Commission to End Health Care Disparities

1. Commission to End Health Care Disparities Commissioner Date

2. About Disparities • Racial and ethnic health disparities are a major public health problem in the United States. • Access is not the issue under discussion • Physicians can be catalysts in improving care for racial and ethnic minorities in the United States.

3. Disparities Facts • African American women are more than twice as likely to die of cervical cancer than are white women • In 2000, death rates from stroke were 40 percent higher among African American adults than among white adults • In 2000, American Indians and Alaska Natives were 2.6 times more likely to have diagnosed diabetes compared with non-Hispanic Whites, African Americans were 2.0 times more likely, and Hispanics were 1.9 times more likely

4. Disparities Facts • Although African Americans and Hispanics represented only 26 percent of the U.S. population in 2001, they accounted for 66 percent of adult AIDS cases • In 2001, Hispanics and African Americans aged 65 and older were less likely than Non-Hispanic Whites to report having received influenza and pneumococcal vaccines • In 2000, the black-to-white ratio in infant mortality was 2.5 (up from 2.4 in 1998)

5. Potential Sources of Disparities • Awareness/Perceptions of Problem • Bias • Communication Skills • Competence (technical/cultural) • Safety • Effectiveness • Patient Centeredness • Timeliness

6. Actions of the Federation of Medicine • Council on Ethical and Judicial Affairs report, Black-White Disparities in Health Care • AMA forms an Advisory Committee on Minority Physicians (1991) • AMA forms a Minority Affairs Consortium (1997) • Two Council on Scientific Affairs reports (CSA) • Race and Ethnicity as Variables in Medical Research (1998) • Health Literacy (1998) • Cultural Competency Compendium (1999)

7. 2001/2002 AMA signs memorandum of understanding (MOU) with DHHS to collaborate on eliminating racial and ethnic health disparities AMA signs MOU with the Kaiser Family Foundation on eliminating racial and ethnic disparities in cardiac care CSA report, Ethnic and Racial Disparities in Health Care - Calls upon the AMA to develop a program addressing this issue Actions of the Federation of Medicine

8. Actions of the Federation of Medicine 2003 • Board of Trustees report, Strategies for Eliminating Racial and Ethnic Disparities in Health Care. • Supports the IOM findings from “Unequal Treatment” • Promotes action to identify opportunities and barriers to eliminating disparities in health care, • Encourages working with public health & other groups to increase physician awareness of and professional obligations to reduce disparities, and • Promotes racial and ethnic diversity within the profession.

9. The Task Force on Disparities • October 2003, the AMA convenes a Task Force on Disparities in Health Care with leadership from 24 specialty and state societies • April 2004, the Task Force, now co-chaired by the National Medical Association (NMA) and the AMA, elects to: • Name itself the Commission to End Health Care Disparities • Focus on racial and ethnic disparities • Focus on health care • Focus on physician leadership • Focus on 4 strategies

10. Commission to End Health Care Disparities • July, 2004, the Commission, now with a 1 year planning grant from the Robert Wood Johnson Foundation meets to formalize itself and develop strategic actions • Unanimously approve a Mission and Vision statement • Establish four advisory committees: • Professional Awareness • Education & Training • Data/Information Gathering • Workforce Diversity

11. Commission to End Health Care Disparities Mission The Commission to End Health Care Disparities, inspired by the Institute of Medicine (IOM) Report, “Unequal Treatment,” recognizes that health care disparities exist due to multiple factors, including race and ethnicity. We will collaborate proactively to increase awareness among physicians and health professionals; use evidence-based and other strategies; and advocate for action, including governmental, to eliminate disparities in health care and strengthen the health care system.

12. Commission to End Health Care Disparities Vision Aided by the work of the Commission and its member organizations physicians, health professionals, and health systems will provide quality care to all people

13. Commission to End Health Care Disparities • January 2005, the AMA sponsors a Press Conference to formally announce the formation of the Commission to End Health Care Disparities. • Speakers include • Dr John Nelson: President, AMA • Dr Randall Maxey: Past President, NMA • Dr Elena Rios: President, National Hispanic Medical Association (NHMA) • Dr Louis Sullivan: Chair, the Sullivan Commission

14. Commission Committees • Professional Awareness Advisory Committee • Established to raise the awareness of disparities as an issue among physicians and physician organizations. • Education and Training Advisory Committee • Established to identify and or develop materials and products that can be used by physicians to provide some direction on addressing disparities.

15. Commission Committees • Data/Information Gathering Advisory Committee • Established to identify data needs of physicians to help them understand the scope of the disparities problem. • Workforce Diversity Advisory Committee • Established to set measurable goals for achieving work force diversity (regionally) and develop nurturing/growing environments by: • Developing an educational pipeline • Encouraging and promoting professional leadership of minorities

16. Current Accomplishments • 46 organizations sign the Mission and Vision statements • The Commission approves the structure and strategic directions • Commission member organizations commit to cultural competence training for their leadership

17. Current Activities • Assess factors associated with the level of physician engagement with racial and ethnic disparities in their practice and their community • Identify validated self training programs on cultural competence to be used by Commission member organizations • Monitoring Organization Change

18. Current Activities • Develop and disseminate a Speaker’s Kit and form a Speaker’s Bureau on racial and ethnic disparities in health care • Assess medical schools admissions committees to determine the degree of minority participation • Develop a campaign to medical schools encouraging their minority faculty to engage in admissions and faculty hiring decisions

19. Health Care Disparities & XXX Organization

20. Commission Members Association of American Medical Colleges Blue Cross Blue Shield Association California Medical Association California Medical Association Foundation Chicago Medical Society Florida Medical Association Inc Gay and Lesbian Medical Association Illinois State Medical Society Massachusetts Medical Society Medical Society of New Jersey Medical Society of the State of New York Michigan State Medical Society National Black Nurses Association National Hispanic Medical Association National Medical Association Ohio State Medical Association Partnership for Prevention Society of Critical Care Medicine Texas Medical Association The CHEST Foundation (ACCP) Uniformed Services University White House Initiative on Asian Americans and Pacific Islanders Alliance of Minority Medical Associations American Academy of Allergy, Asthma & Immunology American Academy of Family Physicians American Academy of Ophthalmology American Academy of Pediatrics American Association of Public Health Physicians American College of Cardiology American College of Emergency Physicians American College of Obstetricians and Gynecologists American College of Physicians American College of Preventive Medicine American College of Surgeons American Medical Association American Medical Women's Association American Osteopathic Association American Psychiatric Association American Public Health Association American Society of Addiction Medicine American Society of Clinical Oncology Association of American Indian Physicians