# Presentation: 842609

## HIT and Racial/Ethnic Minority Health

- Opportunities, Challenges and Solutions
- Presentation to
- Consumer Empowerment Workgroup
- American Health Information Community
- Office of the National Coordinator for Health IT
**Ruth T. Perot, M.A.T.**
- Executive Director/CEO
- Summit Health Institute for Research and Education, Inc.
- December 5, 2007

## Death rates for African Americans are higher than for non-Hispanic whites for heart diseases, stroke, cancer, chronic lower respiratory diseases, influenza and pneumonia, diabetes, HIV/AIDS, and homicide.

Native Hawaiians are 2.5 times more likely to be diagnosed with diabetes than non-Hispanic white residents of Hawaii of similar age.

In the Latino/Hispanic community, Puerto Ricans suffer disproportionately from asthma, HIVAIDS, and infant mortality, while Mexican-Americans suffer disproportionately from diabetes.

- Death rates for African Americans are higher than for non-Hispanic whites for heart diseases, stroke, cancer, chronic lower respiratory diseases, influenza and pneumonia, diabetes, HIV/AIDS, and homicide.
- Native Hawaiians are 2.5 times more likely to be diagnosed with diabetes than non-Hispanic white residents of Hawaii of similar age.
- In the Latino/Hispanic community, Puerto Ricans suffer disproportionately from asthma, HIVAIDS, and infant mortality, while Mexican-Americans suffer disproportionately from diabetes.

- Health Disparities Persist

*Source: The Office of Minority Health,* _[http://](http://www.omhrc.gov/templates/browse.aspx?lvl=1&1flID=2)__[www.omhrc.gov/templates/browse.aspx?lvl](http://www.omhrc.gov/templates/browse.aspx?lvl=1&1flID=2)__[=1&1flID=2](http://www.omhrc.gov/templates/browse.aspx?lvl=1&1flID=2)_

## Health Disparities Persist

- Asian Americans have a high prevalence of chronic obstructive pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver disease.  Tuberculosis is 13 times more common among Asian subgroups, such as Cambodians, Chinese, Laotians, Koreans, Indians, Vietnamese, and Filipinos, than among the U.S. population. Compared to the U.S. average, Hepatitis B is 25 to 75 times more common among immigrants from Cambodia, Laos, Vietnam, and China.
- American Indians and Alaska Natives have an infant death rate almost double the rate for whites. AI/ANs are twice more likely to have diabetes than whites. AI/ANs also have disproportionately high death rates from unintentional injuries and suicide.

*Source: The Office of Minority Health,* _[http://](http://www.omhrc.gov/templates/browse.aspx?lvl=1&1flID=2)__[www.omhrc.gov/templates/browse.aspx?lvl](http://www.omhrc.gov/templates/browse.aspx?lvl=1&1flID=2)__[=1&1flID=2](http://www.omhrc.gov/templates/browse.aspx?lvl=1&1flID=2)_

## Why Address These Disparities?

- Source: Institute of Medicine, *Unequal Treatment*, March 2002, p. 4.
- Source: Agency for Healthcare Research and Quality, *2006 National Healthcare Disparities Report*, December 2006, p. 2

- “Evidence of racial and ethnic disparities in healthcare is, with few exceptions, remarkably consistent across a range of illnesses and healthcare services. ....The majority of studies...find that racial and ethnic disparities remain even after adjustment for socioeconomic differences and other healthcare access-related factors.”
- “Consistent with extensive research and findings in previous NHDRs, the 2006 report finds that disparities related to race, ethnicity, and socioeconomic status still pervade the American health care system”

## HIT’s Promise

- More efficient delivery of health care services – minimizing such problems as lost records, repetitive data-gathering, and duplicative procedures;
- Reduction of medical and pharmaceutical errors;
- HIT-enhanced provider/consumer communication in order to facilitate behavior change and enhance health outcomes;
- Increased knowledge, health management skills, and compliance with treatment regimens among health consumers;
- Expanded capacity of health care providers to serve racial/ethnic and other “hard to reach” populations, and
- Cost savings

## Risks of Minority Non-Participation in HIT 

- Risks of Minority Non-Participation in HIT

- Gaps in health care quality for racial and ethnic minorities will widen.
- Anticipated cost savings will not be achieved because spending for racial and ethnic minority health care will be unaffected by efficiencies and improved quality achieved through HIT use.
- Goal of ensuring that most Americans have access to EHRs by 2014 will not be achieved.
- Disparities will be exacerbated.

## HIT At Work

## Prerequisites for Achieving HIT’s Promise in Racial/Ethnic Communities

- Prerequisites for Achieving HIT’s Promise in Racial/Ethnic Communities

**Build on Potential Assets**
- Katrina’s impact  - greater awareness of HIT’s life-saving potential.
- Increased IT use for non-entertainment purposes in communities of color.
- Greater openness to HIT among prospective community champions.

## Prerequisites – Continued 

- Prerequisites – Continued

**Address Barriers to Adoption**
- Broadband connectivity
- Resources for PHR and EHR acquisition
**Demystify HIT**
- Build on the consumer/provider interaction
- Spread the word about promising practices
- Mt. Bayou
-  The Institute for Urban Family Health
-  Kinshasa, The Congo

## Recommendations

- AHIC and Federal government provide leadership to assure full minority participation in HIT decision-making.
- ONC and AHIC assure greater minority participation in AHIC and AHIC 2.
- Fund research, evaluation and demonstration projects in racial/ethnic minority communities on culturally appropriate HIT uses.

## Other Recommendations

- Allocate resources for outreach and education by trusted minority communicators.
- Do no harm through HIT policies.
- Prioritize needs of safety net providers.

## For more information, contact:

**Summit Health Institute for Research and Education, Inc.**
- 1776 Massachusetts Avenue, N.W., Suite 615
- Washington, D.C. 20036-1904
- Phone: 202-371-0277, ext. 1317
- Fax: 202-452-8111
- Email: _[rperot@shireinc.org](mailto:rperot@shireinc.org)_
- Website: _[www.shireinc.org](http://www.shireinc.org/)_