State, National Public Health Leaders to Explore Strategies to Eliminate Minority Health Disparities at First Statewide Summit
ALBANY, N.Y. (Jan. 12, 2009) – More than 200 state and national public health leaders are meeting Tuesday and Wednesday at New York's first statewide Summit on Minority Health Disparities to begin the development of a comprehensive action plan to eliminate minority health disparities in New York State.
Sponsored by the New York State Department of Health (DOH), the University at Albany's Center for Women in Government and Civil Society and the New York State Minority Health Council, the Summit takes place at the Campus Center Ballroom, University at Albany, 1400 Washington Ave.
"All New Yorkers should be able to receive high-quality, affordable health care that protects and preserves their well-being," said Governor David A. Paterson. "We are especially concerned about those population groups bearing a disproportionately large burden of illness, such as those with low incomes, minorities living in urban settings and people in underserved areas of the state. Our goal is to provide access to the kind of care that prevents, detects and treats these conditions before they become life-threatening."
This two-day Summit will explore the strategies and interventions that reduce or eliminate health disparities. It will also provide a forum where participants can exchange information and create a shared vision to identify effective approaches for addressing health disparities in New York State.
"Despite billions of dollars invested in health care in New York, health disparities persist for minorities and those with low incomes," said state Health Commissioner Richard F. Daines, M.D. "We must continue to expand opportunities for all New Yorkers to receive quality health care, with strategies like Governor Paterson's initiatives to expand access to health insurance coverage, and the budget reforms that would provide incentives for more community-based primary and preventive care. But to address health disparities effectively, we need a strong partnership that includes government, health care providers, local public health departments, and community-based organizations, and a shared vision for execution."
"The persistence of health disparities among some of the State's most vulnerable populations is a stark reminder of work yet to be done," said Anne C. Beal, M.D., MPH, Assistant Vice President for the Program on Health Care Disparities at the Commonwealth Fund and Chair of the New York State Minority Health Council. "However, New York State is positioning itself to be a national leader in eliminating disparities. This Summit provides a venue for department of health leadership to come together, and exchange information on what programs and interventions across the state have been effective for reducing disparities."
As an example Dr. Beal cited, the Health Department's Prevention Agenda Toward the Healthiest State, which sets goals for health outcomes like infant mortality. "In addition to tracking the health status of all New Yorkers, the Prevention Agenda tracks health indicators for minorities to make sure no one is left behind as we work to improve the health for all New Yorkers," said Dr. Beal. "The Commissioner and department leadership clearly understand that reducing disparities is a core part of improving health across New York State."
The moderator will be Richard G. Younge, M.D., MPH, chair of the New York State Minority Health Council's Ad Hoc Committee on the Health Disparities Summit.
Commissioner Daines will open the Summit with remarks on the progress and challenges in addressing health disparities in New York. Deborah Bachrach, Deputy Commissioner for the Office of Health Insurance Programs, will speak on "Health Disparities Through the Lens of Medicaid."
Other speakers and panel discussions are as follows:
- "The Role of State Health Departments in Eliminating Racial and Ethnic Health Disparities," Brian Smedley, Ph.D., Vice President and Director of the Health Policy Institute of the Joint Center for Political and Economic Studies in Washington, D.C.
- "Developing a Blueprint for Ending Health Disparities," Garth Graham, M.D., MPH, Deputy Assistant Secretary for Minority Health of the U.S. Department of Health and Human Services.
- "The Role of Research in Health Disparities Action Plan Development and Implementation," John Ruffin, Ph.D., Director of the National Center on Minority Health Disparities of the National Institutes of Health.
In 2007, DOH's Minority Health Surveillance Report covering health data for the years 2003-2004 showed a negative trend in several areas of minority health. For example, a study of white, African American and Hispanic children in the WIC program showed higher rates of obesity in 2004 than they did in 1995. In addition, the percentage of low birth weight births increased for all groups except Hispanics.
Other trends showed some improvement, including lower death rates for minorities in HIV/AIDS, asthma, and certain cancers compared with minority rates for these diseases 10 years earlier, but these rates have not decreased equally across racial/ethnic groups. African Americans suffer disproportionately compared to other groups on certain health indicators. For example, they have the highest age-adjusted mortality rates for diabetes, certain cancers, HIV/AIDS, asthma and heart disease. African American adults also have the highest prevalence of diabetes compared to all other groups.
Minorities showed gains on some measures that reflect improved access to health care. For example, the rate of early diagnosis of prostate cancer was nearly 90 percent for all racial/ethnic groups compared with rates ranging from 68 percent to 77 percent 10 years earlier. However, Hispanics are least likely to have early-stage diagnoses of prostate cancer and colorectal cancer. Experiencing cost as a barrier to doctor visits, having no regular health care provider and lacking health insurance are challenges faced most often by Hispanic adults.
State initiatives to improve the health of minorities continue to be implemented, including expanded access to health insurance, implementation of a new prevention agenda, health care quality incentives tied to reimbursement, and expanded use of health information technology.
Because many families with working parents are uninsured, in 2008 New York expanded the State Children's Health Insurance program (SCHIP), making affordable coverage available to every child in New York.
Building on these reforms, Governor Paterson proposes to:
Expand Access to Coverage
The Governor proposes income eligibility expansions in Family Health Plus to 200 percent of the federal poverty level, making more than 400,000 additional New Yorkers eligible for coverage. Family Health Plus is a public health insurance program for adults, ages 19 to 64, who do not qualify for Medicaid. He has also proposed expanding employer-offered dependent insurance coverage to family members from ages 19 to 29. Families would pay the full cost of the policy at significantly reduced rates than seeking individual policies.
Increase Funding of Hospital Care to the Poor
Governor Paterson would add $282 million to the Indigent Care Pool available to hospitals, health centers and mental health clinics, of which 50 percent will go to subsidize state public hospitals serving increasing numbers of uninsured patients.
Expand Access to Primary and Preventive Care Services
A comprehensive $3.5 billion health care reform plan to reform the State's Medicaid reimbursement system to invest in more effective and cost-efficient primary care settings, reduce inpatient rates and reallocate funds to higher reimbursement rates for ambulatory care settings.
Last year DOH launched the Prevention Agenda Toward the Healthiest State, encouraging a joint planning effort by county health departments and hospitals in conjunction with schools, business and health plans. Addressing health disparities is a major emphasis of the Prevention Agenda. More information is available at the Prevention Agenda website: http://www.nyhealth.gov/prevention/prevention_agenda/.
Implement Plan to Fight Obesity
The Governor has proposed the Healthy Food/Healthy Communities Initiative to offer a new revolving loan fund to increase the number of health food markets in underserved communities; ban trans fats in restaurants; require calorie posting in chain restaurants; ban junk food sales in schools and place an additional sales tax on sugared beverages such as soda. Up to $1 million in funding would establish the Community Coalitions for Obesity Prevention to support regional coalitions that will create environmental and policy changes to promote access to healthy, affordable food and safe environments for physical activity.
Enhance Lead Poisoning Prevention
The Governor would make permanent a 2007 program in the Childhood Lead Poisoning Primary Prevention Program and add $2.5 million to continue to identify zip codes with more children with elevated blood-lead levels and charge local health departments to develop and implement a housing-based primary prevention plan for each such zip code.
Increase Cancer Screening
Expand cancer screening programs by $3.2 million for free mammograms, ovarian cancer screenings and colorectal screenings for uninsured and underinsured people.
Last month, DOH unveiled the Prevention Quality Indicator (PQI), a new web-based tool used to identify gaps in preventive and primary care by geographic area, as measured by hospitalization rates for conditions generally considered preventable with access to good primary care. It also reveals health disparities by breaking data down according to patients' race and income.
For example, the downtown Brooklyn zip codes of 11201, 11205 and 11217 reveal hospital admission rates for uncontrolled diabetes that are more than 2.5 times statewide norms, with admission rates for African Americans and Hispanics nearly five times the statewide rate. In Western New York, the south Buffalo zip codes of 14201, 14202, 14203 and 14204 have total PQI hospitalization rates about 50 percent higher than the expected statewide rate. Hospital admission rates for diabetes are more than double the statewide rate. Visit the PQI website at: https://apps.health.ny.gov/statistics/prevention/quality_indicators/.
New York's Minority Health Surveillance Report can be found at http://www.health.ny.gov/statistics/community/minority/docs/surveillance_report_2007.pdf