Federal Policy to Advance Racial, Ethnic, and Tribal Health Equity (2023) / Chapter Skim
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Summary Annex: Report Conclusions by Chapter
Summary Annex: Report Conclusions by Chapter
Pages 25-32
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There are conclusions on data gaps, the connection of the social determinants of health to health and health inequities, and the policy topics the committee reviewed. CHAPTER 2: CONNECTION BETWEEN HEALTH EQUITY AND HISTORY, FEDERAL POLICY, AND DATA • Conclusion 2-1: The lack of oversampling of underrepresented racial, ethnic, and tribal populations in national health surveys and other relevant federal data collection efforts -- for example, the Office of Management and Budget categories of American Indian or Alaska Native and Native Hawaiian or Pacific Islander -- limits the availability of reliable data, and therefore meaningful action, by federal programs, researchers, and advocates to advance health equity for these communities.
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From page 26... ...
Since racially and ethnically minori tized populations and tribal communities are disproportionately represented in the groups that would be impacted by an increased federal minimum wage, such an increase is one method to address racial and ethnic inequities in economic stability and, therefore, health and well-being. • Conclusion 3-3: Federal social benefit programs, such as the Sup plemental Nutrition Assistance Program, Special Supplemental Nu trition Program for Women, Infants, and Children, and the Earned Income Tax Credit, significantly alleviate poverty and reduce the negative health consequences of poverty; however, there are bar riers that prevent participation among many people who would otherwise qualify for these programs.
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Since wealth operates in tandem with income to enable access to healthier living conditions, quality health care, and amelioration of stress, these racial and ethnic inequities in wealth produce racial and ethnic inequities in health and well-being. • Conclusion 3-7: Policies to support savings and wealth accumula tion, for example, government subsidies of savings accounts for children, can increase wealth and narrow racial and ethnic differ ences in savings rates and wealth holding.
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CHAPTER 5: HEALTH CARE ACCESS AND QUALITY • Conclusion 5-1: Medicaid and the Children's Health Insurance Program are the most important federal policies that address the racial and ethnic inequities in access to affordable health care. The Medicaid expansions in eligibility incentivized in the 2010 Afford able Care Act have increased insurance coverage, improved health outcomes, and reduced racial and ethnic health inequities in access to preventive services, delayed care, and unmet health care needs.
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The bar riers disproportionately affect racially and ethnically minoritized populations, thus contributing to place-based racial and ethnic health inequities. While federal policies can address these barriers by limiting restrictive use of Medicaid flexibilities and effectively incentivize increasing access, these policy changes will require over coming political and philosophical barriers related to Medicaid, federalism, and the role of government to ensure universal access to health care.
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Increased federal investment in housing interventions for low-income people, such as the housing voucher program, could improve housing security and health outcomes for children and adults, especially among Black, Latino/a, American Indian and Alaska Native, and Native Hawaiian and Pacific Islander popula tions, and advance racial and ethnic health equity. Federal invest ment in housing would benefit from evidence-based guidelines to ensure that such investments do not contribute to future health inequities.
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Civic infrastructure and civic engagement are important factors in building social cohesion and inclusionary de cision making that lead to better design and implementation of policies that affect health equity. • Conclusion 7-6: Important considerations when crafting federal action on health equity include leveraging existing policies and authority, considering the limitations of executive orders, and ar ticulating elements that build belonging, community inclusion, and civic muscle into federal agency policy development processes.
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32 FEDERAL POLICY TO ADVANCE HEALTH EQUITY persistent, and preventable and federal policy is an important tool for correcting historical and contemporary harms. • Conclusion 8-2: Federal policy can play a key role in eliminating health inequities by collecting and employing high-quality and accurate data, doing a better job of including and empowering communities that are most affected, and coordinating and holding those who implement policy accountable.
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