October 27, 2016
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Center Releases Dual Health Disparities Reports

WASHINGTON - The Center for American Progress has issued two new reports exploring how the Affordable Care Act will help patients from racial and ethnic minorities with chronic illnesses, and how the Affordable Care Act will improve efforts to address the critical gaps in the data that measure racial and ethnic health care disparities.

Easing the Burden: Using Health Care Reform to Address Racial and Ethnic Disparities in Health Care for the Chronically Ill

Chronically ill Americans from racial and ethnic minorities have much to gain from the implementation of the Affordable Care Act. These Americans are more likely to be without health insurance coverage—they make up more than half of America’s uninsured—and they suffer higher rates of chronic illness than the general population. They are more likely to have the risk factors such as obesity that predispose them to chronic illnesses, and are less likely to receive the preventive screenings, regular care, and necessary medications that could prevent or ameliorate their chronic conditions.

Being uninsured often means postponing needed health care services. That’s why people of color in our nation are diagnosed at more advanced disease stages, and once diagnosed, they receive poorer care. Nearly half (46 percent) of nonelderly black adults and more than a third (35 percent) of nonelderly Hispanic adults who do not have insurance report having one or more chronic health conditions. Many more of these Americans do not have a usual source for health care, have substantially higher unmet health needs than their insured counterparts, and have high out-of-pocket costs.

Inevitably, they are sicker and die sooner.

This paper will focus primarily on how implementation of provisions in the new health care reform law can help those who benefit the least from our current health system by addressing disparities in prevention, diagnosis, and treatment of chronic illnesses, thus easing the additional health care burdens borne by racial and ethnic minorities with chronic conditions.

A key tenet of health care reform and making the health care system sustainable into the future is the recognition that most chronic diseases can be prevented. Improving access to prevention services, in combination with better management and coordination of the care delivered to the chronically ill, is an investment that pays off in the medium term with reduced rates of health care services utilization, and in the long term with better health outcomes and more productive lives at lower cost.

Read the full report (pdf) Download the executive summary (pdf)

Measuring the Gaps: Collecting Data to Drive Improvements in Health Care Disparities

There are currently large and worrisome health disparities across the United States in access to quality health care between racial and ethnic minority groups and white Americans. In some cases these disparities have existed for a long time and are getting worse.

Collecting and analyzing valid and reliable data regarding these disparities provides the building blocks for identifying differences in care and developing targeted interventions to improve the quality of care delivered to specific population groups—regardless of whether those population groups are identified by geography, disability, socioeconomic status, race, or ethnicity.

The drive toward quality care for all Americans serves to highlight the areas where there is inequity not just in quality but in access and in more subtle measures such as cultural and linguistic concordance. However, while there is a growing consensus that integrating the reduction of disparities into the quality of care is a coherent and efficient approach to redesigning the health care system—an approach that focuses on the patient and is blind to their race or ethnicity—it cannot be assumed that this will necessarily result in the elimination in health care disparities.2 Race-specific strategies may be necessary to address some types of disparities.

The Affordable Care Act expands the current requirements for the collection and analysis of health care disparities data. The new health reform law recognizes that greater efforts are needed to quantify racial and ethnic disparities in health care, to investigate their causes and impacts, and to implement and evaluate interventions to address them. There are a significant number of provisions in ACA that require the collection and analysis of data on racial and ethnic health care disparities. These data will be critical for guiding both government policy and the programs and practices of individual health care institutions and providers.

It is important that the collection of data on racial and ethnic heath care disparities is not merely confined to sample sets but involves all health care providers as willing participants in the effort. The importance is twofold: first, the larger the data sets, the more reliable the information; second, health care providers who have data from their own institutions and practices are more likely to look at disparities in care, design targeted programs to improve quality of care, and provide patientcentered care.

It is also critical to ensure that data collected by different agencies of the Department of Health and Human Services are collected with sufficient uniformity and to the same standards so that they can be utilized effectively across all sectors and by all stakeholders.

Read the full report (pdf) Download the executive summary (pdf)



The Center for American Progress is a nonpartisan research and educational institute dedicated to promoting a strong, just and free America that ensures opportunity for all. We believe that Americans are bound together by a common commitment to these values and we aspire to ensure that our national policies reflect these values. We work to find progressive and pragmatic solutions to significant domestic and international problems and develop policy proposals that foster a government that is "of the people, by the people, and for the people."


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