Progress And
Challenges In Reducing Excess Deaths From Health Disparities
J Nadine Gracia,
head of the Office of Minority Health at the US Department of Health
and Human Services, described the evolution of US efforts to tackle
health disparities. She highlighted the Heckler report on Black and
Minority Health in 1985 as a transformational event that has served
for 30 years as a driving force in the field. In analyzing mortality
data from 1979 to 1981, the report estimated that 60,000 excess deaths
occurred per year and identified six causes of death that together
accounted in 1979-1981 for more than 80 percent of the excess
mortality observed among Blacks and other minority groups. These
causes were : cardiovascular disease, cancer, chemical dependency
measured by deaths due to cirrhosis, diabetes, homicides and
accidents, and infant mortality.
Gracia stated that important strides have been made in reducing
certain disparities, but added that there is still a lot of work to
do. She reminded the audience of the importance of addressing minority
health issues because demographic shifts indicate that racial and
ethnic minorities will be the majority population by 2044. She
described the financial toll of health disparities as costing the
country 1.24 trillion and said we have an economic and moral
imperative to eliminate disparities.
Gracia described the passage and implementation of the Affordable Care
Act as a historic shift and credited the Act with reducing the rate of
uninsured persons and improving access to services and to care.
She
closed her remarks by pointing out the importance of social
determinants of health and said the government was accelerating
efforts to achieve greater health equity. She called “good news” the
fact that indicators of social determinants of health are included in
the Health People 2020 plan of action. ■
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