June 24, 2005

Mayor's committee to eliminate health disparities unveils recommendations

In 2003, Mayor Thomas Menino and the Boston Public Health Commission issued an invitation to Boston hospital leadership, including Peter L. Slavin, MD, president of the MGH, to address the issue of racially and ethnically based disparities in access to and delivery of health care in the city. Despite the advances that have been made in the modern medical system, studies have shown that minorities often receive lower quality care than white Americans, even when insurance status, income, age and severity of illness are comparable.

At a press conference June 23, Mayor Menino presented recommendations in five key areas developed by the Hospital Working Group of his Task Force to Eliminate Health Care Disparities. These recommendations — the first major product of the larger task force — represent an important step in achieving health care equality for all Boston hospital patients.

The recommendations call for Boston hospitals to collect patient data on race and ethnicity in a consistent way; develop "pipeline" programs giving Boston public school students access to careers in health care and allowing incumbent hospital workers of color to gain advancement; institute cultural competence training for all hospital staff; integrate disparities measures into routine quality monitoring and improvement; and create community accountability by supporting community-based activities to eliminate health disparities, including diversifying the composition of governing boards.

Each hospital will be asked to submit an implementation plan to the mayor. Within the hospital, the MGH Committee on Racial and Ethnic Disparities — co-chaired by Joseph Betancourt, MD, MPH, senior scientist at the MGH Institute of Health Policy, and Joan Quinlan, director of the MGH Community Benefit Program — has taken up the charge to address the issue of disparities, working under the auspices of the MGH Diversity Committee, to identify key areas where racial disparities may exist at the MGH, to develop solutions for these disparities and to coordinate the hospital's efforts with those of Mayor Menino's task force. The committee, made up of MGH staff from a range of administrative, clinical and patient care areas, meets regularly as a group and through three subcommittees to carry out MGH-specific initiatives aimed at eliminating racial and ethnic disparities. In the fall of 2004, the committee distributed a poster and launched a website to raise awareness about race- and ethnicity-based differences in health care within the MGH community.

Both Betancourt and Quinlan — who participated in the mayor's Hospital Working Group — applaud the progress that has been made to date, both within MGH and beyond. "The subgroups set ambitious goals relative to greater workforce diversity and clinician education in the service of health care equality, and we already are seeing real results," Quinlan says. Betancourt adds, "It's energizing to see the priorities and initiatives we've established here recognized and reinforced at the citywide level."

For more information about the MGH Committee on Racial and Ethnic Disparities or the task force, call (617) 724-2763.

Five key areas of recommendations:

1. Integrate disparities measures in ongoing quality monitoring and improvement.

2. Create systems to collect data on patient race and ethnicity that are consistent citywide.

3. Institute cultural competence training for all staff throughout the institutions.

4. Support "pipeline" programs to expose Boston public school students to careers in health care, and support advancement of incumbent hospital staff of color.

5. Support community-based activities to eliminate health disparities, and create greater accountability through such measures as diversifying governing boards.