Briefing Focuses on Disparities in Health Outcomes

Brian Smedley:Brian Smedley: “Ultimately we bear this burden.”

NASW co-sponsored a U.S. Senate briefing that focused on the potential cost savings of reducing disparities in health outcomes in any health care reform legislation.

The September event was sponsored by the National Working Group on Health Disparities and Health Reform. NASW is a member of the coalition, which aims to ensure health disparity issues are addressed in the health care reform debate.

Speakers from several leading health, mental health and medical organizations explained that eliminating racial and ethnic disparities can improve the quality of health care nationally. Daniel Dawes, senior legislative and federal affairs officer at the American Psychological Association, said it's vital that coalition members speak with one voice. "Reform must be for all and not just some," he said.

Norman Anderson, CEO and executive vice president of the APA, said multiple factors explain the presence of racial and ethnic disparities in health outcomes. He said studies show racial and ethnic minorities experience a greater burden from mental illness.

Other examples show:

  • People who are homeless, incarcerated or institutionalized experience higher rates of mental disorders.
  • Hispanic adolescents report more thoughts about suicide and attempts than whites and African Americans.
  • Schizophrenia is diagnosed more frequently in African Americans.

Anderson said better data collection of the disparities and an examination of the exact factors involved, including biological, behavioral, social and psychological, are needed to help close the gap on health disparities among minorities.

"We need to focus on treating chronic conditions through community programs," he said.

Brian Smedley, vice president and director of the Health Policy Institute of the Joint Center for Political and Economic Studies in Washington, said the costs to treat the uninsured end up higher. Eliminating health disparities ought to be a goal, he said, "because ultimately we bear this burden."

According to a recent study by the institute, "The Economic Burden of Health Inequalities in the United States," more than 30 percent of direct medical costs for African Americans, Hispanics and Asian Americans were excesses resulting from health inequities — more than $230 billion over a four-year period. Adding indirect costs to these inequities over the same period came to $1.2 trillion.

"The cost of inaction is a price we cannot pay," Smedley said.

Timothy Waidmann, senior researcher in the Urban Institute's Health Policy Center, said the costs of health disparities will double by 2050.

Carolyn ClancyAHRQ’s Carolyn Clancy noted: “We have an imperative to make sure [health care] is excellent for everyone.”

Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said the U.S. is improving in some areas of health care, but less so in others. She agreed that health disparities need to change.

"The challenge is, how do we find those savings?" she asked.

Later, Clancy added: "We have an imperative to make sure [health care] is excellent for everyone."

Len Nichols, director of the Heath Policy Program at the New America Foundation, said it is "in our best interest to protect all of us."

The U.S. Bureau of Labor Statistics estimates that 41.5 percent of the workforce will be racial and ethnic minorities over the next decade.

Out of Many, One — an organization working for health parity for people of color — reports that 96 percent of the $2 trillion spent on health in the U.S. is on treatment. Shifting some of these resources to prevention would be a wise investment, the group stated.

Materials at the briefing included NASW's outline on the need to end disproportionate health outcomes. It pointed out that social workers aim to ensure that vulnerable populations have access to quality health care. As part of interdisciplinary teams, social workers help clients overcome barriers to quality care in hospitals, community health clinics and public health and social service agencies, the statement said.

Rita Webb, NASW policy adviser for women and racial and ethnic diversity issues, said after the meeting that NASW supports an equal right to continuous, high-quality care that is effective, efficient, safe, timely and patient-centered. The association also supports ensuring workforce development of the profession to meet the needs of special populations.