Despite reform disparities need attention

The healthcare reform initiatives to improve healthcare won't be enough unless U.S. disparities in health and healthcare occur, U.S. researchers suggest. Dr. Matthew M. Davis and Dr. Jennifer K. Walter, both of the University of Michigan Health System, say the Affordable Care Act may not address pervasive and persistent disparities in healthcare related to factors such as sex, race, ethnicity, social class and insurance status. "Individuals deserve healthcare that is not only of high quality, but of high quality for all," Davis, co-director of the Robert Wood Johnson Foundation Clinical Scholars program at the University of Michigan in which Walter is a research fellow, says in a statement. "If we don't address disparities in health and healthcare, we will fundamentally limit how much healthcare quality can improve." For example, the recent history of U.S. childhood vaccination efforts illustrates how effective policies can be when disparities are not only acknowledged but tackled head-on, Davis says. "A generation ago, many disadvantaged kids died of measles in the inner cities of the U.S., essentially because our vaccination efforts were of poor quality," Davis says. "But today, with a clear priority on measuring and fixing those disparities through lots of hard work, we now have substantially reduced disparities and improved our quality in childhood vaccination." The commentary appears online ahead of print in the Journal of the American Medical Association.