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April 27, 2017By Cara V. James, PhD, Director, CMS Office of Minority Health
National Minority Health Month: Bridging Observance and Action to Achieve Health Equity
Each April we observe National Minority Health Month. This year’s theme was, Bridging Health Equity Across Communities. This theme acknowledges the important role that social determinants of health play in individual and community well-being. It also evokes action and activitiy around health equity. For it is not enough for us to simply observe National Minority Health Month and share statistics on long-standing health and health care disparities. We should strive to move the needle by reducing these disparities and improving health care quality and outcomes for all. As this National Minority Health Month, comes to a close, I’m hoping each of us can take a moment and consider the following question:
What will it take to achieve health equity?
CMS has adopted a health equity framework that focuses on increasing understanding and awareness of disparities, developing and disseminating solutions, and implementing sustainable action. As we have sought to implement this framework, we have identified a number of areas that need to be considered when addressing a specific disparity– the social determinants of health, data, and the seven “A’s”.
First and foremost, we need to acknowledge there is a problem to be addressed. We need to agree on the goal and identify what resources will be necessary to meet it. Resources can be difficult to come by, so determining how the goal aligns with existing priorities may be key. Next we must decide what actions do we need to take to achieve our goal? Are we already doing some or all of them?
Seven A’s for Addressing Health Equity
- Acknowledge there is a problem to be addressed.
- Agree on the goal, and identify what resources are necessary to meet it.
- Align the goal with existing priorities.
- Determine what actions are needed to achieve the goal.
- Create alliances to implement the actions.
- Analyze progress, and adjust the plan as necessary.
- Have shared accountability for reaching the goal.
We know that health equity cannot be achieved by a single individual or organization, so forging alliances and working together is critical. We also know that we must be able to measure our progress. Having data and doing analysis of it are important for the development, assessment, and revision of our health equity plan. The last of the A’s requires us to be accountable and ask the question – what happens if we do not reach our goal? There shouldn’t be one person or organization responsible for the success or failure of a plan, but a shared accountability.
While we are considering each of the seven A’s, we must also consider the myriad of social factors that influence health and well-being of individuals and the communities in which they reside. Whether we refer to them as social risk factors or social determinants of health, we know that things such as socioeconomic position, race, ethnicity, cultural context, gender, social relationships, and residential and community context affect our health more than the care we receive from our health care providers. We must consider these factors as we think about our goals, the actions we need to take, and the alliances we forge.
Finally, achieving health equity is going to require the collection, analysis, and reporting of data across various demographic categories, including race, ethnicity, disability, and geography. Only through this process will we be able to identify disparities and measure their reduction or elimination and ultimately determine the success of our efforts.
The CMS Office of Minority Health is helping to embed these actions across CMS and HHS. For example, we routinely share HEDIS and CAHPS quality measures stratified by race, ethnicity, and gender, providing health plans with actionable data to innovate and prioritize health equity and quality improvement activities. Organizations participating in the Accountable Health Communities Model will be montoring disparities as they link beneficiaries with commmunity services. We are working with our sister agency, the Health Resources and Services Administration’s, Federal Office of Rural Health Policy on a Chronic Care Management Education and Outreach Campaign. The campaign is focused on professionals and consumers in underserved rural areas, and racial and ethnic minorities. We are also collaborating with organizations outside the federal government to help reduce readmissions among racially and ethnically diverse beneficiaries, and to develop their own plans for achieving health equity.
As we continue on our path to equity, we encourage you to consider the seven A’s, the role of social risk factors, and the importance of data in your day-to-day activities. Recommit every day to the ultimate goal of achieving health equity by bridging observance and action during the remainder of National Minority Health Month and throughout the year.
To learn more about achieving health equity and other activities underway at the CMS Office of Minority Health, visit: go.cms.gov/omh.