States Taking Different Approach To Finding Root Causes Of Racial/Ethnic Health Disparities

Main Category: Public Health
Article Date: 18 Dec 2007 - 5:00 PDT

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Officials in several states are "revamping health departments to focus less on scientific data and more on the role of 'social determinants' -- things like poverty and discrimination -- [that] some say are widening the health gap" between minorities and whites, the AP/Florida Times-Union reports.

Michael Royster, who recently was named head of Virginia's Office of Minority Health and Public Health Policy, said that whereas state health officials might previously have focused on smoking as a factor behind high cancer rates among minorities, they now are examining factors such as the high prevalence of tobacco ads in urban communities. He said, "What we're looking at is not only health care, but the roles that health care, health behaviors and these broader social determinants play in creating health inequities."

Efforts two states have taken include:

• Pennsylvania has created an Office of Health Equity, which is trying to determine why blacks have the highest rates of cancer in the state; and
  
• Minnesota for years examined how socioeconomic factors influenced health disparities and used the data to craft legislation that aimed to reduce infant mortality disparities by half by 2010.

States' focus on reducing racial and ethnic health disparities is in part related to their search for ways to reduce health costs, Tony Iton -- director of public health for Alameda County, Calif. -- said. According to the National Association of State Budget Officers, states spend one-third of their budgets on health care each year. Iton added, "Health care spending has exceeded the rate of growth of all sectors in most state budgets, and they're not getting the results they would expect to get. You're seeing people being open to looking at this more comprehensively."

James Marks, senior vice president of the Robert Wood Johnson Foundation, noted that health departments do not have legislative power to improve housing, wages or other socioeconomic factors that might influence health disparities. He said, "It is often policies that are outside (health officials') responsibility that needs to be changed. It requires mayors and governors ... they've got to be the ones to call together the private sector and the public sector" (Walker, AP/Florida Times-Union, 12/16).

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