placed in the broader context of improving overall health care quality or reducing medical errors.

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