TBD

差异报告，跟踪美国卫生服务的不平等。由于该报告是第一次 2003年发表的调查结果一致表明，虽然我们在质量上有所改进， 在减少医疗保健差距方面并不成功。尽管事实上， 我们继续在医疗保健上投入更多。医疗保健成本一直在以不可持续的速度上升， 据统计，2009年， 医疗保险和医疗补助服务（CMS）。尽管在这些地区提供保健服务的费用很高， 在美国，我们继续观察到医疗保健质量的交付系统分散和不公平 交付。 同样，当我们看到种族和族裔少数群体在健康状况和获得保健方面的差距时， 数字相当惊人！每年约有83，000名少数种族和族裔的人因种族歧视而死亡。 健康差距，作为一个国家，我们正在花费大约3 000亿美元作为这些疾病的结果。 当我们加入健康的社会决定因素时--意识到单靠医疗保健无法充分改善 总体健康或减少健康差距而不解决人们在哪里和如何生活-你可以看到如何 这个问题很复杂。 尽管健康公平是我们所有人都在进行的医疗保健转型之旅的关键组成部分， 在开始时，在全面和跨学科协调卫生政策方面几乎没有做什么 研究，分析，并在地方，州，区域和国家合作解决这一严重问题 水平 随着近年来几项与健康相关的政策的通过，重点一直放在弯曲成本上 曲线和变得更有效率，更少的移动fon/vard。虽然可能很难预测意外的 通过利用我们合作伙伴的集体力量和专业知识， 我们可以解决少数种族和族裔面临的严重健康差距。 正在推进的一项重要的卫生政策是ACA，其中包括解决卫生公平问题的条款 并消除弱势群体健康状况和医疗保健方面的差距。了ACA 包括与健康公平有关的规定，这些规定为实现健康公平提供了一个桥梁， - 增加获得文化上适当的护理的机会， 医疗保健、预防保健和比较有效性研究。对于少数种族和族裔， 最有可能没有保险，经历更高的失业率，收入更低-这 这使得更难获得雇主赞助的医疗保险覆盖-医疗补助的扩大和 建立健康保险交易所将为这些社区提供获得重要保健服务的机会。在 此外，ACA提供了一个独特的机会，以扩大与健康差距有关的研究范围， 增加临床试验的多样性，并确定、开发和分发适当的干预措施和解决方案， 解决这些差距。该法律还提供了新的投资，以增加文化 合格的初级保健医生和其他卫生专业人员。 基于这些原因，《反腐败法》的实施为实现以下目标提供了一个关键机会： 在全国范围内实现健康公平。最高法院最近对ACA的裁决，虽然基本上 削弱了ACA将医疗保险覆盖范围扩大到工作穷人的努力的一个关键方面- 医疗补助扩展-通过使该计划的扩展成为各州的选择，尽管如此， 《反腐败法》和旨在解决健康差距的规定。因此，MSM将帮助区域内的国家 四.加强其卫生公平和卫生改革议程，并向其他国家通报经验教训。

Disparities Report, which tracks the inequities in health services in the United States. Since the report was first published in 2003, the findings have consistently shown that while we have made improvements in quality, we have not been as successful in reducing disparities in healthcare. This dichotomy has resulted despite the fact that we continue to spend more on healthcare. Healthcare costs have been escalating an unsustainable rate, reaching an estimated 17.3 percent of our gross domestic product in 2009 according to the Centers for Medicare and Medicaid Services (CMS). Despite these high costs for the provision of health services in the United States, we continue to observe delivery system fragmentation and inequities in the quality of healthcare delivered. Likewise, when we look at the disparities in health status and access to care for racial and ethnic minorifies, the numbers are quite alarming! Each year approximately 83,000 racial and ethnic minorities die as a result of health disparities and as a nation we are spending an estimated $300 billion as a result of these disparifies. When we add in the social determinants of health - realizing that healthcare alone cannot adequately improve health overall or reduce health disparities without addressing where and how people live - you can see how complex this issue is. Despite the fact that health equity is a key component of the transforming journey of healthcare that we are all embarking on, little has been done to comprehensively and trans-disciplinarily coordinate health policy research, analysis, and collaboratively address this serious problem at the local, state, regional, and national level. With the passage of several health-related policies in recent years, the focus has been on bending the cost curve and becoming more efficient with less moving fon/vard. While it may be difficult to predict the unintended consequences of many of these policies, by leveraging the collective strengths and expertise of our partners we can tackle the grave health disparities confronting racial and ethnic minorities. One significant health policy being advanced is the ACA, which includes provisions addressing health equity and the elimination of disparifies in health status and healthcare among vulnerable populations. The ACA includes health equity-related provisions, which provide a bridge to health equity that affords marginalized groups - particularly racial and ethnic minorities - increased access to culturally appropriate care, quality healthcare, preventative care, and comparative effectiveness research. For racial and ethnic minorities who are the most likely to be uninsured, experience higher unemployment rates, and have a lower income - which makes it harder to obtain employer-sponsored health insurance coverage - Medicaid expansion and the creation of health insurance exchanges would provide these communities access to vital health services. In addition, the ACA provides a unique opportunity to expand the scope of research related to health disparities, increase diversity in clinical trials, and identify, develop and distribute appropriate interventions and solutions to address these disparities. The law also provides new investments to increase the number of culturally competent primary care physicians and other health professionals. For these reasons, the implementation of the ACA offers a critical opportunity to realize the goal of achieving health equity throughout our country. The recent Supreme Court ruling on the ACA, while essentially weakening a key aspect of the ACA's efforts to expand health insurance coverage to the working poor - Medicaid Expansion - by making the expansion of this program optional for states, nevertheless upheld the ACA and the provisions aimed at addressing health disparities. As a result, MSM will help states within Region IV strengthen their health equity and health reform agendas, and inform other states of lessons learned.