US government to act to reduce health disparities
WASHINGTON (AP) — From cradle to grave, minority populations in the United States tend to suffer poorer health and get poorer health care than white Americans. In a first-of-its-kind report, the government is recommending steps to reduce those disparities.
The plan being released Friday runs the gamut from improving dental care for poor children to tapping "promotoras," savvy community health workers who can help guide their Spanish-speaking neighbors in seeking treatment.
But it acknowledges that giving everyone an equal shot at living a healthy life depends on far more than what happens inside a doctor's office or actions federal health officials.
"It's also a product of where people live, labor, learn, play and pray," Dr. Howard Koh, assistant secretary of Health and Human Services, told The Associated Press. "We really need a full commitment from the country to achieve these goals."
HHS would not put a dollar figure on its own pending projects but said it plans to pay for them with money already in hand and not subject to Congress' continuing budget battle.
The tight economy casts doubt on how much states and other groups may be able to chip in, said Dr. Paul Jarris, executive director of the Association of State and Territorial Health Officials.
But "we'll never be a healthy nation unless we address these inequities," Jarris said. "There's a lot of momentum finally building" to do so.
Recent years have brought some improvements in health disparities, although racial and ethnic minorities still lag in many areas — from higher infant mortality rates to lower overall life expectancy. In between, they're more likely to suffer from a host of illnesses such as diabetes, heart disease, kidney disease and asthma.
Part of the problem is access to care: Minorities make up more than half of the 50 million people who are not insured, the HHS report says. The Obama administration's year-old health-care overhaul addresses some of the insurance gaps.
But there is a growing appreciation that disparities are more complex. Even geography plays a big role, through shared ancestry and customs, local industry, easy access to fresh fruits and vegetables, and how easy and safe it is to get physical activity in a particular community.
Among the HHS plans outlined in Friday's report:
—Working with states to increase by 10 percent the number of poor children who receive preventive dental care, including cavity-blocking sealants.
—Hiring trusted local people to serve as community health workers who can help diabetics understand and stick to their doctor's care instructions. A Medicare pilot program has begun in Mississippi and Texas and will spread to other areas.
—Increasing use of trained promotoras, the Spanish term for those trusted locals. Head Start will use them to direct parents to health services.
—Developing reimbursement incentives to improve the quality of care for minority populations, such as better prevention of heart disease and strokes.
—New studies comparing which treatments work best for diabetes, asthma, arthritis and heart disease in minority populations.
—Creating an online national registry of certified interpreters that doctors or hospitals can use for patients who do not speak English.
—State grants to measure and improve community asthma care.
HHS held meetings around the country to gather suggestions from state and local officials, community groups and average citizens on barriers to health equality, and a separate report reflects strategies for community efforts.
(기사내용)
미국 소수인종 건강격차 해소 조치
워싱턴 (AP) - 미국의 소수인종은 요람에서 무덤까지를 보장하는 건강관리 면에서 백인보다 건강상태가 더 나쁘고 불리한 대우를 받게 될 가능성이 높다고 한다. 미국정부는 처음으로 이런 격차를 줄일 조치를 취할 것 이라고 한다.
8일 발표된 계획에 의하면 빈민층 어린이의 치아치료에서 부터 스페인어 주민이 치료를 받을 수 있도록 지도하는 유능한 지역 건강요원의 발굴에 이르기 까지 다양하다.
평등한 건강생활을 보장하는 것은 의사의 치료나 정부의 건강관리 담당자의 활동 이외에 더 많이 것이 요구된다.
AP통신과의 인터뷰에서 미국 보건사회복지부 하워드 고차관은 사람의 건강은 사는 장소, 일, 취미와 종교의 산물이며 “이런 건강 격차해소 목적을 달성하기 위하여 국가의 전폭적인 지원이 절실히 필요하다” 고 말했다.
현재 진행 중인 사업에 필요한 자금액에 대해서 언급을 하지 않았지만 정부건강 관련기관의 한 관리는 경제악화로 인하여 정부와 일반단체로 부터의 보조금이 불투명하다고 말하고 이 격차를 해소하지 못하면 미국은 건강한 사회가 될 수 없다고 말했다.
최근 몇 년 간에 소수인종의 건강격차 해소에 많은 진전이 이루어 졌지만 아직도 신상아 사망률과 평균수명 등 많은 면에서 뒤쳐져 있다. 건강격차로 인하여 당뇨병, 심장병, 신장병과 천식 같은 병으로 고생하게 된다.
미국의 소수인종은 5천만 명 이상이 건강보험의 혜택을 받지 못하고 있는데 오바마 행정부는 이런 보험혜택의 격차를 줄이려고 건강보험법 개정을 서두르고 있다.
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