April is National Minority Health Month, a fitting occasion to reflect on what is needed to improve care and achieve equitable outcomes in the United States. Sometimes on the front lines, when taking care of an individual patient, it can be hard to recognize when poor outcomes for an individual reflect a more pervasive and systemic pattern. But data collected at the national level shows that for three important indicators – infant mortality, age-adjusted death rates and life expectancy – the United States ranks lower than most peer nations and racial and ethnic disparities exist in quality and length of life among U.S. residents.
This year’s theme, “Partnering for Health Equity,” gives us a chance to celebrate the work of our partners to address health disparities, whether it’s Make the Road New York’s work with community health workers or Unite Oregon and OSPIRG’s grassroots and policy work to ensure that coordinated care organizations are responsive to community input.
Here at the Center, we are working to tackle disparities through advocacy and organizing by building the power of consumers and communities to speak up to improve health and by ensuring that policies focus on achieving high quality and equitable outcomes. To mark the month, here are a few things I’m reading:
- Linda Villarosa’s powerful article in the New York Times Magazine examines the high rates of death among Black infants, and of death or near death among Black mothers. The article points out how racism could be contributing to worse outcomes for Black mothers and babies and looks at how doulas might be part of the solution. Community Catalyst Board Member Joia Crear-Perry’s opinion piece on rewire.com underlines the impact of racism and suggests that we list “racism as a modifiable risk factor for poor maternal health outcomes.”
- Karen Joynt Maddox’s perspective article in the New England Journal of Medicine explores the impact of alternative payment methodologies on vulnerable populations. While some alternative payment models have helped to narrow disparities, there is also evidence that models may disproportionately penalize hospitals or clinics serving poor people. The article suggests strategies such as refining risk adjustment, evaluating improvement (not just achievement), rewarding proportional improvement and explicitly designing payment models to focus on reducing disparities.
- The story of how Medicare forced the desegregation of every hospital in the United States shows how muscular public policy—driven by committed activists and public servants–can create powerful and lasting change. It is a story that is well worth reading, whether in David Barton Smith’s book, The Power to Heal: Civil Rights, Medicare, and the Struggle to Transform America’s Health Care System or Community Catalyst Action Fund Board Member John McDonough’s excellent review.