Workers who earn low wages can experience health inequities, something the U.S. government can do more to prevent, says a new report from NASEM. The report calls on Congress to raise the minimum wage.
Photo by Marcos Jesus Martin Dorta, courtesy iStockphoto
“This report’s recommendations are a path forward for improving equity in the federal policies, systems and structures that shape our health and well-being.”
— Victor Dzau
The federal government can do more to advance health equity in the U.S., but it will require better coordination, says a new expert report.
Created by a committee of the National Academies of Sciences, Engineering and Medicine, the report recommended that a new federal body be created to coordinate work on disparities across federal agencies.
“Many federal policies affect health, even if that is not their main focus,” committee member Hedwig Lee, PhD, associate director of the Center for Race, Ethnicity and Equity at Washington University in St. Louis, said at a news conference releasing the report. “Without sufficient data or analysis to understand the disparate effects of policies across racial and ethnic groups, policies are often adopted that inadvertently reinforce inequities.”
The new body is just one of many recommendations in the July report, which was created at the request of the U.S. Department of Health and Human Services’ Office of Minority Health.
The committee also turned its eye toward Congress, suggesting that it take a larger role in reducing inequities by assessing how any proposed legislation might impact health equity. It could also reduce disparities bypassing legislation that expands access to federal safety net programs for vulnerable populations that do not currently qualify for them.
Other recommendations in the report include raising the stagnant federal minimum wage, expanding funding for schools and neighborhoods, and improving survey methods to gather more inclusive data.
Collecting data that accurately captures the diversity of the U.S. population is important, as it will allow federal policymakers to better address the needs of communities, said Megan Lowry, NASEM media manager.
U.S. health inequities are widespread and persistent, with people of color experiencing shorter lives and higher rates of chronic diseases. Policies on social determinants such as education, income, health care access and neighborhood environments can either hinder or advance health equity, the report said.
Noting that American Indian and Alaska Native people in the U.S. often experience some of the nation’s worst health, the report called for mandatory advance appropriations for the Indian Health Service, reestablishment of the Indian Affairs Committee and raising the IHS director to the level of an assistant secretary.
“This report’s recommendations are a path forward for improving equity in the federal policies, systems and structures that shape our health and well-being,” Victor Dzau, MD, the National Academy of Medicine president, said at the news conference.
While the report committee members called for myriad actions at the federal level, they also emphasized the critical role that community-level engagement plays.
It is not sufficient to simply keep communities informed about policies, according to committee member Juan De Lara, PhD, an associate professor of American studies and ethnicity at the University of Southern California. Policymakers must also expand engagement and collaboration with community members.
“Although community participation is often touted as a value in policymaking and program-design process, two problems persist,” De Lara said during the news conference. “First is a lack of specificity as to what constitutes community engagement or inclusion, and second is the lack of accountability mechanisms to ensure that authentic community input has been integrated into the policy or program.”
For more information on the report, “Federal Policy to Advance Racial, Ethnic and Tribal Health Equity,” visit www.nationalacademies.org.
- Copyright The Nation’s Health, American Public Health Association
