Health Equity and Disparities

CSG Director of Health Policy Debra Miller outlines the top five issues for 2014, including Medicaid expansion and cost containment, health insurance exchange implementation, building adequate mental health systems, health workforce adequacy and the aging of the baby boomers and the pressure it puts on health care systems.

The cost of health care in the United States has grown an average of 2.4 percent faster than the gross domestic product since 1970; it now represents 18 percent of the total GDP, according to the Kaiser Family Foundation. One challenge contributing significantly to these costs is access to health care in hard-to-serve locations. Problems accessing care is especially common in rural areas. According to the American Academy of Family Physicians, 21 percent of the U.S. population lives in rural areas, but only 11 percent of medical specialists practice in those areas. This results in a significant segment of the population that is frequently underserved. One possible solution is a series of medical licensing compacts intended to reduce existing barriers to the process of gaining licensure in multiple states.

Oral health is important to the overall health of an individual. Tracking and comparing oral health indicators is an integral component of a state’s public health strategy, as diseases and certain conditions related poor oral health—like tooth decay, periodontal or gum disease, and oral or pharyngeal cancer—are costly issues. Overall, national spending on dental services reached $108 billion in 2011.

CSG Director of Health Policy Debra Miller outlines the top five issues for 2013, including Medicaid funding and expanded eligibility, health insurance exchange implementation, mental health and violence prevention, promoting healthy behavior through incentives, and health workforce adequacy.

BE IT NOW THEREFORE RESOLVED, that the Council of State Governments urges states to conduct fingerprint based criminal background checks on all nurse licensure applicants by  enacting a relevant provision in the jurisdiction’s Nurse Practice Act or relevant regulations.

Going to work sick can impact your recovery time, co-workers’ health, and potentially customers depending on the job. Sick food workers, regardless of the location of the worker in the food supply chain, can cause others to get sick. The Food Chain Workers Alliance’s new report shows that more than half of workers go to work sick. Handling food while sick can spread diseases like Hepatitis A, E. coli, Salmonella, and Shigella. The CDC estimates that 3,000 Americans die of foodborne disease each year.

Obesity is a growing issue affecting millions of Americans. As we try to combat the negative health effects of obesity there is a push for prevention. Politicians, citizens, and researchers are scrambling to find a cause of obesity. The problem is there is no “magic pill” or perfect solution. Causes of obesity are debated and the search is on for something to blame for the drastic changes in American’s weight. A recent focus has been food deserts. This term describes areas where supermarkets, grocery stores, and other healthy food options are not readily available. To see if your community falls under this category go to The Department of Agriculture’s food desert locator tool below.

The diabetes epidemic extends to 26 million Americans, 8.3 percent of the population. The Southern states have the highest rates of diagnosed diabetes, while no particular region of the country stands out with the lowest rates.  As the nation’s population ages, more people are diagnosed with this disease, currently the 7th leading cause of death in the U.S.  African-Americans are two times more likely to die from diabetes that whites.

CSG state policy profiles on sexual health and prevention provide the latest statistics for each state and Puerto Rico on HIV/AIDS, sexually transmitted infections and teen pregnancy.

But more significantly, the profiles provide answers to the question "what can be done?" Effective state policies recommended by the Centers for Disease Control and Prevention (CDC) are highlighted. Each state's profile reviews whether policies have been implemented in line with these recommendations.

The CSG state profiles are the place for state decision makers to get up-to-date statistics and analysis of research-proven state actions to prevent HIV/AIDS, STIs and teen pregnancy.

Although childhood poverty rates declined throughout most of the 1990s, they have been on the rise again.  Between 2008 and 2009, child poverty jumped 10 percent – the single biggest year-over-year jump in the data’s history.  And from 2000-2009, rates increased in 38 states.  That means 1 in 5 children now live in poverty.