Maryland Department of Natural Resources 2013 Black History Month Program. African Americans Environmental Justice and Health Disparities. Arlee Gist, B.A., Deputy Director Office of Minority Health and Health Disparities Maryland Department of Health and Mental Hygiene February 21, 2013.
Black History Month ProgramAfrican AmericansEnvironmental Justice and Health Disparities
Arlee Gist, B.A., Deputy Director
Office of Minority Health and Health Disparities
Maryland Department of Health and Mental Hygiene
February 21, 2013
“A higher burden of illness, injury, disability, or mortality experienced by one population group in relation to a reference group; and a healthcare disparity can be described as differences in, for example, coverage, access, or quality of care.” **What is a health disparity?
What is a disparity?
“…Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States” *
* The Henry J. Kaiser Family Foundation, Policy challenges and opportunities in closing the racial/ethnic divide in health care. Race, ethnicity, and health care issue brief. 2005, The Henry J. Kaiser Family Foundation: Washington, D.C.
** National Institutes of Health (US). NIH strategic research plan to reduce and ultimately eliminate health disparities; 2000 October 6.
1895 – Booker T. Washington at Atlanta Exposition Meeting: discussed deficiencies in Negro health care
1899 – W.E.B. Dubois “The Philadelphia Negro: A Social Study”: a sociological study of Negroes including health
1903 – W.E.B. Dubois “Souls of Black Folk”: discussed declining health of Negroes post slavery
1968 –“Kerner Commission Report”: speaks of gains in Black American’s social welfare, however health inequalities remain severe and troubling
1976 – National Medical Association: met in Washington, D.C. and discussed access, morbidity and mortality disparities between Blacks and Whites
1980 – Black Congress on Health Law and Economics: met in Dallas, Texas and discussed strategies for bridging health care gaps between Blacks and Whites
1985 – Report of the HHS Secretary’s Task Force on Black and Minority Health (Heckler-Malone): identified the continuing existence of health disparities
1999 – IOM Report: “Unequal Burden of Cancer”, Alfred Haynes & Brian Smedley, Editors: cancer as experienced by ethnic minorities and medically underserved
2002–IOM Report: Confronting Racial and Ethnic Disparities in Health Care: Brian Smedley, Adrienne Stith, Alan Nelson, Editors: race and ethnicity remain as significant predictors of health care quality
Found health disparities in birth rates and death rates for minority populations compared to the White population;
Found that there was a disparity in the number of hospital beds available to minorities compared to whites;
Noted that environmental factors such as inadequate diet, occupational hazards, and poor housing conditions may lower their resistance to infection and increase the likelihood of disease.Report of the Governor’s Commission on Problems Affecting the Negro Population, 1943
Healy, J.P., Report of the Governor's Commission on Problems Affecting the Negro Population. 1943, African-American Department.
A Governor appointed 27 member Commission was charged with conducting “a thorough examination of the programs and laws relating to the health status of Maryland’s minority citizens”;
Focused on cardiovascular disease, AIDS, cancer, maternal and child health, homicide, aging, substance abuse, mental health, medical indigency, and minority health manpower.Now is the TimeAn Action Agenda for Improving Black and Minority Health in Maryland, 1987
Maryland Department of Health and Mental Hygiene, Now is the Time: An Action Agenda for Improving Black and Minority Health in Maryland. The Final Report of the Maryland Governor's Commission on Black and Minority Health. 1987, Baltimore, MD
Studied the nature and extent of problems in employment, health care, criminal justice, and education and the effect these problems have on African-American males in Maryland.
Approaches to such extensive problems of health care and insurance must be comprehensive;
Address the need for better coordination and outreach within existing programs;
Address the need for development of additional programs aimed at African American males that include new ways of creating health environment, lifestyle, and positive changes in health indicators.Report of The Governor’s Commission on Black Males, 1993
The Maryland State Governor's Commission on Black Males, Report of the Governor's Commission on Black Males. Maryland's African-American Males Health, Education, Employment and Economic Development, and Criminal Justice. 1993: Annapolis, MD.
Maryland Population, 2010 U.S. Census by Race and Ethnicity (45.3%) Minority
Source: 2010 Census Demographic Profiles, Department of Planning, Projections and Data Analysis/State Data Center, May 2011
** higher is better,
Blacks are worse off
Source: Maryland Asthma Surveillance Report, Asthma in Maryland, 2011. and BRFSS 2006-2010
Black vs. White Disparity Rate for Adults with Asthma, Maryland 2009
Access to healthcare
the major issue for
higher mortality rate
among Blacks in Maryland.
Maryland BRFSS, 2009; Maryland HSCRC, 2009; Maryland VSA, 2005-2009
Rates are age-adjusted to the 2000 U.S. standard population.
Source: Maryland Asthma Surveillance Report, Asthma in Maryland 2011
Source: CDC Wonder Mortality Data 2000-2009
The Action Plan’s main objectives
Objective 1: AWARENESS – Increase awareness of the significance of health disparities, their impact on the state and local communities, and the actions necessary to improve health outcomes for
Maryland’s racial and ethnic minority populations.
Objective 2: LEADERSHIP – Strengthen and broaden leadership for addressing health disparities at all levels.
Objective 3: HEALTH AND HEALTH SYSTEM EXPERIENCE – Improve health and health care outcomes for racial and ethnic minorities and underserved populations and communities.
Objective 4: CULTURAL AND LINGUISTIC COMPETENCY – Improve cultural and linguistic competency.
Objective 5: RESEARCH AND EVALUATION – Improve coordination and use of research and evaluation outcomes.
The Maryland Health Improvement and Disparities Reduction Act (SB 234) was signed on April 10, 2012.
1. Establish Health Enterprise Zones (HEZ) in small geographic areas having very poor health statistics, health disparities and high poverty. The HEZ is eligible for loan repayment assistance, tax credits, capital equipment credits, electronic medical records assistance and participation in the Patient Centered Medical Home program, and funding for four years.
2. Establish and incorporate a standard set of measuresregarding racial and ethnic variations in the State Quality Outcomes reports generated by the Maryland Health Care Commission.
3. Require each non-profit hospital in the State to include in their Annual Community Benefits Reports, a description of the hospital's efforts to track and reduce health disparities.
4. Require institutions that offer programs necessary for the licensing of health care professionals in the State to report on their actions taken to reduce health disparities.
5. Two State commissions that work with hospital and health insurer data, shall recommend standards for evaluating the impact of the Maryland Patient Centered Medical Homes on eliminating health disparities.
6. Form a Workgroup to develop standards and criteria for cultural competency in medical and behavioral health treatment settings
The purposes of establishing HEZs is to target State resources to:
Office of Minority Health and
Maryland Department of Health and Mental Hygiene201 West Preston Street, Room 500
Baltimore, Maryland 21201Website: www.dhmh.maryland.gov/mhhd
Phone: 410-767-7117Fax: 410-333-5100Email: [email protected]