June 2007 report from Families USA shows how comprehensive health care reform created an environment within which disparities advocates and local and state leaders in Massachusetts could increase media and public awareness of health disparities and move legislation to eliminate them.
The 2006 Massachusetts comprehensive health care reform created several bodies to monitor health disparities and advance steps to eliminate them. As Families USA reports, these steps are important, but advocates believed it was necessary to enact more substantive policies. Health Care for All, which played a lead role in passing the 2006 reform, led the creation of a broad coalition to address equity and justice in health policy, called the Disparities Action Network (DAN).
After a series of meetings and brainstorming, the coalition developed House-2234, An Act Eliminating Racial and Ethnic Health Disparities in the Commonwealth. The bill centers around creation of a Health Equity Office which would coordinate the many programs and projects working to eliminate disparities, across the state. In addition to the Office of Health Equity, the bill’s measures include: several grant programs to support community agencies, hire community health workers, and fund community-based research; data collection coordination; health literacy promotion; promote diversity in the health care workforce; creation of an environmental health index to identify communities with high rate of death and illness; and a chronic disease management program improving wellness education.
Although the legislation is still in committee and the work of the DAN is on-going, Families USA identifies several lessons learned that disparities advocates in all states can take away, including:
- Heightened media and public attention to health care reform surrounding major legislation presents a wave for disparities advocates to ride, upon which they can increase awareness of health disparities and use the momentum to advance disparities legislation.
- A strong and diverse disparities coalition, including both disparities advocates and advocates for expansion, can coordinate the collective strength and outreach capability of these various groups to raise public awareness of disparities and advance their agenda through the public and the legislature.
- Policy is an important tool to reducing disparities, along with direct services. Disparities are a systemic problem and require systemic answers.
- The complexity of health disparities, which arise from socioeconomic, cultural and physical environmental conditions, requires program and policy solutions beyond just access and quality. Environmental and social determinants of disparities must be addressed.