Pay special attention this week to the new March/April issue of the journalHealth Affairs. The entire issue, which RWJF sponsored, is devoted to disparities. The findings presented here—and they are striking—reveal in specific detail from a range of important perspectives how factors such as social determinants, disparities in the health care system, and the lack of diversity in the health professions coalesce to undermine the quality and fairness of our health and health care.
Start with the prologue on "The Social Determinants of Health" and the first article analyzing "Geographic and Racial/Ethnic Disparities in Child Health." Dolores Acevedo-Garcia and colleagues—including David R. Williams, director of the RWJF Commission to Build a Healthier America —paint a disturbing picture of an "unequal geography of opportunity."
Next, the article on "Race, Ethnicity and the Education Gradient in Health" by Rachel Tolbert Kimbro and colleagues, examines how education is a more powerful determinant of health behaviors and outcomes for certain racial/ethnic groups than for others.
On the health care quality side, a Datawatch article explores how the site of care affects health care disparities. The new study, "The Characteristics and Performance of Hospitals that Care for Elderly Hispanic Americans," is the first to examine where Hispanics receive hospital care and finds that a small number of hospitals care for most elderly Hispanics in the nation. The researchers document how hospitals that disproportionately serve Hispanics provide lower-quality care for common medical conditions.
Additional articles authored by RWJF-funded researchers include:
- "Disparities in Physician Care: Experiences and Perceptions of a Multi-Ethnic America"—If public policies provided minority groups with better insurance coverage and language skills, many of the health care disparities found in this study would be narrowed.
- "Evaluating Interventions to Reduce Health Care Disparities: An RWJF Program"—Now that racial/ethnic disparities have been well documented, what can be done to reduce them in real-world settings?
- "Challenges to Using a Business Case for Addressing Health Disparities"—For health care organizations, the social case for reducing health disparities should be just as important as the business case.
Good health comes from healthy lifestyles, good choices and a supporting environment. Good health care comes by delivering the right care at the right time in the right way. Neither will occur without deep, long-lasting transformational change in our systems, in our behaviors and in ourselves.
Getting us there is our passion and our mission. This special issue of Health Affairs certainly helps illuminate our way forward. Our hope is that others will join us on our path and help establish quality and equality for everyone in our society. The health and well-being of all of us in America depends on it.
To learn more about RWJF's initiatives, the programs and projects the Foundation is supporting, and the partners it is working with to address social determinants of health, improve the quality and equality of our health care system, ensure a qualified and diverse health care workforce, strengthen and improve our public health system, and meet the needs of society's most vulnerable populations, subscribe to RWJF.org E-mail Services.