Online Program

Combating disparities under health care reform: A state public health department's experience

Tuesday, November 5, 2013 : 12:30 p.m. - 12:50 p.m.

John Auerbach, MBA, Institute on Urban Health Research, Northeastern University, Boston, MA
The full implementation of the Affordable Care Act (ACA) is likely to have an impact on racial and ethinic health disparities and the goal of health equity. It is possible to gain an understanding of this potential affect by examining the experience of implementing health care reform in Massachusetts beginning in 2007. As the Commissioner of Public Health in Massachusetts during the years from 2007 to 2012 I was charged with looking for concrete indications of the impact. Some were relatively easy to find. Access to health care services improved for all racial and ethnic groups as a result of health care reform. The overall percentage of uninsured dropped from 7% to 2% while the percentage of uninsured Black and Latino residents dropped from 8% and 10% to 4% and 7% respectively. Health indicators or surrogate markers for health also improved in a number of areas including vaccination again the flu, smoking rates and colonoscopy and other cancer screenings. In addition, those with chronic diseases such as asthma and diabetes were more likely to receive the recommended prevention and symptom control services after health care reform. While access to care and health outcomes improved for all groups in numerous instances, the gap between whites and other populations often did not close and in some instances (such as among Latinos) may have widened. This suggests that specialized attention to reducing disparities in needed even as health care reform improves access. I will offer a few positive examples of such efforts.

Learning Areas:

Diversity and culture
Other professions or practice related to public health
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related research

Learning Objectives:
Describe the steps taken by the Massachusetts Public Health Department to reduce health disparities as part of the state's implementation of health care reform Identify the evidence that health care reform affected health access and outcomes of and disparties between different racial and ethnic group Highlight lessons learned from this experience that may be useful for public health practitioners in other states where health care reform will be implemented.

Keyword(s): Health Care Reform, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Commissioner of Public Health in Massachusetts during the years that health care reform was implemented in our state and I oversaw the effort to observe the health impact of reform on disparities. I was previously the Director of the Boston Public Health Commission for a decade. I now lead a research institute with a strong focus on the elimination of health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.