Health Affairs Special Issue on Disparities

A Closer Look at Disparities in Health Care

October Issue of Health Affairs Features Studies Supported by the Robert Wood Johnson Foundation Examining Causes, Consequences of Health DisparitiesHealth disparities are a serious problem in the United States.  The U.S. Department of Health and Human Services reported in April that racial and ethnic minorities are less likely to get the preventive care they need to stay healthy, more likely to suffer from serious illnesses, and when they do get sick, are less likely to have access to quality health care. The October issue of Health Affairs looks at disparities from a number of perspectives, featuring the work of several Scholars and experts funded by the Robert Wood Johnson Foundation (RWJF). Among the articles in the new issue:

• "How Cumulative Risks Warrant a Shift in our Approach to Racial Health Disparities: The Case of Lead, Stress, and Hypertension"

In this commentary, RWJF Health & Society Scholar Margaret Takako Hicken and co-authors recommend that governments and research institutions shift their approaches to health disparities to focus on cumulative risks associated with social and environmental factors, such as stress.

• Read a web story about the study.

• "Rising Closures of Hospital Trauma Centers Disproportionately Burden Vulnerable Populations"

RWJF Physician Faculty Scholar Renee Yuen-Jan Hsia and her co-author look at how closures of hospital trauma centers are affecting Blacks, people without insurance, people living in poverty and other disadvantaged communities. This research was supported by a grant from Changes in Health Care Financing and Organization, an RWJF initiative.

• "Raising Low ‘Patient Activation’ Rates Among Hispanic Immigrants May Equal Expanded Coverage in Reducing Access Disparities"

With an emerging consensus that activating consumers is essential to the success of health reform, authors measured how confident, skillful and knowledgeable Blacks, Whites and Hispanics are about taking an active role in improving their health and health care. The research was conducted by: Peter J. Cunningham of the Center for Studying Health System Change, which was founded by RWJF; Judith Hibbard, a professor of Health Policy at the University of Oregon; and Claire B. Gibbons, senior program officer at RWJF.

• "Undocumented Immigrants, Left Out of Health Reform, Likely to Continue to Grow as Share of the Uninsured"

Because they will not be eligible for public insurance or private coverage through exchanges under health reform, undocumented immigrants will eventually constitute a larger percentage of the nation's uninsured population. Funding for this research, authored by experts at the Urban Institute, was provided by Changes in Health Care Financing and Organization.

• "Collection of Race and Ethnicity Data by Health Plans Has Grown Substantially, But Opportunities Remain to Expand Efforts"

To evaluate the effect of the Institute of Medicine's 2003 call on health plans to collect data on their members' race and ethnicity as a foundation for improving the quality of care and reducing disparities, authors describe the progress made toward collecting these data, the most commonly used data collection methods, and the challenges plans have encountered. The study was funded through an RWJF grant to the America's Health Insurance Plans Foundation. Lead author, Jose Escarcé, is an alumnus of the RWJF Clinical Scholars program and coauthor, Elise Lawson, is a current Clinical Scholar at UCLA.

• "A Regional Health Collaborative Formed by New York-Presbyterian Aims to Improve the Health of a Largely Hispanic Community"

New York-Presbyterian Hospital's Regional Health Collaborative is a population-based health care model to improve the health of the residents of Washington Heights-Inwood, a predominantly Hispanic community in New York City with high rates of asthma, diabetes, heart disease, and depression. The authors outline this initiative as a model for other urban academic medical centers to better serve populations facing social and cultural barriers to care. Lead author, J. Emilio Carillo, vice president of community health at New York-Presbyterian Hospital, was supported in this work through the RWJF-funded Network for Multicultural Research on Health and Health Care.

The issue also features a study funded by The Commonwealth Fund, "Low-Quality, High-Cost Hospitals, Mainly In South, Care For Sharply Higher Shares of Elderly Black, Hispanic, and Medicaid Patients," that was co-authored by Ashish K. Jha, an RWJF Physician Faculty Scholar program alumnus.

• Learn more about this special issue of Health Affairs.