Health Equity and Disparities

Premature birth is the number one killer of American newborns, according to the March of Dimes. The latest health policy Facts & Figures from CSG goes one step further in its analysis and looks at the disparities in premature births for African-American and Hispanic women compared to white women.

The U.S. ranked behind 29 other nations in infant mortality in 2005. Experts believe the poor U.S. ranking is due in large part to disparities that continue to exist among various racial and ethnic groups, especially African-Americans. African-American babies are more than twice as likely to die in their first year as white babies. Low birth-weight and pre-term births are risk factors for infant mortality, but there is little consensus about why babies are born too soon or too small, or why racial and ethnic disparities persist.

An Indiana proposal would require medical professionals to pass a criminal background check in order to practice in the state.

The majority of state Medicaid programs are testing models of coordinated medical care to improve quality and reduce costs, particularly for patients with multiple chronic illnesses.  Patient-centered medical homes are similar to managed care approaches and health maintenance organizations, but ask providers to focus on improving care rather than managing costs. Such medical homes focus on improving the relationship between doctors and patients, aim to put the patient at the center of the care system, and provide coordinated and integrated care over time and across care settings. Descriptions of eleven states’ pilot programs or authorizing legislation are included.

With the recent federal policy change allowing use of federal funds for needle exchange programs, there is renewed focus on cost-effective public health syringe services programs to prevent HIV and hepatitis C infections and to reduce disparities. State law modifications to allow syringe services programs are described.

Today Secretary Kathleen Sebelius, U.S. Department of Health and Human Services, announced the availability of $250 million to expand the primary health care workforce. The funds are part of the federal reform legislation passed in March.

The funds will be used to expand the number of primary care physicians by 500 by 2015 and support training for additional physician assistants and nurse practitioners. States will be granted $5 million to plan and...

Expedited Partner Therapy (EPT), a cost-effective policy for treatment of curable sexually transmitted diseases, is legal in 23 states. EPT is one approach to treating sexual partners of patients diagnosed with chlamydia or gonorrhea infections, where patients provide treatment directly to their partners.

One-third of teens become pregnant before age 20. One-fourth of young women acquire a sexually transmitted infection by age 19, making them more susceptible to HIV infection.  This 4-page brief describes successful state health and education policies as well as successful targeted youth education activities that can prevent these conditions.

African-American women are hardest hit by HIV/AIDS and sexually transmitted infections, and many are unaware of their infections. The highest teen birth rates occur among Hispanics.  This 12-page brief examines the causes and impact of these disparities, and describes evidence-based policy solutions that states have implemented.

A survey of the number and type of physician shortage areas in each state. State solutions include increasing the number of physicians through medical school enrollment and incentive packages.

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