This week, Montgomery County’s Commission on Health is sponsoring a community forum on health care resources and services. Brian Smedley, research director and co-founder of the D.C.-based Opportunity Agenda, will speak on health disparities, an issue he regularly researches both nationally and locally.
Where are the biggest health disparities in Montgomery County?
While data is generally not available at the county level, Montgomery County probably fares better when it comes to health status and health care access than other counties in the state. The county is relatively affluent, rates of uninsurance are low relative to state and national averages, and the county has established several initiatives to extend health care to the neediest residents. But statewide data show that we can do better to reduce the health status gap between minorities and nonminorities. For example, the death rate for African-Americans is greater than for whites in all counties in the state, but this disparity is greater in Montgomery County than it is in Baltimore City or county.
Are members of minority communities getting the same level of care?
We don’t have complete data on the picture of racial and ethnic health care disparities in the state or county, but we know that nationally, African-Americans, Latinos and American Indians tend to have greater difficulty accessing the care that they need. And when they do, it tends to be of lower quality and appropriateness than the carethat white patients receive. This is a very consistent finding in a number of large, major studies.
What has been the most surprising finding in your research?
I’m most often struck, not by the persistence of health inequality, or of evidence that the health care system doesn’t serve everyone equally, but the fact that we as citizens are largely unaware of these problems. We’ve got to realize that our fates as Americans are deeply intertwined — the health problems that hurt some communities have broad ripple effects, both in human and economic terms, for all communities.
How did you get started in the field?
I began working in this field as a congressional science fellow in 1993, when I worked for Bobby Scott, who represents the Fifth District of Virginia in the House. Congressman Scott is passionate about racial justice and equality, and in this job I had the opportunity to learn about some of the challenges and opportunities for addressing inequality. In 1997, I began working at the Institute of Medicine, where I directed several studies focused on the benefits of diversity in the health professions, racial and ethnic health care disparities and population health.
– Dena Levitz
