$300-Million Grant Program Seeks to Fix Disparities in Health Care

The Robert Wood Johnson Foundation, in Princeton, N.J., has announced a $300-million commitment through 2011 to improve and reduce racial and regional disparities in health care in 14 locations in the United States.

The foundation will make grants to “community alliances” of doctors, hospitals, political leaders, and residents in the 14 areas, as well as provide “technical assistance and expert resources,” says Michael Painter, a physician and senior program officer at the foundation.

The foundation Thursday released research conducted by the Dartmouth Atlas Project at the Dartmouth Institute for Health Policy and Clinical Practice, in Lebanon, N.H., showing that patients’ race and the region in which they live play large roles in the quality of care they receive.

For example, the study shows that 64 percent of white women got mammograms between 2004 and 2005, compared to 57 percent of black women.

In Mississippi, 57 percent of female patients aged 65-69 got mammograms in that time period, but in Maine, 74 percent got mammograms. The national average is 64 percent. (Further results of the Dartmouth study can be found on the foundation’s Web site.)

Blacks vs. Whites

“These findings underscore the importance of the local health-care system as the focus for efforts to improve care,” said Elliott Fisher, director of the Center for Health Policy Research at Dartmouth and one of the study’s co-authors, in a statement.

“In most regions, blacks are less likely to receive recommended care than whites, but the differences across regions are generally much larger than the differences within regions,” said Dr. Fisher.

“And in some regions of the country,” he said, “African Americans receive care equal to that of whites — but the care for everyone is well below the national average. These findings point to the critical importance of local efforts that bring together stakeholders to improve quality and reduce disparities everywhere. “

Aligning Forces

The study and $300-million commitment is a part of the foundation’s ongoing Aligning Forces for Quality program, which began in 2006 with an effort to improve care for patients with chronic illnesses in an outpatient setting.

The program will focus on the following 14 cities and states, most of which were chosen from a nationwide call for proposals: Cincinnati; Cleveland; Detroit; Humboldt County, Calif.; Kansas City, Mo.; Maine; Memphis; Minnesota; Seattle; South Central Pennsylvania; Western Michigan; Western New York; Willamette Valley, Ore.; and Wisconsin.

The foundation’s goals are to help doctors improve the quality of care for patients; give people information that allows them to manage their own health and make informed choices about their care; improve care in hospitals, with a special focus on nursing; and reduce inequality in care for minority patients.

“We’re asking the communities to specifically pay attention to racial and ethnic health-care disparities in these efforts,” says Dr. Painter. “The first step is getting much, much better at collecting race and ethnicity demographic data to identify the disparities where they are. A lot of the communities don’t even realize that they have disparities.”