House Panel Examines Health
Disparities
May 31, 2002- The House Government Reform Subcommittee
on Criminal Justice, Drug Policy, and Human Resources May
21 held a hearing to explore racial disparities in health
care. The hearing was prompted in part by the Institute of
Medicine report released in March that found that minorities
in the United States generally receive poorer health care
than whites, even when income, insurance, and medical conditions
are similar.
A panel of government witnesses described the efforts of
various HHS agencies to address these disparities. John Ruffin,
Ph.D., director, National Center for Minority Health and Health
Disparities, discussed three core programs the center has
implemented to strengthen research efforts targeted at minority
health disparities:
- a loan repayment program for health disparities research
and an extramural clinical research loan repayment program
for individuals from disadvantaged backgrounds;
- an endowment program to provide funds to facilitate capacity
building for minority and other health disparities research
at institutions that have demonstrated a commitment to training
researchers from minority and health disparity populations;
and
- the Centers of Excellence in Partnerships for Community
Outreach, Research on Health Disparities and Training (Project
EXPORT), to promote research on health disparities, to encourage
members of health disparity groups to participate in biomedical
and behavioral research as well as prevention and intervention
activities, and to build research capacity.
Dr. Ruffin also described a number of partnership projects
the center has undertaken with other NIH institutes and centers
and other HHS agencies. He also discussed NIH's Strategic
Research Plan and Budget to address health disparities, noting
three main goals for the plan: research, infrastructure, and
community outreach.
Nathan Stinson, Jr., Ph.D., M.D., M.P.H., deputy assistant
secretary for minority health and director of the Office of
Minority Health (OMH) at HHS, discussed five main activities
for the office:
- strategic communication and information dissemination;
- systematic policy coordination and development;
- coalition and partnership building;
- research demonstrations, investigations, and evaluations
aimed at improving the health of racial and ethnic disparities;
and
- collection of comprehensive health data by racial and
ethnic categories.
Carolyn Clancy, M.D., acting director, Agency for Healthcare
Research and Quality, explained to the subcommittee how AHRQ's
research complements NIH research by focusing on the "effectiveness"
of clinical services. She noted that disparities associated
with race and ethnicity are a critical component of efforts
to improve quality of care overall. Dr. Clancy outlined the
EXCEED (Excellence Centers to Eliminate Ethnic and Racial
Disparities in Healthcare) program, a collaborative effort
with NIH, the Health Resources and Services Administration,
and a number of national and local foundations. Each of the
nine EXCEED centers focuses on four to seven studies organized
around a central theme that attempt to analyze reasons for
disparities and identify and evaluate the effectiveness of
strategies for reducing and eliminating them. She also described
two annual reports mandated by AHRQ's reauthorizing legislation
that will be issued for the first time in FY 2003. The National
Quality Report will provide a detailed picture of the state
of health care quality in America. The National Healthcare
Disparities Report will detail "prevailing disparities
in health care delivery as it relates to racial factors and
socioeconomic factors in priority populations."
Ruben King-Shaw, Jr., deputy administrator and chief operating
officer, Centers for Medicare and Medicaid Services, noted
the agency works at two levels to reduce disparities. CMS
employs a broad agency strategy that promotes evidence-based
activities, such as the use of clinical practice guidelines
and the reporting of performance measures, to move toward
care that is similar across population subgroups. The agency
also works to reduce disparities caused by differing access
to and delivery of health care services. He also gave the
subcommittee examples of CMS activities to reduce racial and
ethnic disparities in three major categories: outreach and
education; quality improvement projects; and research and
demonstrations.
Information:
Dave Moore, Senior Associate Vice President
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
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