We focus on improving health outcomes for people of color because those are the groups whose opportunities to achieve optimal health are the most unequal — and the data shows it.
Health disparities are pervasive in Connecticut.
- Black children and teens were more than five times more likely than white children to go to the emergency room for asthma in 2018.
- The infant mortality rate in 2018 was more than twice as high for babies born to Black mothers than babies born to white mothers.
- Hispanic residents with diabetes are three times more likely to have a leg amputated than white residents with diabetes.
- Black adults were hospitalized for preventable reasons at a rate nearly twice as high as the state average in 2012. The rate of preventable hospitalizations among Black children was 2.5 times higher than the state average for all children.
But it doesn’t have to be this way.
It’s easy to think of these kinds of disparities as intractable problems. But that’s not the case. Change is possible; it can come from a combination of policy changes, partnerships, and strategic funding.
We know that because we’ve seen it happen.
Here are some examples:
Collaborating to reduce disparities in health insurance coverage
Connecticut has one of the lowest uninsured rates in the country, but the likelihood of being uninsured varies widely by race and ethnicity.
In 2013, 26 percent of Hispanic residents under 65 in Connecticut lacked health insurance. That was nearly three times the rate among whites (9 percent of whom were uninsured).
By 2015, that had changed. The uninsured rate for Hispanic residents under 65 dropped dramatically, to 11 percent.
Put another way: Among Hispanics, the likelihood of being uninsured fell from one in every four people to one in every 10.
How did that happen? The major reason was the Affordable Care Act, which made coverage available and more affordable to many low- and moderate-income state residents. Overall, the uninsured rate in Connecticut fell from 12 percent to 7 percent according to the Kaiser Family Foundation.
But getting so many more people covered took more than policy change alone. It took hard work by people in the very communities that had high rates of uninsured residents. One critical tool was direct outreach and health insurance enrollment assistance, to help people get through a process that can be daunting.
These local and statewide efforts were collaborative, and we’re proud of the role the Connecticut Health Foundation played. Among other things:
- We helped fund enrollment assistance programs to ensure that people who wanted coverage could get help from knowledgeable people who spoke their language.
- We commissioned research to identify ways to make the enrollment process as seamless and consumer-friendly as possible.
- We provided grants to develop ways to help the newly insured understand how to use their coverage.
- We participated in the creation and operation of the state’s health insurance marketplace, Access Health CT, by being part of board committees and advisory groups.
There is more work to be done to maintain these gains and eliminate the remaining disparities in insurance coverage. The progress that came from the work of many people and organizations gives us confidence that change is possible.
What we’re working on now
Supporting sustainable funding for community health workers
Community health workers are frontline public health workers who serve as a bridge between their communities and the clinical care and social service systems. They work with people in a holistic way, looking for ways to best meet their needs and support them in managing their health and well-being. Community health worker is an umbrella term; many are better known by job titles such as patient navigator, care coordinator, or health coach.
Research shows that community health workers can improve health outcomes for people with conditions including diabetes, asthma, cardiovascular disease risks, and HIV. They also help ensure people receive preventive care.
Despite their value, community health worker services are generally not financed in a sustainable way. As a result, many are funded through grants rather than long-term funding sources.
Because community health workers can play such a valuable role in improving health outcomes and reducing disparities, the Connecticut Health Foundation has been working to assure that this workforce can be integrated into the health care system and funded in a way that assures the availability of these services.
This includes:
- Commissioning research to identify community health worker interventions that could be implemented in Connecticut and produce a positive return-on-investment, then funding a demonstration project to implement the model.
- Supporting advocacy by community-based organizations for sustainable payment for community health workers.
- Working with partners to support the creation of a voluntary certification process for community health workers in Connecticut, which is considered a step toward being able to secure sustainable payment.
- Providing grants to health care organizations to evaluate existing community health worker models and identify the impact of incorporating community health workers into their services.