Health Equity

Improvements in health equity depend on a better understanding of health disparities and efforts to reduce avoidable differences in health outcomes as well as other conditions, such as access to safe housing, healthy food, transportation and jobs. Better data collection and measurement are essential, particularly for monitoring and addressing the inequitable impacts of the pandemic.  SHADAC’s work in this area includes projects focused on equity in the Medicaid program, in-depth resources focused on data and measurement, and highlighting successful strategies in advancing health equity for key public health efforts, such as vaccination.

Relevant SHADAC work:
Click on any title below to learn more about the project.

Medicaid Equity Monitoring Tool: Phased Project with RWJF

With support from the Robert Wood Johnson Foundation, SHADAC is leading a multi-phased project to assess whether identifying a set of key equity-related indicators and populating these relevant measures into a larger digital tool (i.e., a “Medicaid Equity Monitoring Tool”) could be a helpful, feasible, and reliable way of tracking and advancing progress in achieving health equity in Medicaid at the state and federal levels. Phase 1 of the project began in May 2021, and a majority of this initial, exploratory work consisted of convening an advisory committee with purposefully diverse perspectives and experience working with the Medicaid program, consultation of and interviews with key informants, and conducting reviews of selected literature. SHADAC is currently in Phase 2 of the project, with a current focus on the selection of a partner organization that will help facilitate community engagement in helping to develop this tool, as well as conducting additional background research into the data and contextual measures that could populate such a tool. As with the first phase, work in Phase 2 will close with a recommendation to RWJF regarding the feasibility of moving forward with building, operating, and maintaining a Medicaid Equity Monitoring Tool.

Collection of Race, Ethnicity, Language Data on Medicaid Applications 

Collecting and monitoring data on Medicaid enrollees that is broken down by race, ethnicity, and language (REL) is an essential first step in assessing health disparities as well as identifying strategies for improvement in state Medicaid programs. Although all state Medicaid agencies and most U.S. territories collect self-reported data on REL from applicants during the eligibility and enrollment process, many states continue to face longstanding and persistent challenges in collecting complete, accurate, and granular data on REL. In this issue brief prepared for State Health and Value Strategies with funding from the Robert Wood Johnson Foundation, SHADAC researchers Emily Zylla, Elizabeth Lukanen, and Hannah Geressu provide an overview of federal REL data collection standards, and examine Medicaid application questions, answer options, and instructional language used by Medicaid programs in all 50 states, the District of Columbia, and five U.S. territories

Collection and Availability of Data on Race, Ethnicity, and Immigrant Groups in Federal Surveys that Measure Health Insurance Coverage and Access to Care

This SHADAC brief was created to assist state and federal analysts with survey development and/or analysis of existing survey data to generate estimates of health insurance coverage and access to care across racial and ethnic groups and according to nativity and/or immigrant status. The brief presents the collection and classification of survey data for populations defined by race, ethnicity, and nativity/immigrant (REI) status as well as the availability of these data in public use files.

Borrowing Proven Policy Strategies to Vaccinate Kids Against COVID-19

With the authorization of the first COVID-19 vaccine for children ages five and older, most kids in the United States are now eligible to be immunized. The objective of this brief, produced by SHADAC researchers for State Health & Value Strategies (SHVS), is to highlight the strategies and tools that have contributed to prior successful U.S. efforts to widely vaccinate children against contagious diseases and reduce vaccination disparities, so that they may be applied to initiatives to immunize kids against COVID-19.

Collection of Sexual Orientation and Gender Identity (SOGI) Data: Considerations for Medicaid and Spotlight on Oregon

Thirteen million people identify as part of a sexual or gender minority (SGM) in the United States, and an estimated 1.17 million of those SGM adults (age 18-64) have Medicaid as their primary source of health insurance. A State Health and Value Strategies brief, authored by SHADAC researchers, documents the few examples of SOGI data collection efforts occurring at the federal level and in Medicaid, and highlights the efforts of an Oregon community stakeholder process that identified several key areas for SOGI data improvement.

Expert Perspective: States' Reporting of COVID-19 Health Equity Data

States’ Reporting of COVID-19 Health Equity Data looks in-depth at which states are reporting data on the impacts of COVID-19 on vulnerable populations, including communities of color, populations with lower incomes, and residents of congregate living facilities. Also included are interactive maps that explore the extent to which states are reporting data breakdowns by age, gender, race, ethnicity, and locational levels (ZIP code), group residence type, and for health care workers.