Health Equity
Many states are transforming their health care delivery systems to improve health and control costs. Reducing health disparities — and addressing their social and economic causes — is at the heart of many of these efforts.
Health equity means everyone has an equal opportunity to live a long and healthy life regardless of race, ethnicity, gender, income, neighborhood, education, or any other social condition.
Despite its high price tag, the majority of health care spending ignores critical determinants of health, including social and economic factors, the environment, and health behaviors. By increasing health equity, states can achieve improved, long-term health outcomes.
The following resources showcase effective state efforts to achieve health equity, improve care, and prioritize the social determinants of health. To suggest a resource or share your state’s efforts, contact Elinor Higgins.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
























































































































































Expanding the Oral Health Workforce to Promote Overall Health: Arizona Uses Dental Hygienists to Improve Hospital Patient Safety
/in Policy Arizona Reports Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Health System Costs, Medicaid Managed Care, Medicaid Managed Care, Oral Health, Population Health, Workforce Capacity /by Neva KayeArizona recently made an innovative change in its scope-of-practice rules governing supervision of dental hygienists to enable hospitals to more easily use these providers to help prevent ventilator-assisted pneumonia (VAP) – the leading cause of death from nosocomial infections in critically ill patients. VAP, the second most common nosocomial infection, increases the duration of hospitalizations […]
Behavioral Health Workforce Innovations: How Massachusetts and New York Engage Community Health Workers and Peers to Address Racial and Ethnic Disparities
/in Policy Massachusetts, New York Featured News Home, Reports Behavioral/Mental Health and SUD, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Health Coverage and Access, Health Equity, Population Health, Social Determinants of Health, Workforce Capacity /by Jill RosenthalAcknowledgements: The author wishes to thank the state officials and stakeholders in Massachusetts (Masachusetts Department of Public Health, Commonwealth of Massachusetts Executive Office of Health and Human Services) and New York (New York State Office of Mental Health, New York State Department of Health, Families Together in New York State) who graciously shared their experiences or reviewed a draft of this publication. Trish […]
State Medicaid Strategies to Promote Early Identification and Treatment of Pregnant Women with Substance Use Disorder
/in Policy Featured News Home, Reports Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, Eligibility and Enrollment, Essential Health Benefits, Health Coverage and Access, Health Equity, Health IT/Data, Infant Mortality, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Safety Net Providers and Rural Health /by Carrie Hanlon, Taylor Platt, Eddy Fernandez and Lyndsay SanbornStates face rapidly rising rates of substance use disorder (SUD) and overdoses among pregnant women and increases in maternal deaths and poor birth outcomes, such as neonatal abstinence syndrome (NAS) and neonatal opioid withdrawal syndrome (NOWS).[1] To understand how states promote early identification of SUD and treatment access for pregnant women, the National Academy for […]
Resources to Help States Improve Integrated Care for Pregnant and Parenting Women
/in Policy Toolkits Behavioral/Mental Health and SUD, Care Coordination, CHIP, Chronic and Complex Populations, Chronic Disease Prevention and Management, Eligibility and Enrollment, Eligibility and Enrollment, Essential Health Benefits, Health Coverage and Access, Health Equity, Healthy Child Development, Infant Mortality, Integrated Care for Children, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health /by NASHP StaffState Medicaid Quality Measurement Activities for Women’s Health
/in Medicaid Managed Care Maps Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Equity, Infant Mortality, Integrated for Pregnant/Parenting Women, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Quality and Measurement, Quality Improvement, Special Populations and Services /by NASHP StaffMinnesota and Indiana Governors Work to Improve Social Equity and Health in Every Zip Code
/in Policy Indiana, Minnesota Blogs CHIP, CHIP, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Health System Costs, Healthy Child Development, Housing and Health, Infant Mortality, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health /by Elinor HigginsIn their 2019 state of the state speeches, 13 governors addressed social equity, acknowledging that reducing inequities and improving opportunities for all residents improves lives and health outcomes. Two of them — Indiana and Minnesota – offer examples of how states are orchestrating their legislative and administrative efforts to reduce health disparities and promote social […]
Toolkit: State Strategies to Support Older Adults Aging in Place in Rural Areas
/in Policy Toolkits Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Health System Costs, Housing and Health, Long-Term Care, Physical and Behavioral Health Integration, Population Health, Safety Net Providers and Rural Health, Social Determinants of Health, Workforce Capacity /by Neva Kaye and Kristina LongThis toolkit highlights state initiatives to help older rural adults age in place by increasing services that help people remain in their homes, expanding and professionalizing the caregiver workforce, improving transportation access and services, and making delivery system reforms within Medicaid programs. Download the toolkit. Introduction Rural areas across the nation have higher concentrations of […]
State Officials Fear Final Public Charge Rule Could Deter Health Coverage Enrollment
/in Policy Blogs CHIP, CHIP, Eligibility and Enrollment, Health Coverage and Access, Health Equity, Healthy Child Development, Maternal Health and Mortality, Maternal, Child, and Adolescent Health, Population Health, Social Determinants of Health, State Insurance Marketplaces /by Maureen Hensley-Quinn and Anita CardwellThe Department of Homeland Security (DHS) recently finalized a rule that significantly changes immigration policies related to “public charge” determinations. Under long-established US immigration policies, individuals who are deemed likely to become a “public charge” and require extensive government support can be denied an adjustment of their immigration status (e.g., issued a green card) or […]
State Medicaid Levers to Promote Immunization: California’s Experience
/in Policy California Reports CHIP, Chronic Disease Prevention and Management, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Eligibility and Enrollment, EPSDT, Essential Health Benefits, Health Coverage and Access, Health Equity, Health IT/Data, Health System Costs, Healthy Child Development, Immunization, Maternal, Child, and Adolescent Health, Medicaid Managed Care, Medicaid Managed Care, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement /by Rebecca CooperVaccines are a powerful and cost-effective tool to prevent diseases and save lives. Once common, deadly diseases such as polio, measles, and mumps are preventable and smallpox no longer exists outside of a laboratory. According to research estimates, of 4.3 million infants born in the United States in 2009, vaccines will prevent 40,000 deaths and […]
Oregon and Connecticut Hold Hospitals Accountable for Meaningful Community Benefit Investment
/in Policy Connecticut, Oregon Blogs Community Benefit, Cost, Payment, and Delivery Reform, Health Equity, Health System Costs, Hospital/Health System Oversight, Population Health, Social Determinants of Health /by Amy Clary and Elinor HigginsTax exemptions for nonprofit hospitals cost states billions of dollars in lost tax revenue each year. In return, hospitals are required to invest in activities and services that benefit their communities. Some states, including Oregon and Connecticut, are going beyond federal requirements by holding hospitals accountable for making meaningful investments in the community’s health and […]