Searching for Disparities Solutions:
“Trying harder will not work”
Michael W. Painter, JD, MD
Senior Program Officer
Our Disparities Strategic Objective
Reduce racial and ethnic disparities in the care
of cardiovascular disease, diabetes mellitus and
depression by 2008
Most think the Federal Government Should Do
More…
Total
Whites
African
Americans
Hispanic
Americans
65%
57%
91%
84%
Harvard School of Public Health/Robert Wood Johnson Foundation/ ICR,
September 2005
Health Care Costs-2004
• $1.9 trillion
• 16% GDP
• $6,280 per person
Performance of the U.S. Health Care System
“The First National Report Card on Quality of Health Care in America”, RAND 2004
(Funded by the Robert Wood Johnson Foundation)
Past Disparities Strategies Are Not Working:
August 18, 2005, NEJM
CABG
10
8
6
4
2
Rate (per 1000 enrollees)
12
White men
White women
Black men
Black women
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Year
Funded by the Robert Wood Johnson Foundation
The Federal Environment
• Katrina
• Iraq war
• Judicial nominations
• Mounting Federal deficit
• Medicaid cuts
• Medicare Rx benefit
• Rising health care costs
• Rising numbers of uninsured
• Poor care quality and disparities
Mrs. J Needed Quality Care That Was:
• Culturally appropriate
• Evidence based
• Patient centered
$$$
Providers
Plans
INNOVATE
Quality
Care
$$$
Cost Savings
Our Solutions Network Includes:
• Expecting Success
• Finding Answers
• Leading Change
• Hablamos Juntos
• Legal Barriers Project
• Urban Indian Health
Commission
• National Health Plan
Collaborative
• Medicaid Plan
Collaborative
RWJF Solutions Network
Expecting
Success
Finding
Answers
Leading
Change
RWJF
Targeted
Research
Legal
Barriers
Project
Hablamos
Juntos
Plan
Collaboratives
Focusing on Next Steps
• Developing a Solutions Network
• Leading the field—Disparities and Quality
• Refining the Research Agenda
• Implementing Effective Interventions
• Focusing on Special Populations
• Turning to Health Information Technology