HEALTH DISPARITIES IN MARYLAND: AN OVERVIEW

1
HEALTH DISPARITIES IN MARYLAND AN OVERVIEW

• MICHELLE A. GOURDINE, MD
• Deputy Secretary for Public Health Services
• Maryland Department of Health and Mental Hygiene
• Public Health Institute
• November 15, 2005

2
Racial and Ethnic Disparities

• The 2002 Institute of Medicines published
  report, Unequal Treatment Confronting Racial
  and Ethnic Disparities in Health found that U.S.
  racial and ethnic minorities experience a lower
  quality of health services

3
Racial and Ethnic Disparities

• Racial and ethnic minorities
• Experience inequities in the types and quality of
  health care received
• Are less likely to receive routine care

4
Racial and Ethnic Disparities

• Disparities persist across all dimensions of
  healthcare
• Disparities exist within all minority
  subpopulations
• From The 2004 National Healthcare Disparities
  Report released by the Agency for Healthcare
  Research and Quality

5
Disparities in Maryland

• The overall health of Marylanders has improved in
  recent decades due mostly to medical science and
  technology advancements.
• However, the medical system has not consistently
  provided high quality care to the entire
  population.

6
Disparities in Maryland

• In Maryland,
• 1987 report, Now is the Time, identified health
  disparities between Blacks and Whites in Maryland
• 2001-2003, Healthy Maryland 2010 documents
  recommended strategies for reducing racial
  disparities
• Nevertheless, health disparities continue

7
Minorities in Maryland

• Maryland is quickly becoming a minority state.
• 39.6 percent minority in 2004, a 2 increase from
  2003.
• Minorities could be 50 percent of the population
  by 2010.
• Eight of twenty-four jurisdictions have 30 or
  more minorities.
• Almost 20 of the population in the rural
  eastern shore counties are minorities.

8
Disparities are Found in All Maryland
Jurisdictions(Age adjusted rates for Blacks
could not be calculated in two Jurisdictions)
Maryland overall
Baltimore City
Data Source Division of Health Statistics,
Vitals Statistics Administration, DHMH Chart
Prepared by Office of Minority Health and Health
Disparities, DHMH, 10/17/2005
9
Access to Care is an Issue for All Minorities
(All minority rates are significantly higher than
Whites)
10
Pre-Natal Care is an Issue for All Minorities
11
End-Stage Renal Disease in Maryland By Ethnicity
12
End-Stage Renal Disease in Maryland By Race
13
Selected Details of Black vs. White Mortality
Disparities

• Because of the large size of Marylands African
  American population, a more detailed analysis of
  health disparities for this group can be
  performed.
• Selected details are presented on the following
  slides.
• (From the Maryland Vital Statistics Annual Report
  2003)

14
Black/White Disparity in All-cause Mortality
15
Black/White Disparity in Heart Disease Mortality
16
Black/White Disparity in Cancer Mortality
17
Black/White Disparity in Diabetes Mortality
18
Office of Minority Health and Health Disparities

• Maryland legislation has established an Office of
  Minority Health and Health Disparities (MHHD)
• Develops plans to reduce health disparities,
• Increases the cultural competency of health
  professionals,
• Promotes health and disease prevention, and
• Undertakes various activities that will
  ultimately eliminate health disparities

19
Maryland Plan to Eliminate Minority Health
Disparities

• The Maryland Plan to Eliminate Minority Health
  Disparities is being developed
• The Plan is expected to by completed in early
  2006.
• Over 1,000 persons/organizations have provided
  input, with many making numerous recommendations.

20
Maryland Eliminating Disparities- Now

• 785,750 five-year federal grant from the U.S.
  Department of Health and Human Services Office of
  Minority Health

21
Maryland Eliminating Disparities- Now

• Goal one, Healthcare Workforce Diversity will
  increase the number of minorities graduating from
  health professional schools.
• Goal two, Systems Change will conduct an internal
  self-assessment within our Department to increase
  the focus on reducing health disparities.

22
Office of Minority Health and Health Disparities

• The Office is enhancing its Disparities Website
  that will support health disparities programs all
  over the State
• Information clearinghouse
• Speakers bureau
• Best practices
• Grant information and other resources.
• Check out the site at www.mdhealthdisparities.or
  g