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Saturday, January 24, 2015

Welcome to Day 3 of Health Action!

Health Action 2015 
Saturday, January 24

2:00 p.m.So Long and Farewell

We at Families USA have had a blast the past three days. Meeting all of you hard-working advocates has been inspiring and energizing for us. Relive Health Action 2015 by checking out our highlights blogs:

Day 1 Health Action Highlights
Day 2 Health Action Highlights

Watch C-SPAN's coverage of our Friday program on Medicaid expansion and CHIP:

11:15 a.m.Morning Plenary: How Are Demographics Shifting in the United States, and What Does That Mean for Health Care?

Brian Smedley, Co-Founder and Executive Director, National Collaborative for Health Equity
Paul Taylor, Senior Fellow, Pew Research Center

Health Action attendees just saw the future. The Pew Research Center’s Paul Taylor gave us a rundown of the major shifts in the composition of the U.S. population and the profound implications those shifts have for health care. 

Demographic changes currently underway are tremendous, said Taylor. We’re on our way to being a country where the majority is non-white and the number of older Americans is growing.

What’s driving this change? The modern immigration wave that began when we opened our borders in 1965. This was the third great immigration wave in our nation’s history, with earlier waves from Western Europe in the1840s-1880s and the wave of Southern and Eastern Europeans around turn of the last century.

The immigrant stock in the population now is similar to the pattern in the country 100 years ago. (Immigrant stock = share of U.S. population at a given time with immigrant parents.)

“The strength of this country rests with immigrants as it always has.”—Paul Taylor

Seventy percent of all interracial/interethnic marriages involve a white spouse. What are we going to call the children that are produced by these marriages?

Are we heading to a post-racial society where race doesn’t matter? No. Race is very complicated, and in some ways it’s our original sin.

The next big change is the growing percentage of aging Americans. This change is the result of two trends – an increase in life expectancy and a decline in fertility rates. 

The rest of the world’s leading economies are also getting older, but at a faster rate, and these countries are facing the challenges of caring for older residents. 

Taking care of people in old age is what we must grapple with. People have favorable impressions of Social Security. They don’t see it as a poverty program – more of a tax system. That’s why the ratio of taxpayers to retirees is so important. Today, we’re down to just under 3 taxpayers per beneficiary. At that point, the math doesn’t work. 

Social Security is our most muscular anti-poverty program. Without Social Security and Medicare, half of seniors would be poor.

This social safety net has done a magnificent job and it has worked. The question is: Will it work for tomorrow?

Brian Smedley, National Collaborative for Health Equity

The causes of health inequality have their roots in historic and contemporary forces, such as discrimination, segregation, and poverty concentration.

The health status of our nation is being increasingly defined by the health of people of color. The nation bears the economic burden of health inequalities – spending on health care, loss of tax revenue, etc. 

Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying racial injustices

“Equality is not the same as equity.” – Brian Smedley

How can we tackle these challenges? By working on these areas:

  • Equity in health care delivery: as a result of our market-driven health care system, many communities don’t have resources they need to address their health needs
  • Equity in the health care workforce: more diverse and better distribution of health care providers
  • Equity in community conditions for health: increase access to health-enhancing resources

What can we do specifically?    

  1. Expand health professions training programs, including improving cultural competence
  2. Expand community health centers
  3. Match Medicaid reimbursement to that of Medicare

Minority providers display better “patient care process” (like listening to patients describe complaints). IOM report in 2004 issued recommendations to improve health profession training institutions to encourage a more diverse and culturally competent workforce.

Equity in community conditions for health that are problems: high concentration of environmental health risks like pollution, food deserts, unhealthy food vendors, lack of access to safe spaces for exercise or recreation, higher cost of living, stress, and more.

It’s hard to eat better and exercise when community conditions don’t support those behaviors. 

We need place-based investments (e.g., incentivizing groceries to move into poor communities, land use and zoning policies to reduce the concentration of health risks, like limits on fast food restaurants, joint use agreements w/schools, early childhood programs) and people-based investments to counter this inequality.

The fact is that we have come to this place where we live in separate and unequal communities as a result of policies. 

Are you concerned about the lack of health equity in this nation? Roll up your sleeves and get involved! Join HELEN – Health Equity and Leadership Network: http://healthequitynetwork.org

8 a.m.Good morning from the final day of Health Action 2015!

We’re excited to tie together the themes we have explored at conference this year.

Our morning plenary will focus on the shifting demographics in the United States and examining what the means for the health care arena moving forward.

Then, our final lunch will focus on how to stay energized, inspired, and prepared to work to protect and improve health coverage for consumers in the year ahead.