Health Equity and The Colorado Trust’s Environmental Scan

By Ned Calonge, MD, MPH, The Colorado Trust

Last week, I attended my first meeting as a new member of the Institute of Medicine Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities held in Hartford, Connecticut. The meeting focused on those provisions in the Affordable Care Act that address health equity, similar to information included in our recent issue brief, Health Equity and the Affordable Care Act. The presenters covered the promising influence of coverage expansion, patient-centered medical homes, safety-net providers and hospital community benefit programs on health equity issues.

One of the most engaging presentations was given by two community advocates and grantees of The Connecticut Health Foundation: Alta Lash from United Connecticut Action for Neighborhoods and Reverend Nancy Kingwood, MSHS, from the Ashe Faith Project. These advocates reminded us that for all the promise of the Affordable Care Act, most of the benefit anticipated from Medicaid expansion and insurance purchase through the new “health care marketplace” (the new name for health exchanges) will be difficult to realize without authentic community engagement of those individuals currently uninsured and underserved.

The power of community engagement was evident throughout The Trust’s environmental scan on health equity in Colorado which we conducted this past year. We engaged over 1,000 Coloradans through nearly 30 community engagement events, multiple key informant interviews and focus groups, foundation funding gap analysis and a statewide survey.

In considering health equity, participants identified certain challenges common across different regions of the state, including issues regarding affordability and access, complexity of the health care system, cultural competency of the health care system, and the social determinants of health. Multiple communities discussed specific issues concerning access to care, delivery and payment reform, health care workforce support, and the patient experience. Communities mentioned needs ranging from mental health/substance abuse treatment, coordinated health care, transportation, health literacy and personal responsibility, to name only a few.

The findings are detailed in The Trust’s latest report, Access to Health >> Health Equity: Findings from The Colorado Trust’s Environmental Scan. The level of understanding, engagement and commitment on the part of scan participants in considering the challenges, potential solutions and roles for The Trust was inspiring, and represents an energy we hope to tap into as we pursue the advancement of health equity in Colorado. We are working hard to turn the scan results into grantmaking, so stay tuned.