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OCR for page 185
APPENDIX II
PUBLIC TESTIMONY
The committee devoted a day of its two-day March workshop
to hearing testimony on the National Healthcare Disparities Report
from 20 academics, advocates, and other national experts on racial,
ethnic, geographic, and socioeconomic health care disparities. Table
TT-1 presents the names and organizational affiliations of those who
appeared. The committee invited these experts after soliciting
suggestions from a number of sources, including AHRQ. Committee
members Joseph Betancourt and Doriane Miller planned the public
testimony sessions.
Much of the testimony addressed two major issues:
l. Nature of the report. Many of the experts called for AHRQ to
produce a report that would help policy makers, advocates, health care
professionals, and others to better understand the causes behind
disparities. A descriptive report, they believed, would document the
kinds of disparities that are already well known. However, they
believed that a report that also examined the factors that produce
disparities could provide the basis for legislation and other kinds of
policy change aimed at eliminating disparities. It could also serve as a
means to monitor progress made towards elimination. In addition, it
could provide an agenda for professional education, quality
improvement initiatives, and further disparities-oriented research.
2. Analysis of Disparities. Experts offered their views on how the
NHDR should analyze health care disparities. Many called for the
report to take into account health care as well as the physical, social,
and economic factors that affect health status and care. These factors
include educational quality, health and social services, community
crime rates, housing quality, and insurance barriers. Some experts
identified certain kinds of disparity issues that should be included in
the report such as those involving priority and chronic conditions and
the languages spoken by patients and providers.
185
OCR for page 186
186 GUIDANCE FOR THE NATIONAL HEALTH CARE DISPARITIES REPORT
TABLE II-1 Expert Testimony on the National Healthcare Disparities
Report
EXPERT ORGANIZATION
State University of New York Health
Dennis Andrulis Ph.D. M.P.H. Sciences Center
, ,
Association of Academic Health
Roger J. Bulger, M.D., F.A.C.P. Centers
Kathryn J. Coltin, M.P.H. American Association of Health Plans
Sunset Park Family Health Center
Merle Cunningham, M.D., M.P.H Network of Lutheran Medical Center
Asian and Pacific Islander American
Gem P. Daus, M.A. Health Forum
Arthur B. Elster, M.D. American Medical Association
Vanessa Northington Gamble, M.D., Health Policy and Medical Education
Ph.D. Consultant
Washington Business Group on
Julianna Gonen, Ph.D. Health
Gina Gregory-Burns, M.D. Kaiser Permanente
American Association of People with
Andrew J. Imparato, J.D. Disabilities
Bette Keltner, Ph.D., R.N., F.A.A.N. American Nurses Association
Nebraska Center for Rural Health
Keith Mueller, Ph.D. Research, University of Nebraska
Institute for Health Care Studies,
David Nerenz, Ph.D. Michigan State University
National Association for the Mentally
Darlene Nipper, M.S. Ill
Washington Business Group on
ReaPanares M.H.S. Health
,
Lucille Norville Perez, M.D. National Medical Association
American Association of Family
Jeannette South-Paul, M.D. Physicians
Association of State and Territorial
Ulder Tillman, M.D., M.P.H. Health Officials
National Association of City and
Adewale Troutman, M.D., M.P.H. County Health Officials
Steven Wilhide, M.P.H., M.S.W. National Rural Health Association
OCR for page 187
APPENDIX II
187
In addition, experts raised data-related issues such as the need
to collect accurate data on insurance coverage, including provider and
payment systems. This would avoid reliance on inaccurate recall by
survey respondents. Data from health care plans on racial and ethnic
identification could also be improved by, for example, coordinating
the data that health care plans must gather, risk adjusting for disparity
reporting, and formulating and disseminating interventions to
eliminate disparities.
Experts raised other analytical issues. They include the
following:
The report should present information on disparities that can
inform health care policy at the federal, state, and local levels.
The report should permit data on health care disparities to be
tracked over time.
The report should contain data that are especially pertinent to
some races or ethnicities such as nativity and language
r" .
proIlclency.
The report should recognize the diversity of geographic areas. For
example, some rural areas are closer to major metropolitan areas
than others and some suburban areas have substantial racial and
ethnic populations.
The report should use levels of analysis that include
individuals, communities, and health care systems.
OCR for page 188
Representative terms from entire chapter:
disparities report
