Moving Beyond Health Reform Toward Health Equity

With implementation of the Affordable Care Act in full swing, the focus has shifted from questioning its constitutionality to how well the law will live up to its promises.
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With implementation of the Affordable Care Act (ACA) in full swing, the focus has shifted from questioning its constitutionality to how well the law will live up to its promises.

Critics have a laser focus on the law's alleged shortcomings, and as with any major piece of legislation, there are many. But the law lays the foundation for a better, healthier and more fiscally sustainable future for millions of Americans. While this is a major step forward, what Americans need is more than just health insurance but rather, true health equity for everyone.

To achieve health equity, we must first stamp out the health disparities that continue to persist, especially in minority communities. These disparities trigger worse health outcomes, lower quality of life, and higher rates of illness and death. The ACA responds to this challenge by creating new opportunities for affordable health insurance, an important piece of the puzzle, but one that does not in and of itself address the underlying and deep rooted causes of health disparities.

The need to tackle health disparities could not be greater. In a three year span alone, health disparities cost the nation over one trillion dollars. As the nation's demographics continue to change and minority communities become an increasingly larger share of the population, addressing racial and ethnic health disparities becomes ever more important. Yet Congress has targeted federal public health initiatives and programs for major cuts in the coming years. And if the summer's appropriations bills are any indication, federal public health dollars could become rarer, with programs fighting over an ever-shrinking piece of the pie.

Policymakers have zeroed in on one of the few federally funded programs specifically dedicated to improving the health of minority communities, the Centers for Disease Control and Prevention's Racial and Ethnic Approaches to Community Health (REACH) program. REACH is a long-standing and time-proven national initiative that aims to tackle racial and ethnic disparities by supporting community-based programs and culturally-tailored interventions to end health barriers among Asian Americans, Alaska Natives, African Americans, American Indians, Hispanics/Latinos and Pacific Islanders.

For over 10 years, REACH has made racial and ethnic minority communities healthier by improving health outcomes and chronic disease management. Unlike traditional public health interventions, REACH looks at the multifaceted causes of health disparities including where people live, work, learn and play. Funded organizations like the Asian & Pacific Islander American Health Forum (APIAHF) are using cross-cutting approaches to eliminate chronic diseases and obesity by promoting proper nutrition and physical activity in racial and ethnic communities.

For example, APIAHF is partnering with the University of Hawaii in Guam, which is working to develop creative approaches to reducing the high rates of obesity in its jurisdiction. According to research by the University of Guam, an estimated 35 percent of the population in Guam is obese -- a staggering figure that impacts all aspects of quality of life, including work life. This is why the University of Hawaii is partnering with local government offices in Guam to implement worksite wellness programs that allow employees to voluntarily participate in wellness and fitness activities during working hours.

The idea is simple: boost employee morale, lessen the impact of chronic diseases and help workers adopt healthier habits. In the long term, these programs also save taxpayers and employers on health care costs. The University of Hawaii's program is just one example of the impact federal public health dollars can have. Ninety other organizations across the nation are using REACH dollars in innovative ways such as developing community gardens to grow food that meets the local community's cultural and dietary needs and starting farmers markets to increase access to fruits and vegetables.

In the coming weeks, Congress will make a number of tough decisions as it moves forward on spending bills for next year. Sacrificing critical federal public health dollars for prevention and innovative strategies should not be one of them.

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