One of the ways CPEHN participated in National Minority Health Month in April was by co-hosting a panel of experts with the Asian Pacific Islander Capital Association to discuss the status of health equity among the Asian Pacific Islander (API) community. The experts highlighted various approaches we can all take to eliminate health disparities disproportionally affecting certain API communities.
What are the barriers keeping communities from achieving a healthy community?
“You can’t fix what you don’t know,” proclaimed Jonathan Tran from The California Endowment. He was referring to the lack of information and data available regarding South East Asian communities. Before funding and resources can be streamlined into building a healthier community, access to comprehensive data must exist. Since data regarding Asian Americans is characterized for as a whole, research studies are limited in their ability to accurately identify information about the issues affecting specific Asian American subgroups. When all communities are counted for and validated, the numbers can be used to implement change. The AHEAD Act — AB 1726 — addresses this necessary concern by requiring higher education institutions and public health agencies to disaggregate data for additional API groups.
To effectively identify racial and ethnic disparities in health and health care, it is essential that key elements such as patient race, ethnicity, and language proficiency be collected routinely and then utilized to measure performance. There is now also great attention being given to the impact of social determinants on health disparities--including environmental factors, food insecurity, transportation, and safe housing--among others. Hospitals in Pursuit of Excellence of the American Hospital Association and the Disparities Solutions Center at Massachusetts General Hospital are hosting a webinar, “Going Beyond REaL Data Collection: Collecting Social Determinants of Health” on Tuesday, February 23rd, from 9:00 AM – 10:00 AM PT.
This webinar will discuss strategies and approaches implemented by hospitals and health care systems to collect the social determinants of health, with the understanding that this information will be critical for population health efforts of health plans, hospitals and health centers nationwide. Speakers include:
Kirsten Bibbins-Domingo, PhD, MD, MAS, Director, UCSF Center for Vulnerable Populations at San Francisco General Hospital
Lenny López, MD, MDiv, MPH, Chief of Hospital Medicine, University of California San Francisco - SFVA and Senior Faculty, the Disparities Solutions Center at Massachusetts General Hospital
Aswita Tan-McGrory, MBA, MSPH, Deputy Director, Disparities Solutions Center at Massachusetts General Hospital
Today, Governor Jerry Brown made it easier for all children to enroll in affordable health coverage, regardless of immigration status, when he signed Senate Bill 4, authored by Senator Ricardo Lara. Under the measure, eligible children currently receiving limited health care services will be automatically enrolled in full-scope Medi-Cal coverage in 2016. This is a victory for all kids, and will serve as a good first step as we continue our work to expand coverage to undocumented immigrant adults.
However, health is about more than just coverage. Earlier this week, the Governor vetoed Assembly Bill 176, authored by Assemblymember Rob Bonta. This bill would have required several state agencies to use more detailed ethnic categories when collecting demographic data for Asian Americans, Native Hawaiians, and Pacific Islanders (AAs and NHPIs). This data is essential for identifying inequities within AA and NHPI communities, of which there are more than 50 in California. Existing data sources, including the California Health Interview Survey, show disparate rates of chronic health conditions such as diabetes, asthma, and obesity among diverse AA and NHPI communities. Combining all of these unique subgroups into one data category only serves to mask the underlying inequities.
CPEHN remains committed to Health for All and will continue to support policies that require more detailed data collection to help us fully understand the health needs of our communities.
In order to adequately address health disparities, it is important to have as much information as possible on where inequities exist and what populations are most impacted. One of the best ways to address disparities is through collection of disaggregated data on race, ethnicity, and language spoken. One of the key aspects of CPEHN’s policy agenda is enhancing the collection and use of this data to develop more detailed and targeted strategies for reducing disparities.
This week, the California Health Report looked at how data collection can be used to reduce disparities experienced by children in the Medi-Cal program. In particular, the story focused on how children’s health advocates are pushing for Medi-Cal to report on more quality measures besides the minimum required:
The federal Centers for Medicare & Medicaid Services, which regulates the Medi-Cal program, has a list of 24 child health indicators this year. States are required to report on the quality of their low-income health programs, but filing data on the 24 indicators is optional…
California reported on 13 of the indicators in April and expects to report on the same ones when it files next year’s report, which will use 2015 data, said DHCS spokeswoman Carol Sloan.
Advocates argue that California should take the lead in reporting more quality measures because it has the largest Medicaid population in the country.
CPEHN’s Cary Sanders is featured in the story and discusses how reporting on more quality measures in Medi-Cal would help inform efforts to reduce disparities.
Earlier today, the UCLA Center for Health Policy Research hosted a webinar to look at the current state of available data on sexual orientation and gender identity and how the California Health Interview Survey (CHIS) has played a key role in improving collection of this data.
The event, The Importance of CHIS in LGBT Research and Data Collection, featured a presentation by Gary Gates, the Blachford-Cooper Distinguished Scholar and research director at the UCLA Williams Institute. Dr. Gates focused on how CHIS, a comprehensive population-based health survey, has been collecting sexual orientation over the past decade. Over that time span, Dr. Gates said, public perception has been shifting and many states have passed legislation legalizing same-sex marriage and other benefits. The demographic data available through CHIS shows the impact of this shift in public perception, and Dr. Gates expressed excitement about continued improvement in the future, particularly in regards to gender identity data.
. @drgaryjgates "I can't tell you how important it is that CHIS has made the commitment to include gender identity in next survey"
Dr. Gates highlighted some specific trends over the past decade by looking at a variety of demographic data, including age, income, and race/ethnicity. He found that younger people and people of color are identifying as lesbian, gay, or bisexual at a higher rate than they were 10 years ago and that this is likely the result of changing societal perceptions.
The U.S. Department of Health and Human Services Office of National Coordinator for Health Information Technology has proposed a regulation to require electronic health record systems to document and use disaggregated data on race, ethnicity, language, sexual orientation, gender identity, and social and behavioral factors that influence health. This data will make it easier to identify disparities and achieve health equity.
The regulation would require up to 900 race and ethnicity categories and up to 600 language categories, the first time that any federal department has required comprehensive disaggregation. This also would be the first time that sexual orientation and gender identity data would be routinely collected.
Public comments supporting this proposed regulation are needed. Please submit yours today! While comments submitted by organizations are important, it also is very important for individual members of the public to submit personalized comments.