Government Plan Takes Aim At Minority Health Care Gap

A new U.S. Department of Health and Human Services report shows that people of color, throughout their lives, tend to suffer from poorer health and have less access to quality health care, than whites. These disparities exist in a range of areas including cardiovascular disease, cancer and infant mortality. Host Michel Martin speaks with Dr Howard Koh, Department of Health and Human Services Assistant Secretary for Health, about a new action plan to reduce disparities in minority health care.

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MICHEL MARTIN, host:

Now to a different challenge for minority populations: health and what the government calls a first-of-its-kind effort to deal with those disparities. It's a fact, which we have reported here that racial and ethnic minorities tend to suffer from poor health and less access to health care than the majority white population.

According to a new report from the U.S. Department of Health and Human Services, major disparities exist for cardiovascular disease, asthma, diabetes, infant mortality, cancer, violence, behavioral health and so on. Joining us to talk more about the report and a plan of attack to confront minority health disparities is Dr. Howard Koh, assistant secretary for health for the U.S. Department of Health and Human Services. He's here with us in our Washington, D.C. studio. Thank you so much for being here.

Dr. HOWARD KOH (Assistant Secretary for Health, U.S. Department of Health and Human Services): Thank you.

MARTIN: Now, first of all, this isn't just a matter of right-to-do or this is, like, a good thing to do. There are serious, kind of, cost issues involved here. The report says that minorities make up more than half of the approximately 45 to 50 million people who are uninsured and if you consider that if current trends continue, white Americans will be the minority by about 2050.

So is part of the concern here that if these disparities aren't addressed, we could be facing a huge bill - even bigger bill for health care down the road than we are now?

Dr. KOH: Sure. Well, there are many reasons why we should be concerned about these trends. First of all, as you just mentioned, in terms of demographics, we have increasing diversity in this country and we have cities right now where minorities are the majority, in fact, in about 10 percent of counties in four states where minority populations are the majority.

But we have increasing health care costs (unintelligible) to preventable illness. And from the global point of view, Michel, we need all people to reach their full potential for health. And that's a noble goal, but that goal is far out of reach for too many people right now.

MARTIN: Well, but is this a health issue or is this is a socioeconomic issue?

Dr. KOH: It's all the above and we're in a time in public health where we need to take the broadest possible perspective on these challenges and that's why the government has put out this report.

MARTIN: Tell me what we've learned in this report that we didn't already know. For example, there are some issues that have surfaced recently, have been discussed more than in the past, like the whole question of food deserts, places where it's actually very difficult to access quality in affordable food.

But a lot of this information has been known. So, did we learn something new in this report that we didn't already know? Or is it more a matter of pooling together the resources and saying that there's going to be some coordinated approach here?

Dr. KOH: Well, the weight of evidence shows that these disparities affect literally every aspect of public health, as you just mentioned. So, for cancer, for heart disease, for HIV, for tobacco, for flu immunization, and the list goes on and on, we know that minorities have a disproportionate burden. They have less access to prevention. They have less insurance coverage and they get less access to quality care.

And so these are issues that have mounted and are really producing tremendous burdens on this country. And we now know that we have an opportunity with the Affordable Care Act and an increasing emphasis on prevention and community-based efforts. So this is the right time to release the report and do something about this.

MARTIN: If you're just joining us, this is TELL ME MORE from NPR News.

We're talking about minority health disparities. The Department of Health and Human Services just released what they're calling the first-of-its-kind report and strategy designed to address the disparities in overall health between racial and ethnic minorities and the white population. We're speaking with Dr. Howard Koh, assistant secretary for health for the U.S. Department of Health and Human Services.

So, let's talk strategy now. What is going to be different here?

Dr. KOH: Well, we have five broad goals in this strategy and it's very comprehensive. First, obviously to reduce the rates of the uninsured. Secondly, to improve and diversify the health care workforce. That's a tremendous need. Third, to make sure that population health is improved in areas like cancer, heart disease, HIV and asthma. Fourth, to improve data collection. We need better data on what the health challenges are. And then fifth and most importantly, with this report, the department itself is showing its commitment to better coordination, to prioritizing these efforts and really tracking outcomes and giving a regular report to the American people over the future.

MARTIN: Can you give me an example of what you think could be improved in a way that people could understand who don't follow these issues every day?

Dr. KOH: Sure. For example, we have issues with respect to coordination of care for patients. And everybody has lived through that as a patient. And so we have - an announcement, for example, yesterday that a department put forward saying that we need better coordination of care through centers for Medicare and Medicaid services. We need to stress patient protection in hospitals. That's done through coordinated care and a better emphasis on quality.

So these efforts require not just federal officials and better funding, but also community-based efforts and patient engagement. We feel that getting everybody involved is going to make a difference moving forward.

MARTIN: But what I'm asking you is, does this strategy cause people to do anything different? Or does it merely lay out guidelines for what they should do?

Dr. KOH: Well, again, this is an extraordinary time for the country, Michel, because we have an effort to really build systems of care and prevention for all people. So that's what we're doing with the Affordable Care Act, with efforts that are imbedded in this plan. And we want special emphasis on racial and ethnic minorities because they have been carrying a disproportionate burden for far too long. And we need a country where all people reach their full potential for health. And that's what we're holding forth as a vision today.

MARTIN: And, finally, this comes at a time when you say this is a very important, sort of, decision point for the country as, I think, most people know, that there's been a lot of resistance to the Affordable Care Act. What happens to the strategy if this act is successfully challenged?

Dr. KOH: Well, first of all, the Affordable Care Act is the law of the land and we're moving forward with implementation every day. And then there are many aspects of this plan that are moving forward literally by the day. So, we have also many other efforts that started before the Affordable Care Act.

For example, the first lady's Let's Move initiative to fight childhood obesity has been a very strong effort that is not necessarily linked to the Affordable Care Act, but together with it can produce tremendous results. The president himself unveiled a national HIV strategy last summer, which is moving forward to redirect resources to care for this domestic epidemic. And so we have many initiatives that are ongoing.

And by the way, a national health planning effort called Healthy People, and we just unveiled the next 10-year plan several months ago. And so those are goals and objectives for the whole country that unifies the country in making the country healthier. And so we feel that this plan is part of this overall effort to give everybody a shot at a full potential for health.

MARTIN: Dr. Howard Koh is the assistant secretary for health for the U.S. Department of Health and Human Services. He was kind enough to join us in our Washington, D.C. studio. Dr. Koh, thank you so much for joining us.

Dr. KOH: Thank you.

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