Health Care Reform
State health care reform efforts under way across the country could help reduce racial and ethnic health care disparities if executed in ways that address issues facing minority communities, according to a study in Health Affairs. The author of the study writes that most states attempting coverage expansions have experienced difficulty with some groups, such as childless low-income adults, some documented immigrants and undocumented immigrants.
The author recommends that supporters of health care reform initiatives look beyond expanding health insurance coverage to also address structural, cultural and linguistic obstacles that disproportionately limit access to care for many minority communities. For example, policymakers can implement quality-of-care incentives that reward efforts to reduce disparities and improve patient outcomes. The author also recommends policies that increase community and patient participation -- such as patient education programs and training for community health workers -- and an assessment of the state's health care infrastructure, including safety-net hospitals.
The author adds that efforts to reduce racial and ethnic disparities should also address factors "outside of the health care area," including strategies to improve coordination among state agencies for education, housing, employment and poverty; incentives to encourage better food resources in underserved communities; and monitoring of environmental health threats (Smedley, Health Affairs, March/April 2008).