I recently wrote a piece on what the Affordable Care Act does about racial and ethnic health disparities, a long-standing problem that had never been addressed by federal legislation before the law's passage. The law takes important steps to improve health care access and quality for low-income communities of color, but its efforts to confront unequal neighborhood conditions that drive poor health in the first place (such as environmental pollution and lack of supermarkets) aren’t up to snuff.
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What a difference a few days makes. Almost as if on cue, on Friday the Department of Health and Human Services released two strategic plans with the specific goal of reducing health disparities. The HHS Action Plan to Reduce Racial and Ethnic Health Disparities largely focuses on implementing portions of the Affordable Care Act—such as improving data collection on health inequities, establishing cultural competency educations for health workers and expanding community health centers. The National Stakeholder Strategy for Achieving Health Equity, however, targets what’s going on in local communities.
“A lot of health and health care is not just about the doctor,” Garth N. Graham, HHS Deputy Assistant Secretary for Minority Health, told The Root about the Stakeholder Strategy. The plan was created with input from grassroots organizations, local businesses and academic institutions across the country – all which stressed that it does little good to preach about proper diet and exercise without understanding the neighborhood context. “It’s also about how people interact with other components of daily life,” he said.
With that premise in mind, the hefty, 228-page Stakeholder Strategy provides a roadmap for how local communities can partner with local businesses and local government to create community solutions, buoyed by investment from various federal agencies. Whether the challenge involves food deserts, water pollution, mold-infested housing, or lack of parks and other recreational facilities, the document offers ideas to solve them.
“We don’t want to make this seem like eliminating health disparities is entirely a federal effort,” said Graham. “What you need is strong federal commitment and investment; then other things can occur from there on the community level.”
Both the HHS Action Plan and the National Stakeholder Strategy go into effect immediately, using existing department funds for now. Despite a Republican-controlled House of Representatives which is likely to oppose the initiatives in the next fiscal year, HHS remains optimistic about the leadership from various supporters in Congress, such as Congresswoman Barbara Lee (D-Calif.) and Senator Benjamin Cardin (D-Md.), both of whom spoke at a Washington press conference announcing the plans.
Brian Smedley, vice president for the Health Policy Institute at the Joint Center for Political and Economic Studies, who also spoke at the presser, noted the economic impact associated with health disparities. According to a Joint Center study (pdf), between 2003 and 2006 health care inequities cost Americans $1.24 trillion.
On a local level, however, I wondered if the political will to take this on was really there. It’s not like this is a new problem – low-income community health challenges have persisted since…forever. Graham is considerably more optimistic.
“You can’t assume that because a situation is bad, it will always be bad,” he said. “These ideas came from people at the local level, so this is about giving them a forum. People can now display to their local legislatures, state health departments and other organizations, what a concrete strategy looks like. We’re connecting that with a national effort, so communities know they’re also part of something even bigger.”
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