64%
71%
1995
2008
21% 16%
7% 6%
7% 6%
1% 1%
WHITE
ASIAN AMERICAN LATINO
BLACK
AMERICAN
INDIAN
Source: Association of American Medical Colleges
AETNA: ADDRESSING
HEALTHCARE INEQUALITY
Over the past several
years, health-benefits
company Aetna (No. 48 on
The 2009 DiversityInc Top
50 Companies for
Diversity® list) has focused
on creating programs that
improve healthcare
equality for the 36. 8 million
people it serves.
The goal: to increase
access to healthcare
and reduce disparities in
outcomes for racial and
Rawlins says. “It’s critical to
address them.”
Aetna is doing exactly
that through its Racial and
Ethnic Equality Initiative,
which Dr. Rawlins co-leads.
The program uses a database to facilitate care for
specific racial and ethnic
groups. In 2001, Aetna
began asking members to
voluntarily identify their
race, ethnicity and language
preferences. Since then,
6. 2 million members have
shared this information.
Based on that feedback,
Aetna created a Racial and
Ethnic Equality Dashboard,
which provides a snapshot
of disease prevalence
among members by geography, race and ethnicity.
“We are using that
data to create outreach
programs to improve care
for affected populations,”
says Dr. Rawlins.
For example, Aetna
identified Latinas and Black
women ages 40 and older
who had not had mammo-
gram screenings for more
than one year.
Between October
2006 and January 2007,
the company reached out
to those members, either
through telephone calls
by bilingual case managers or mailings in English
and Spanish, to encourage
them to get a mammogram
and to offer information
on convenient mammog-raphy locations in their
communities. The result: a
30 percent improvement
in mammogram-screening
rates among those members, with rates increasing
from 20 percent to more
than 26 percent.
Aetna has also piloted
initiatives to address hypertension and diabetes,
which disproportionately
affects Blacks and Latinos.
“Using a data-driven
approach,” says Dr. Rawlins,
“we can engage our
members and improve
outcomes for all the populations we serve.”
ethnic populations, says
Dr. Wayne Rawlins,
national medical director
at Hartford, Conn.-based
Aetna. “It’s not enough to
just acknowledge that
disparities exist,” Dr.
likely than whites to practice in
underserved communities and to
treat uninsured patients,” says Dr. Rios.
Studies have also found that patients
are more comfortable and willing
to communicate with a healthcare
provider who looks like them and
speaks their language, she adds.
Although providers may not be
overtly biased, if they don’t speak
the language of their patients or
understand their culture, religion or
other differences, they’re less likely
to win their trust. Consider LGBT
patients. “Many gays and lesbians are
reticent to go to the doctor unless
they have a healthcare provider who
can speak to them in a non-judg-mental way,” says Fox.
That’s why cultural-competency
training and tools for healthcare
providers are vital for improved care.
This can range from providing patient
translation services to gathering information on their religious preferences.
In addition, when it comes to
developing new effective drugs
and treatments, physicians and
patients from underserved communities must be included in the
clinical-trial process. Otherwise, a
drug or treatment may be approved
without knowing its effectiveness
on all populations. The U.S. Food
and Drug Administration estimates
that in 1999, the last year for which
statistics were available, fewer than
8 percent of people who were
registered for clinical drug trials were
Black, Latino or Asian, while those
groups represented 28 percent of
the population. Their participation in
trials is important because different
patients respond differently to various medications.
