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The Ethics of Equity in Health Care. Defining Inequity. …differences in health care that are unnecessary, avoidable, unfair and unjust… Whitehead and Dahlgren 1991. Defining Equity.
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Defining Inequity …differences in health care that are unnecessary, avoidable, unfair and unjust… Whitehead and Dahlgren 1991
Defining Equity Equity in health is the absence of systematic disparities in health between groups that are differently positioned in a social hierarchy. Braveman and Gruskin 2007
Examples from Research Studies Diabetes Health Disparities: A Systemic Review of Health Care Interventions, Peek, Cargill and Huang, 2007
Disparities 2008: NHQR found that across the process of care measures tracked in the reports, patients received recommended care less than 60% of the time 2008: AMA forms permanent commission to end health care disparities 2011: NHDR indicates that few disparities in quality of care are getting smaller, and almost no disparities in access to care are getting smaller
United States Demographics Race/Ethnicity Gender United States Census Bureau, 2011
Cardiovascular Disease Deaths, US Number of deaths due to all cardiovascular disease, including heart disease and strokes, per 100,000 population
Heart Disease Death Rate per 100,000 for Males 35+, 2007-2009
Diabetes Prevalence, US Percent of adults who responded yes to the question “Have you ever been told by a doctor that you have diabetes?” Does not include pre-diabetes or gestational diabetes.
Diabetes Health Disparities • Racial and ethnic minorities bear a disproportionate burden of the disease of diabetes with: • higher prevalence rates • worse diabetes control • higher rates of complications
CHRISTUS Health 2012- Equity in Care Initiative Measures of health care disparities are quality measures Quality improvement tools and techniques can be used to address health care disparities But quality measures are not necessarily health care disparity measures unless they are stratified by race, ethnicity, language, etc.
2013 Equity in Care Goal Ninety percent of all acute care inpatient admissions will be identified by race and ethnicity.
2014 Equity in Care Goal Stratify race, ethnicity and language data and identify quality improvement tools and techniques to address health care disparities.
