The ACA contains a variety of provisions focusing on the role of prevention in the promotion of better health. The law led to the creation of a national health council to promote prevention. The council is predicated on the idea that it is not enough to consider only health care when the discussion is about the improvement of health outcomes for all. Rather, the built environment itself—access to parks, good public transportation, and job opportunities—should be considered. The council’s membership includes the U.S. Department of Health and Human Services (HHS) as well as other federal agencies such as the U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Transportation.
The Community Transformation Grants (CTGs) that are included in the ACA also focus on improvements to the built environment. Although there is a strong evidence base for the importance of considering the built environment to improve health, many members of the Senate did not understand the connection. The provisions that focus on improvements to the built environment remained in the final bill, however.
Consistent funding streams for preventive services are also included in the law, as is maintenance of the public health infrastructure. Community preventive services such as disease prevention and safety net programs, which have consistently been underfunded in the past, are seen to be important continued investments in the ACA, explained Martinez.
Data Collection Standards
The collection of race and ethnicity data across federal agencies is essential to get a better sense of the degree of health disparities in the United States. The availability of good data also provide the ability to evaluate subpopulations; for example, not all Asian American populations are alike, said Martinez. Data collection efforts should be coordinated across agencies so that a clearer picture of what is occurring in communities of color can be obtained.
Federal Minority Health Agencies
A number of actions relating to the elevation of federal agencies focusing on minority health are a part of the ACA, including elevation of the Office of Minority Health within HHS to the HHS secretary’s Office. This gives the Office more prominence in the public realm and more clout to accomplish those efforts aimed at achievement of reductions in health disparities in communities of color.