Organizational Affiliation: The Commonwealth Fund
Author: John McDonough, Brian Gibbs, Janet Scott-Harris, Karl Kronebusch, Amanda Navarro, and Kima Taylor
Date: June 2004
Contact Information: The Commonwealth Fund
Pages: 87
Content Summary
This report consists of an Executive Summary which outlines the findings and suggestions from the research. The report is broken down into two categories which capture the areas in which interventions should be concentrated: State Infrastructure and Capacity and Health Conditions. The State Infrastructure category is focused on issues related to access and management issues. The issues addressed in this section are cultural and linguistic competency, data, elderly, insurance coverage, primary care, purchasing, regulatory approaches, state infrastructure, and workforce development.
The Health Conditions category is concentrated more closely on health-specific issues including asthma, cancer, cardiovascular disease, diabetes, HIV/AIDS, immunization, infant mortality, injury prevention, mental health, obesity, physical activity, and tobacco use, and oral health.
In each section they analyze the promising practices, statutes, regulations, and programs that are currently in place and provide recommendations for improvement in each area.
Major Findings
The authors suggest that state policymakers should address eight issues in order to create legislation that eliminate racial disparities. Those issues are better and more consistent data collection, determine which disparities reduction initiatives produce positive results, stronger cultural and linguistic competence in all disparities reduction activities, workforce development programs to increase diversity and improve cultural competence in health care professions, health screening and access to services, creating and improving state minority health offices and infrastructure, involve all health system stakeholders, and create a national coordinating body to promote continuing state activities to eliminate racial and ethnic health disparities.
The analysis of state infrastructure and capacity finds that implementing cultural and linguistic competency programs, funding bilingual services, and improving contract language can reduce costs and errors. Improving data collection practices will help prioritize health problems. Elderly services need to improve by funding long-term care for Medicaid recipients to decrease the disparities between Whites and minorities in the use of these services. They assess the insurance needs of all adults not just those with children as well as those of immigrants as areas in which improvement is necessary. They suggest the use of community centers and reduction in financial barriers as methods for improving access to primary care among racial minorities.
The analysis of health conditions bears many suggestions for research, screening, prevention, and disease control for each of the health conditions. They also provide examples of programs in various states that successfully target the health conditions of racial minorities.
Unaddressed issues or concerns
This report does not account for the large discrepancies in applying programs from one area to a different area with unique demographic and public health intervention participation. These variations are particularly important in addressing environmental health issues on which the report does not adequately focus (Bailey 108).
Reference List
Bailey, Adrian J., James D. Sargent, Megan K. Blake. “A Tale of Two Counties: Childhood Lead Poisoning, Industrialization, and Abatement in New England.” Economic Geography. 74 (1998): 96-111.
How to Access Report
www.cmwf.org
(Publication #746)