State Health Improvement Process (SHIP)
Racial and ethnic minority populations in Maryland fare worse than Non-Hispanic Whites in three ways: poorer health status, less access to primary care, and greater use of expensive hospital services. Many of these differences are the result of historic and ongoing discrimination and economic and educational disadvantage, and are considered health inequities and health disparities that need to be eliminated.
Data documenting racial and ethnic health and health care disparities in Maryland have been reported in a variety of reports and show:
- Blacks experience significant disparities in infant mortality, late prenatal care, end-stage kidney disease, and new cases of HIV.
- Hispanics experience significant disparities in health insurance coverage, new cases of HIV, late prenatal care, and end stage kidney disease.
- American Indians and Alaska Natives experience disparities in infant mortality, end-stage kidney disease, and new cases of HIV.
- Asians and Pacific Islanders experience disparities in end-stage kidney disease and health insurance coverage.
Health disparities generate a tremendous burden of preventable excess cost to the health care system. A report from the Joint Center for Political and Economic Studies, entitled The Economic Burden of Health Inequalities in the United States found that nationally, health disparities among racial and ethnic minorities accounted for 229 billion dollars for the four year period 2003 to 2006. This is an annual national cost of disparities of 57 billion dollars. Maryland's share of this cost of disparities is between 1 and 2 billion dollars per year. Analysis of the cost of excess hospital admissions for Blacks in Maryland (compared to White admission rates) has revealed about half a billion dollars of excess cost.
MHHD has led the Department in completion of a number of programs to reduce health disparities in Maryland.
- Published the Maryland Plan to Eliminate Minority Health Disparities, Plan of Action 2010-2014 (2010)
- Published the Maryland Chartbook of Minority Health and Minority Health Disparities Data, Second Edition
- Established the Maryland Statewide Health Disparities Collaborative that advises the Department on policies and programs that reduce disparities. Workgroups of this Collaborative are developing recommendations for the department and administration to assist with implementation of the State Health Improvement Process (SHIP)and Disparities Reduction Act of 2012.
- Developed minority chronic disease data for local health improvement plans associated with the SHIP for local coalitions to target affected minority groups. View the minority chronic disease data for the DC Metro, Lower Shore, Southern Maryland, Western Maryland, West-Central Maryland and NorthEast Maryland .
- Fund local health disparities programs in most of the State's jurisdictions focusing on tobacco and cancer, minority infant mortality, minority cardiovascular disease mortality, and chronic disease risk factors. These local health programs involve partnerships with local health departments, empowerment of minority communities, use of race and ethnic data, and inclusion of community outreach workers to bridge communication with the target population.
The State's Health Care Quality and Cost Council, led by Lt. Gov Anthony Brown, established a Workgroup to identify strategies to eliminate disparities in the health care system. The Workgroup recommended (1) creation of Health Enterprise Zones (HEZ), (2) a Maryland Health Innovation Prize, and (3) analysis of health care quality data by race and ethnicity. The 2012 Legislative Session passed a bill to implement the HEZ. The Quality and Cost Council's Prevention Subcommittee also identifies and pursues state policy initiatives that impact health disparities, with a focus on tobacco, nutrition (obesity), and hypertension.
The Maryland Health Improvement and Disparities Reduction Act of 2012
passed by the Maryland General Assembly and signed into Law by the Governor on April 10, 2012 establishes Health Enterprise Zones to focus state resources on local areas of poor health and documented health disparities.
The Act also includes provisions that promote analysis of race and ethnic data and enhances cultural competence in the health care system.
MHHD working with the Health Disparities Collaborative is an active participant in developing the policies and procedures for the implementation of this Act, to assure that the five key strategies that are embodied in the logic model above become part of the Health Enterprise Zones (HEZs).