RWJF brief examines differences in US, European disparity strategies

A new policy brief from the Robert Wood Johnson Foundation and the Urban Institute compares efforts to reduce healthcare disparities in the United States and the European Union (EU).

Within the health policy community, there is little consensus on disparities; there is not even a concrete definition of the term, according to the brief. Beyond that, one major difference in disparity measurement is whether to address disparities among particular marginalized groups, such as racial and ethnic minorities in the U.S., or the social circumstances that create such disparities in the first place.

However, in the U.S., according to the brief, research on disparities tends to disregard the health gap between the economically successful and unsuccessful. "Moreover, we are at risk of allowing the shortcomings of our healthcare system to distract us from attending to the most important causal determinants of health disparities," it states.

Within the EU, the brief states, policy solutions to healthcare disparities have focused on non-medical factors affecting health, such as working and living conditions. In 2009, a study by the European Commission analyzed determinants of health inequalities found that income-related health disparities are often connected to differences in health-related risks and behaviors and noncommunicable diseases, and that weaker social safety nets correlated with lower self-reported health levels. British health policy authorities have cited evidence that these connections indicate a need for income redistribution to address them.

In contrast, in the United States, policy solutions to disparities typically involve use of evidence-based guidelines and increased diversity and minority representation among healthcare providers, according to the brief. Healthcare experts have argued that nonmedical factors, be they environmental, economic, education-related or behavioral, determine health far more than healthcare does.

A recent survey found healthcare equity in the U.S. improved in 2013, but there is still room for improvement, FierceHealthcare previously reported.

To learn more:
- read the brief (.pdf)

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