Universal Health Care as a Health Disparity Intervention
Authors: Ashwini R. Sehgal
Journal: Annals of Internal Medicine (2009)

Editorials21 April 2009Universal Health Care as a Health Disparity InterventionAshwini R. Sehgal, MDAshwini R. Sehgal, MDFrom Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH 44109.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-8-200904210-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Health disparities have been the focus of intense scholarly interest over the past decade, with about 2000 articles and 150 books devoted to the subject. To help make sense of this burgeoning literature, I find it useful to categorize work in health disparities into 3 sequential phases. First, in the descriptive phase, we identify the presence of a disparity by race, sex, socioeconomic status, type of health insurance, or some other relevant grouping. Second, in the mechanistic phase, we determine the reasons for the disparity. Third, in the interventional phase, we use our descriptive and mechanistic findings to develop and ...References1. Institute of Medicine. Care Without Coverage. Washington, DC: National Academy Pr; 2002. Google Scholar2. Hadley J. Insurance coverage, medical care use, and short-term health changes following an unintentional injury or the onset of a chronic condition. JAMA. 2007;297:1073-84. [PMID: 17356028] CrossrefMedlineGoogle Scholar3. Shone LP, Dick AW, Klein JD, Zwanziger J, Szilagyi PG. Reduction in racial and ethnic disparities after enrollment in the State Children's Health Insurance Program. Pediatrics. 2005;115:697-705. [PMID: 15930198] CrossrefMedlineGoogle Scholar4. McWilliams JM, Meara E, Zaslavsky AM, Ayanian JZ. Health of previously uninsured adults after acquiring Medicare coverage. JAMA. 2007;298:2886-94. [PMID: 18159058] CrossrefMedlineGoogle Scholar5. Baker DW, Feinglass J, Durazo-Arvizu R, Witt WP, Sudano JJ, Thompson JA. 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A 10-year experience with universal health insurance in Taiwan: measuring changes in health and health disparity. Ann Intern Med. 2008;148:258-67. [PMID: 18283203] LinkGoogle Scholar10. Sehgal AR. Impact of quality improvement efforts on race and sex disparities in hemodialysis. JAMA. 2003;289:996-1000. [PMID: 12597751] CrossrefMedlineGoogle Scholar11. Fronstin P, Collins SR. Findings from the 2007 EBRI/Commonwealth Fund consumerism in health survey. March 2008. Accessed at www.commonwealthfund.org/usr_doc/Fronstin_consumerism_survey_2007_issue_brief_FINAL.pdf?section=4039 on 5 March 2009. Google Scholar Author, Article, and Disclosure InformationAuthors: Ashwini R. Sehgal, MDAffiliations: From Case Western Reserve University and MetroHealth Medical Center, Cleveland, OH 44109.Disclosures: None disclosed.Corresponding Author: Ashwini R. Sehgal, MD, Center for Reducing Health Disparities, Case Western Reserve University, MetroHealth Medical Center, Rammelkamp Building, Room 213, 2500 MetroHealth Drive, Cleveland, OH 44109; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDifferences in Control of Cardiovascular Disease and Diabetes by Race, Ethnicity, and Education: U.S. Trends From 1999 to 2006 and Effects of Medicare Coverage J. Michael McWilliams , Ellen Meara , Alan M. Zaslavsky , and John Z. 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