HOW FAR HAVE WE COME IN
REDUCING HEALTH DISPARITIES?
Progress Since 2000
Workshop Summary
Karen M. Anderson, Rapporteur
Roundtable on the Promotion of Health Equity
and the Elimination of Health Disparities
Board on Population Health and Public Health Practice
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This study was supported by contracts between the National Academy of Sciences and the Centers for Disease Control and Prevention; Aetna Inc.; Merck & Co., Inc.; Sanofi Aventis; and Kaiser Permanente. The views presented in this publication do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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Copyright 2012 by the National Academy of Sciences. All rights reserved.
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Suggested citation: IOM (Institute of Medicine). 2012. How far have we come in reducing health disparities?: Progress since 2000: Workshop summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
MEMBERS OF THE PLANNING COMMITTEE1
CARA V. JAMES (Chair), Henry J. Kaiser Family Foundation
JEFFREY LEVI, Trust for America’s Health
MILDRED THOMPSON, PolicyLink
PATTIE TUCKER, Centers for Disease Control and Prevention
WILLIAM VEGA, University of Southern California
SID VOORAKKARA, The California Endowment
WINSTON WONG, Kaiser Permanente
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
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MEMBERS OF THE ROUNDTABLE ON THE PROMOTION OF HEALTH EQUITY AND THE ELIMINATION OF HEALTH DISPARITIES1
WILLIAM VEGA (Chair), University of Southern California
MILDRED THOMPSON (Co-Chair), PolicyLink
PATRICIA BAKER, The Connecticut Health Foundation
KAREN BARCH, Sanofi-Aventis
ANNE C. BEAL, Aetna Foundation
AMERICA BRACHO, Latino Health Access
FRANCIS D. CHESLEY, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services (Ex Officio)
JAMILA DAVISON, Emory University
ALLAN GOLDBERG, Merck & Co., Inc.
GARTH N. GRAHAM, Office of Minority Health, U.S. Department of Health and Human Services
TOM GRANATIR, Humana, Inc.
CARA V. JAMES, Henry J. Kaiser Family Foundation
JENNIE R. JOE, University of Arizona
JAMES R. KIMMEY, Missouri Foundation for Health
ANNE C. KUBISCH, The Aspen Institute
JEFFREY LEVI, Trust for America’s Health
JOHN LEWIN, American College of Cardiology
NEWELL McELWEE, Merck & Co., Inc.
GARY D. NELSON, Healthcare Georgia Foundation
ELENA O. NIGHTINGALE, Institute of Medicine
SAMUEL NUSSBAUM, WellPoint, Inc.
DAVID P. PRYOR, Aetna, Inc.
STEVE M. PU, Missouri Foundation for Health
AMELIE G. RAMIREZ, University of Texas Health Science Center at San Antonio
KYU RHEE, Health Resources and Services Administration, U.S. Department of Health and Human Services
SAMUEL SO, Stanford University
PATTIE TUCKER, Centers for Disease Control and Prevention
SID VOORAKKARA, The California Endowment
VICTORIA WICKS, Sanofi-Aventis
WINSTON F. WONG, Kaiser Permanente
TERRI D. WRIGHT, W.K. Kellogg Foundation
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the Institute of Medicine
IOM Project Staff
KAREN M. ANDERSON, Senior Program Officer
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice
ALEJANDRA MARTIN, Research Assistant
ANDRES GAVIRIA, Senior Program Assistant
DORIS ROMERO, Financial Officer
HOPE HARE, Administrative Assistant
DANQING ZHU, Intern
Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:
Magda Barini-Garcia, Office of Health Equity, Health Resources and Services Administration
James Kimmey, Saint Louis University
Jamila Rashid, Office of Minority Health, Department of Health and Human Services
Melissa A. Simon, Northwestern University
Although the reviewers listed above provided many constructive comments and suggestions, they did not see the final draft of the report before its release. The review of this report was overseen by Carmen R. Green, University of Michigan Medical School. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the author and the institution.
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Contents
2 WHAT PROGRESS IN REDUCING HEALTH DISPARITIES HAS BEEN MADE?: A HISTORICAL PERSPECTIVE
Building Stronger Communities for Better Health: Moving from Science to Policy and Practice
Where Do Health Disparities Stand Today?
Magnitude and Consequences of Health Disparities
3 HEALTHY PEOPLE 2010: HOW FAR HAVE WE COME IN REDUCING HEALTH DISPARITIES?
4 FEDERAL PERSPECTIVES ON REDUCING HEALTH DISPARITIES
5 PROMISING PRACTICES IN ADDRESSING SOCIAL DETERMINANTS: OBESITY PREVENTION
The President’s Task Force on Childhood Obesity
Reducing Childhood Obesity: A Strategy to Address Health Disparities
The California Endowment’s Building Healthy Communities Initiative
6 WHAT DO WE STILL NEED TO LEARN ABOUT REDUCING HEALTH DISPARITIES?
7 LEGISLATIVE ACTIONS TO REDUCE HEALTH DISPARITIES
