Taking Action to Achieve Health Equity: Beyond the Affordable Care Act

by Brian D. Smedley, Ph.D.

Vice President and Director of the Health Policy Institute
Center for Political and Economic Studies

Abstract

Racial and ethnic health inequities persist from the cradle to the grave, in the form of higher rates of infant mortality, disease and disability, and premature mortality for many communities of color relative to national averages. These inequities contribute to higher health care costs, but also carry a heavy economic burden for the nation, estimated to be as much as $1.24 trillion in direct health care costs and indirect costs associated with reduced productivity and lost wages and tax revenue. The causes of these inequities are complex, but are associated with differences in socioeconomic status, environmental risks and exposures, occupational exposures, health behaviors, and access to health care. At their core, many of these factors can be traced to historic and contemporary discrimination and differences in neighborhood and work environments that are the result of residential segregation and other structural inequities. This presentation explores how neighborhood and community contexts directly and indirectly shape health and contribute to health inequities as a result of racial and ethnic residential segregation. The presentation will also feature a discussion of policy strategies that de-concentrate poverty, reduce the geographic concentration of health risks, and increase investments in health-enhancing resources in communities that suffer from disinvestment.