1. Health Disparities Group I Sarah England David Grande Corita Grudzen Darrick Hamilton Loretta Heuer Faith Mitchell Wizdom Powell Dawn Elizabeth Rigby Marilyn Sinkewicz Marietta Vazquez

2. Problem Statement Public policy problem. –Patients from certain racial and ethnic backgrounds tend to receive the worst quality of health care. Dimensions of the problem. –In 2002, the Institute of Medicine (IOM), one of the foremost independent research organizations in the country, issued a report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Evidence indicated that in many instances, a patient’s race or ethnicity alone determined the quality of care he or she receives. Even when insurance, income, age, and severity of disease are comparable among white and non-white patients, non-white patients are more likely to receive less medical care.

3. Rationale Importance of this Problem –Racial and ethnic disparities are fundamentally interrelated with the nation’s problems with the quality of health care. –Significant progress in improving the overall quality of health care cannot be addressed until there is an improvement in the quality of health care provided to minority patients. –Disparities result from a number of factors such as: System issues Language barriers Insurance barriers Encounter issues Cultural barriers Ineffective patient-and-provider interaction

4. Stakeholders Support –State Public Health Departments –Local health care facilities (e.g. clinics, hospitals, etc.) –APHA –Civil Rights Groups –AAP (American Academy of Pediatrics) –AAFP (American Academy of Family Physicians)

5. Stakeholders Oppose –Anti-immigration groups –Fiscal conservatives –Ward Connelly’s Group –Privacy Groups Positions are they likely to hold? –Anti-immigration – public funds will be used to fund health care for undocumented workers. –Fiscal conservatives – concerned over cost and spending. –Ward Connelly’s Group – types might oppose the distribution of funds based on subjective criteria (i.e. race) –Privacy groups – might be concerned about data collection efforts.

6. Plan of Action CDC will administer grants to the states. States will apply for grants. –Eligibility criteria will be determined by a State Advisory Committee. –This committee will be comprised of leading epidemiology, social scientists, and public health Officials. –Advisory Committee will determine the outcome measures of disparity (e.g. attributable risk, disparity in chronic disease outcomes).

7. Plan of Action States who receive the grants will work in collaboration with community-based organizations and departments of public health to select cities, locals, or communities with greatest disparity and need in key health areas (e.g. cardiovascular disease, infant mortality, asthma, chronic disease, and obesity). CDC will be charged to collect data on key health disparity areas and will maintain the registry.