Racial and Ethnic Health Care Equity

The Issues

Inequities persist in the health and health care of various racial and ethnic minorities
in America. This is demonstrated by the following data from the Center for Disease
Control and Prevention’s (CDC) Office of Minority Health:

• While the nation’s infant mortality rate has declined in the past few decades, African American infants are still 2.4 times more likely to die in their first year of life than are white infants.
• Heart disease death rates are more than 40% higher for African Americans than for whites.
• Among people younger than 20, American Indians aged 10-19 have the highest prevalence of type 2 diabetes.
• Vietnamese American women have a higher cervical cancer incidence rate than any ethnic group in the United States -- five times that of non-Hispanic white women.
• African American women have higher death rates from breast cancer, despite having a mammography screening rate that is nearly the same as that for white women.
• Compared with non-Hispanic whites, Hispanics living in the United States are almost twice as likely to die from diabetes.  They also have higher rates of high blood pressure and obesity than non-Hispanic whites. 

Additionally, according to the Institute of Medicine's report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare, African Americans and Hispanics tend to receive lower quality of health care across a range of disease areas (cancer, cardiovascular disease, HIV/AIDS, diabetes, mental health, and other chronic and infectious diseases) and clinical services.  For example, African Americans with heart disease are less likely to receive angioplasty or bypass surgery as cited by the AHRQ.

Our Approach

We focus our philanthropic giving on understanding connections between where people live and receive health care, and the quality and equity of the care they receive.  We know these issues are important, but we want to understand why and how to effect change.

The Aetna Foundation also is interested in how to improve health and health care among the nation’s Medicaid population, particularly in settings with large numbers of minority patients. We also want to drive improvement in one of the longest-standing disparities in health care -- infant mortality.

Examples of grants we would support include projects and/or studies to: 

• Explore how a stronger primary care model and relationships with providers could benefit minority populations and close the persistent health care gap 
• Help providers who treat large minority populations become leaders in delivering high-quality care
• Determine what can be done to reduce the numbers of low-birth weight babies born to mothers at risk
• Examine, through observational studies, the correlation between a mother’s health, stress level, and social supports; and the likelihood of having a healthy baby who lives through its first year of life
• Determine, through interventional studies, whether stress-reduction programs (including yoga and meditation) can improve health outcomes for minority patients with chronic conditions, as well as postnatal outcomes for mothers and pregnant women