In their pursuit to improve the overall health of state residents while being good stewards of taxpayer dollars, state health policymakers are prioritizing strategies to understand and mitigate health disparities. The costs of unaddressed health disparities are substantial both to people with unmet needs — in their opportunity for optimal health, quality of life, and economic success — and to the overall economy due to avoidable costs and financial waste. A recent analysis estimates the cost at $320 billion annually — substantially limiting efforts to bend the health care cost growth curve.
Some states are taking a comprehensive approach and concurrently executing multi-pronged strategies to reduce health disparities, while others are implementing targeted approaches that may build on each other sequentially. Targeted efforts may focus on reducing barriers to equal access to quality health care on broader community-led and population-based approaches. It is well-documented that health outcomes are largely determined by social, economic, and environmental factors and that the bulk of health care dollars are spent on costly health care services.
Promising state practices to address disparities include updated data strategies to identify and target needed policy interventions, population-based approaches that build on local partnerships to empower community-led efforts and manage trust, and transformative statewide strategies that reshape government business practices and financing approaches.
This resource is intended to provide state policymakers with a suite of state approaches to address health disparities — from targeted to cross-agency comprehensive strategies. Each section below comprises best practices and state examples from a geographically diverse set of states to guide state policymakers to the opportunity that best suits their states’ needs and capacity. Also included is a lexicon, recognizing the importance of common definitions in this domain, along with links to key tools and resources.
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A Note on Terminology
Agreed-upon terms are essential to aligning state, local, and private efforts to addressing health disparities. Many states use longstanding federal definitions or have used surveys or established task forces (comprised of multiple partners, including communities served) to provide foundational terminology from which to approach the work. State agencies are investing in staff trainings and workshops that promote language standards to be used both internally and externally to the agency — reflecting the importance of language. In this resource, the terms “health disparities” and “unmet need” are used throughout. As noted in the Appendix, we use the Centers for Disease Control and Prevention definition of “health disparities,” which is “preventable difference in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” Where a state uses other terms, such as “health equity,” in the description of its efforts, that language is preserved to respect the state interest.