The National Academy of Science, Engineering and Medicine (NASEM) has announced that a committee will examine the current state of racial and ethnic healthcare disparities in the U.S.
The committee, which includes Distinguished Professor Kosali Simon of the Paul H. O’Neill School of Public and Environmental Affairs, will help update the National Academies’ 2003 report on Unequal Treatment. It will highlight the major drivers of healthcare disparities, provide insight into successful and unsuccessful interventions to reduce disparities, identify gaps in the evidence base, and propose strategies to close those gaps.
“As the nation commemorates the work of Dr. Martin Luther King Jr. this week, it’s notable there are still large disparities in health outcomes by race today: life expectancies at birth are 71.8 years among Black populations, compared to 77.6 years for White populations,” Simon said. “The NASEM committee aims to systematically sift through the research evidence that supports recommendations to advance health equity.”
Simon’s research focuses on the impact of state and federal regulations attempting to ease the availability of health insurance and healthcare for vulnerable populations. Simon has authored close to 150 peer-reviewed publications on a range of health policy topics in top economics, policy, and medical journals. Outside IU, she serves as the President-elect of the American Society of Health Economics and Editor of the Journal of Health Economics. Simon was elected as a member of the National Academy of Medicine in 2021.
The NASEM committee will review the literature on racial and ethnic healthcare disparities in the two decades since the publication of the initial Unequal Treatment report as well as consider ways to scale and spread effective interventions to reduce racial and ethnic disparities in. Topics for review will include but are not limited to:
- Societal factors such as bias, racism, discrimination, intersectionality, and stereotyping at the individual (clinical and non-clinical staff), interpersonal, institutional, and health system levels.
- Technology factors, such as bias in diagnostic tools and algorithms used in clinical practice and decision-making, and variability in access to broad band internet and other telecommunication technologies, as well as digital inequality
- Geographic factors, such as variability in the social determinants of health and access to both social services, (including those not directly related to health care), language, and health care services for acute and chronic conditions in different communities
- Policy factors, such as federal and state laws and regulations and public health programs
- Health care factors, such as the coverage and design of health plans, institutional or clinic-based access, and the demographic and specialty profile of the clinical workforce
- The impact of clinical training and education in perpetuating disparities, and ways to improve training, enhance cultural competency, and diversify the health care workforce.
“Twenty years ago, the original landmark report shocked the nation,” Simon said. “There was apparently a ‘hush in the room’ even when the evidence was reported to committee members. Now its well accepted that confronting disparities in health care is a top priority, but it’s time to meld the last 20 years of evidence produced into an actionable roadmap to address the remaining gaps.”