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Health Disparities

Resources on Equity in Healthcare

HHS Action Plan to Reduce Racial and Ethnic Health Disparities

(IMIA Note:) Please note that the Action Plan includes the following:

Strategy ii.A: increase the ability of all health professions and the healthcare system to identify and address racial and ethnic health disparities. Racial and ethnic minorities, and especially people whose primary language is not English, are more likely to report experiencing poorer quality patient-provider interactions than non-Hispanic Whites.44 The actions below will address this disparity and optimize patient-provider interactions.

ii.A.1 Support the advancement of translation services.
• promote the healthcare interpreting profession as an essential component
of the healthcare workforce to improve access and quality of care for people with limited english proficiency. In partnership with national organizations for certification of interpreters, HHS will improve quality of care for people with limited English proficiency. This includes promoting the knowledge, skills, and abilities required for healthcare interpreting, educating individuals about the pathways into the healthcare interpreting profession, and establishing an accessible online national registry of certified interpreters to allow healthcare facilities and providers to quickly identify certified interpreters. Collaborations with community colleges will develop effective training programs that help build the profession of healthcare interpreters and deliver credentialing examinations for healthcare interpreters.

Improve language access in Medicaid. This initiative will pilot test software for
a web-based enrollment system that enables Medicaid staff to interview non-English speaking or low-literacy applicants, and help those applicants to apply for Medicaid and CHIP benefits. This will allow a higher federal matching rate for state administrative costs dedicated to translation/interpretation services, including American Sign Language or Braille. This initiative will also encourage states to: employ staff members to provide translation or interpretation functions; pay for direct translator/interpreter support to medical providers; translate brochures, commercials, radio and newspaper advertisements, and other promotional material into other languages; and provide interpretation hotlines for Medicaid and CHIP recipients.
lead/participating Agencies: OASH/OMH, CMS, HRSA timeline: Starting in FY 2011

ii.A.2 Collaborate with individuals and health professional communities to
make enhancements to the current National standards for culturally and linguistically Appropriate services in health care (clAs). The CLAS Standards, released in 2000, represent the first national standards for culturally competent healthcare service delivery. These standards will be updated, via a CLAS Standards Enhancement Initiative. Improvements will be informed by the responses received throughout the recently ended public comment period and three previously held regional public meetings. HHS will maximize public input, stakeholder dialogue, and subject matter expertise to ensure that the enhanced CLAS Standards serve the health needs of populations experiencing health disparities.
lead/participating Agencies: OASH/OMH, SAMHSA timeline: Starting in FY 2011

Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement

Institute of Medicine

The quality of health care in the United States is not optimal, and the pace of improvement is slow. In addition, disparities persist for specific population groups. A fundamental step in identifying which populations are most at risk is to collect data on race, ethnicity, and English-language proficiency. A large body of research has documented disparities in access to and quality of health care that are revealed when quality of care measures are examined by these variables. A lack of standardization of race, ethnicity, and language categories has been raised as one obstacle to achieving more widespread collection and utilization of these data.

Free News Report on Health Disparities:
Webcasts of interactive panel discussions, interviews, and policy-oriented conferences and events featured in new online report  Washington, D.C. - Recognizing the need for greater awareness and understanding of racial and ethnic disparities in health and health care, the Kaiser Family Foundation announced today the launch of a news summary report - the Kaiser Health Disparities Report: A Weekly Look at Race, Ethnicity and Health. The report is available through a free weekly email, with stories updated daily online on kaisernetwork.org, the Foundation's news and information service.

Bridging the Divide: Medicare's Role in Reducing Racial and Ethnic Disparities

This event examined a growing body of evidence indicating disparities in quality of care among Medicare beneficiaries of different racial and ethnic backgrounds. Panelists also discussed whether and how the Medicare program should use its clout as a health care payer and player to move toward eliminating racial and ethnic disparities. [Kaiser Network, 1-29-07]

Language Disparities and Timely Care for Children in Managed Care Medicaid

This is a study published in the American Journal of Managed Care entitled "Language Disparities and Timely Care for Children in managed Care Medicaid. Interesting article of the relationship between language of parents (among the variables) and timeliness of care. Although done in WA state, it reiterates the importance of parent ability to communicate and outcome for care for children and identifies that the use of an interpreter results in more timely access.  for more info, go to: http://imiaweb.org/uploads/pages/203.pdf


The Robert Wood Johnson Foundation and Center for Health Care Quality at The George Washington University have developed a short educational video and PowerPoint to explain to providers the importance of identifying and addressing racial and ethnic disparities in care. The video examines the definition of health care disparities and academic evidence of its existence and presents tested solutions to identify and address disparities from previous RWJF-funded initiatives.· Watch the video here:

Ensuring that Health Care Reform Will Meet the Health Care Needs of Minority Communities and Eliminate Health Disparities

The Advisory Committee on Minority Health submitted their report to Secretary Kathleen Sebelius with suggestions ensuring that health care reform meets health care needs of minority communities and eliminates health disparities. The full PDF of the report can be accessed at:


2009 National Healthcare Disparities Report

The National Healthcare Quality Report notes that very little progress has been made on eliminating health care-associated infections (HAIs), with rates of many HAIs increasing in the past year. Reform will improve the quality of care for all Americans through new incentives that reward quality over quantity of care.The 2009 Report also found that among the most prevailing disparity was the lack of preventive care.  For example, many minorities had worsening disparities in the percentage of adults over age 50 who received appropriate screening for colon cancer. Also, African Americans and Hispanics had increasing death rates from the disease.  The new health care reform law ensures that Americans have access to the free preventive services they need to create a system that prevents diseases before they require more costly treatment.


S.810 An Act to Eliminate Racial and Ethnic Health Disparities

MA Health Disparities Act Fact Sheet

2006 National Healthcare Disparities Report released from AHRQ.
The 2006 NHDR uses the same measures of quality as its companion, National Healthcare Quality Report (NHQR), to monitor the Nation's annual progress toward eliminating disparities in health care. Racial/ethnic group comparisons focus on 22 core measures and income group comparisons focus on 17 core measures of quality that support reliable estimates for all groups. Six core measures of access to care are also presented.

Identifying and Evaluating Equity Pprovisions in State Health Care Reform -Commonwealth Fund, April 2008
ABSTRACT: Millions of people in the United States - principally racial and ethnic minorities, immigrants, and those who lack proficiency in English - face barriers to high-quality health care. Such problems are largely due to high numbers of uninsured individuals among these groups, though it persists even when they are insured. By expanding health insurance coverage and addressing issues of access to care, quality of care, patient empowerment, infrastructural reforms, and social and community-level determinants of health, states have the potential to achieve equity. This report seeks to identify state policies that promote equitable health care access and quality and to evaluate existing laws, regulations, or reform proposals in five states - Massachusetts, Washington, Illinois, Pennsylvania, and California. These states’ initiatives, all of which move toward universal health insurance coverage, also address other innovative strategies such as improving health care provider diversity, distribution, and cultural competence.

This study estimated the cost of racial disparities over a four-year period at 1.24 trillion dollars (more than the US annual budget deficit): see http://www.jointcenter.org/hpi/sites/all/files/Burden_Of_Health_FINAL_0.pdf

Health Research and Educational Trust Disparities Toolkit
Hasnain-Wynia, R., Pierce, D., Haque, A., Hedges Greising, C., Prince, V., Reiter, J. (2007).

Health Equity Train-the Trainer Session: Collecting Data to Understand Health Disparities
Khaliif, M, Arocha, I, Choi, S, Bresnahan, R., Freeman, E., Russell, B, Anderson, K.(2009).

Massachusetts Department of Health/Cambridge Health Alliance.

Reducing Health Disparities in Asian American and Pacific Islander Populations.
You can find the course at: http://erc.msh.org/aapi/index.html

Disparities Toolkit by Health Research and Educational Trust's

Minority Health Advisory Committee Issues Disability Report 2011


State Documentation of Racial and Ethnic Health Disparities to Inform Strategic Action

The Healthcare Disparities and Cultural Competency Consensus Standards
The Healthcare Disparities and Cultural Competency Consensus Standards project seeks to expand on NQF’s previous work where a set of criteria to evaluate disparities-sensitive measures was identified and 35 disparity-sensitive measures for the ambulatory care setting were endorsed (National Voluntary Consensus Standards for Ambulatory Care – Measuring Healthcare Disparities). This project will begin with a commissioned paper outlining the methodological concerns with measuring disparities, such as implications of risk adjustment and stratification, unintended consequences of public reporting, and data collection; and revising the NQF disparities-sensitive evaluation criteria. This commissioned paper will help inform future efforts on developing and endorsing performance measures for disparities and cultural competency.

The Commissioned paper is now available for public and member comments through Sept. 7th. 

You can provide comments online by clicking on here and going to the “details” tab, which will allow you to download the paper. To access the commenting tool, you do have to have to login through your account, which is free to create.

Ill-Prepared Health Care’s Barriers for People with Disabilities

Eliminating Health Care Disparities: Implementing the National Call to Action Using Lessons Learned, by Equity of Care

Additional Documents

>Training Module for Documenting Race, Language and Ethnicity

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