Health Disparities: Improving Health Equity
Low-income Americans, racial and ethnic minorities, people with disabilities, lesbian, gay, bisexual, and transgender communities, and other underserved populations have reduced access to health care and suffer poor health outcomes across their lifespan. These underserved populations are less likely to get the preventive care they need to stay healthy and are more likely to suffer from serious illnesses such as diabetes and heart disease. When these populations do get sick, they are less likely to have access to quality health care.
By improving the quality of and access to health care for all Americans, the Affordable Care Act represents the most significant federal effort to reduce health disparities and improve the health of the underserved in the last 40 years. The health care law will invest in prevention and wellness, support improvements in primary care, create linkages between health and social services, and reduce health care costs.
The Affordable Care Act will:
Make Healthy Choices Easy and Affordable
- People of color experience higher rates of many chronic conditions (such as heart disease and diabetes), as well as higher death rates from many of these conditions compared to the general population.
- Among women aged 50 years and over, mammography rates were higher for nondisabled women than for women with activity limitations.
- About one-third of the uninsured have a chronic disease, and they are six times less likely to receive care for a health problem than the insured.
The law strengthens both public and private insurance to provide more Americans access to critical preventive services. Medicare and some private insurance plans will now often cover recommended preventive services like regular check-ups, cancer screenings, and immunizations at no additional cost to people. Americans will not need to choose between seeking preventive care and paying for groceries or gas. The Prevention and Public Health Fund supports a range of efforts, including the new Community Transformation Grant program, to achieve improvements in cardiovascular disease, childhood obesity, tobacco-related diseases, maternal and child health, flu prevalence and asthma rates. This will ensure that our communities support the health and well-being of the underserved.
Improve Access to Quality Health Care in Underserved Communities
- Half of Latinos and more than a quarter of African Americans do not have a regular doctor.
- People with disabilities have difficulty in getting to health care providers, getting in and around the service setting, locating a provider using accessible health care equipment, and communicating with the health care provider and staff about their health needs and concerns.
- Low-income Americans are three times less likely to have a usual source of care compared to those with higher incomes.
People who do not have access to a usual source of primary care are more likely to end up in the emergency department or in the hospital. Over the next five years, the Affordable Care Act provides $11 billion in funding for the operation, expansion and construction of community health centers across the country. This expansion of sites and services will help community health centers to serve nearly double the current number of patients receiving care, regardless of their insurance status or ability to pay. Today, more than 1,100 community health centers provide care to nearly 19 million patients, more than half of whom are members of racial and ethnic minority groups; nearly forty percent have no health insurance; and a third are children. The Affordable Care Act additionally invests in healthcare workforce programs to ensure a diverse, culturally competent workforce by expanding and improving health care interpreting and translation, and supporting increased training of community health workers (such as promotoras).
Advance Scientific Knowledge and Innovation to Better Target Programs
- Although a very large amount of disability-related information is collected and maintained through national survey efforts and program administrative data, the existing sources have numerous limitations, and often inadequately capture the scope of challenges faced by people with disabilities.
- Negative health outcomes for LGBT people are due to a variety of factors, including their reduced access to employer-provided health insurance, and a lack of cultural competence in the health care system. However, due to the current lack of data collection on sexual orientation and gender identity, the root causes of disparity are still in question.
The Affordable Care Act invests in the implementation of a new health data collection and analysis strategy. Identifying disparities and effectively monitoring efforts to reduce them is limited by a lack of specificity, uniformity, and quality in data collection and reporting procedures. Consistent methods for collecting and reporting health data will help us better understand the causes of health problems in underserved populations. For example, improving access to and the delivery of quality health care for people with disabilities requires enhancement of data collection, including the development and implementation of disability standards for data collection. These standards will now be required under the Affordable Care Act. Also, the Affordable Care Act established additional offices of minority health in six agencies and elevated the National Center on Minority Health and Health Disparities (now NIMHD) to an institute level at the National Institutes of Health. Critical to the Department’s success is strengthening its infrastructure to prioritize the challenges of reducing health disparities.
Create a Fairer and Easier to Understand Health Care System
- Although they represent only one-third of the total U.S. population, racial and ethnic minorities comprise more than half of the uninsured.
- Four in ten low-income Americans do not have health insurance.
- Lesbian, gay, and bisexual adults are more likely to delay or not seek medical care. As a result, they are more likely to receive health care services in emergency rooms.
A new, competitive health insurance marketplace will be created in 2014 to enable people to “one-stop shop” and compare prices, benefits, and health plan performance on easy-to-use websites. Americans will be guaranteed a choice of quality, affordable health insurance even if they experience a job loss, job switch, move, or illness. The health care law also expands Medicaid and provides tax credits to help more Americans pay for insurance. In 2014, insurance discrimination will be banned. Communities of color, which have a higher ratio of pre-existing conditions, will no longer be locked out of health care coverage or charged higher premiums. In addition, new changes to the delivery of health care will include incentives to provide medical homes and chronic disease management programs in Medicare and Medicaid.
The Affordable Care Act is a piece of the Obama Administration’s commitment to reduce health disparities and improve the quality of life of all Americans.
The Obama Administration recognizes the importance of a broad approach to addressing the health and well-being of our communities. Members of the President’s Cabinet are taking action to work together to implement programs to improve Americans’ lives, including the Great Outdoors Initiative, the Neighborhood Revitalization Initiative, Executive Order 13548 to make the federal government a model employer of persons with disabilities, and the National Prevention and Health Promotion Strategy. Through these initiatives and others like the President’s Childhood Obesity Task Force and the First Lady’s Let’s Move! initiative aimed at combating childhood obesity, as well as programs supported by the American Recovery and Reinvestment Act of 2009, the Obama Administration is working to ensure every American—regardless of race, ethnicity, age, disability status, gender identity or sexual orientation—has the opportunity to live their healthiest life possible.
For more information on HHS’ commitment to reducing health disparities, please visit: https://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=39&ID=287.
Posted on: June 9, 2011