Health Equity and Disparities

The number of poor children has been on the rise for the past 10 years, although those increases vary across state and racial and ethnic lines.  Higher childhood poverty rates mean bigger costs to states, including future health and criminal justice expenses.  

What isn't new in the report on rural health care from UnitedHealth's Center for Health Reform and Modernization are findings that rural Americans are more likely to suffer from chronic health conditions and have greater difficulty accessing quality health care.

More helpful are the recommended solutions to rural health issues. Fully 30 pages are devoted to review of existing models of rural health care delivery, the promise of rural telemedicine, and new models for high-performing rural provider networks.

Calling addressing health disparities a moral imperative, Maryland Lt. Governor Anthony Brown annouced the formation of a high-powered group to come up with programs, policies, and legislation to reduce disparities.

Adult and childhood obesity remain a major issue for states and the nation. States have implemented various policies and programs to reduce the number of adults and children who are either overweight or obese. The economic benefit of having a healthier population is a significant reason why states continue to push for healthy programs.

Today, Vermont became the first state in the nation to establish a single-payer health care plan for the state. 

Upon the passing of the bill by the Vermont House of Representatives (92-49) and Senate (21-9), Governor Peter Shumlin praised the legislature for becoming "the first state in the country to make the first substantive step to deliver a health care system where health care will be a right and not a privilege."

The legislation guarantees any Vermont resident the right to enroll in a state-sponsored...

The Centers for Disease Control and Prevention recommends six strategies to reduce the spread of HIV and STD's. Only one of 32 rural states has all six policies in place and less than one-third have four or more of the six recommended policies in place. 

Rural households have worse health outcomes than urban households. Access to care is limited due to less insurance coverage, financial hardship and geographical access to care. Highlighted state policies address increasing the health care workforce in rural areas.

Federal health reform expanded private health plan coverage for preventive services that can keep people healthy, save lives and reduce health care costs, which many Americans do not receive. Starting Jan. 1, 2011, new group and individual private health plans are required to cover recommended preventive services, and patients do not have copayments or deductibles when in-network providers are used. To prevent sexually transmitted diseases and HIV/AIDS, covered services include screening tests, prevention counseling and immunizations. Coverage for preventive services by Medicare and Medicaid is also expanded.

All but two states maintained or improved eligibility rules for their Medicaid and Children’s Health Insurance Program, commonly known as CHIP, in 2010.These programs continued to be critical to providing insurance coverage for children and families that otherwise would be uninsured. The median state income limit for children’s coverage is now above 200 percent of the FPL, and pregnant women are eligible up to a median of 185% FPL. However, the median income limit for adult coverage is significantly below the higher eligibility level of 133% FPL that will be implemented under health reform in 2014.

Programs under federal health reform aim to tackle the persistent challenges of rural health disparities through expanded access and quality. New investments in rural primary care work force development and changes to rural hospital financing are part of the strategies to improve quality and reduce cost while improving health. State experts will describe how investments in telemedicine are bringing immediate specialized care to remote areas to save lives and reduce unnecessary care and costs. Hear about state successes in teaching patients to effectively manage chronic diseases, showing how integrating information technology, coordinating health providers, and incorporating evidence-based service improvement could diminish rural health disparities.