As a child, I watched my father, an African American physician, work in some of the most underserved neighborhoods in our community. He treated medical conditions that had escalated to serious illness and disability because of lack of access to affordable, quality health care. Although he served these communities with hope, it pained him to see how unchecked disease and disability had diminished so much potential in underserved, minority communities. He worked patiently, tirelessly to right this inequity the only way he knew: one patient at a time.
Forty years later, health care access and quality are still woefully unequal and alarming racial disparities still exist. African American babies in Maryland are three times more likely to die before the age of one than white babies. African Americans are four times more likely to visit an emergency room for asthma. When adjusted for age, African Americans in this state are twice as likely to die from diabetes or kidney disease than whites, and are almost twice as likely to lack health insurance.
In a state with nationally ranked hospitals and medical schools, and the second highest number of primary care physicians per capita, such disparities are not acceptable. Health disparities are not only untenable at the societal level, but they also have tragic results for individuals and families in shortened lives and increased suffering.
At the request of Governor O’Malley, I have spent the past five years working with leading health care experts and providers and asking: Can’t we do better than this in Maryland? The answer is a resounding “Yes.” And we must. Addressing health disparities is a moral imperative.
That’s why the Governor and I worked with our partners in the General Assembly this year to pass the Maryland Health Improvement and Disparities Reduction Act, which created an innovative pilot program of Health Enterprise Zones (HEZs) in underserved communities. Primary care providers working with community-based organizations in these zones will be offered incentives – loan repayment assistance, tax credits, grants, health information technology – to provide services that directly reduce disparities and improve access to care. The HEZ Initiative provides $4 million in new funding to support a pilot program of two to four zones across the state.
It’s no coincidence that communities in Maryland without basic health care services, frequently communities with large minority populations, have the highest rates of chronic and often preventable illness, such as hypertension, asthma, diabetes and other controllable medical conditions. In underserved neighborhoods, routine symptoms that might be easily treated become serious, intractable health conditions. By saturating these communities with primary care providers and health care services, we can ensure healthier Marylanders who live a better quality of life.
Reducing health disparities also lowers costs for all taxpayers. A 2009 report by the Health Policy Institute at the Joint Center for Political and Economic Studies estimated that between 2003 and 2006, nearly $230 billion in direct medical care costs could have been saved nationwide if racial and ethnic health disparities did not exist. One report of Medicare claims found that African Americans were nearly twice as likely to be hospitalized for such treatable conditions as asthma, hypertension and heart failure, costing Maryland an additional $26 million in 2006. Attracting practitioners to deliver health care services in underserved communities through the Health Enterprise Zones program will help drive down costs while reducing serious illness and disease.
The enterprise zone model has worked successfully on another long-standing problem: economic underperformance in distressed communities. Maryland’s Enterprise Zone program allocated $38 million in property tax credits in 2010 to over 1,000 businesses across 29 qualified economically distressed zones. Those credits stimulated nearly $400 million in private investment, helping to revitalize communities and create over 2,100 new jobs.
The zone model also worked on academic underachievement in New York. The Harlem Children’s Zone initiative blanketed a single block with poverty-reduction programs that included mentoring, tutoring and year-round academic enrichment. The effort won a steep rise in academic success, including high school graduation and college attendance rates.
Our new HEZ program applies a similar, targeted zone concept to specifically improve health care and health outcomes in areas where health disparities have been demonstrated, which are all too often communities of color. As a leader in health care reform, the O’Malley-Brown Administration has been tackling health care challenges with vision and resourcefulness from day one, and adding Health Enterprise Zones to our strategy is the kind of creative thinking for which Maryland is nationally known. We have a responsibility to continue leading the way.
Over the next few weeks, we will be hosting public forums in Baltimore City, Prince George’s County, and Southern Maryland where citizens will have the opportunity to offer input and discuss how this new and exciting program can best make a positive impact on their communities. In addition to the public forums, the State has set up a website, http://dhmh.maryland.gov/healthenterprisezones, and is receiving comments via email at firstname.lastname@example.org.
Equal access to health care should be a right, not a privilege. It’s also fiscally responsible. We cannot afford the rising costs of treating preventable disease and chronic illness. More importantly, we cannot afford the loss of talent and dignity when even one of our neighbors’ potential goes unrealized for lack of health care.
I believe that every Marylander, of every race and ethnicity, in every part of our state, should have the same chance to live a healthy life and to maximize their contributions to society. By continuing to work together, we can make that ideal a reality.
As Chair of Maryland’s Health Quality and Cost Council, Lt. Governor Anthony G. Brown leads the O’Malley-Brown Administration’s efforts to reduce costs, expand access, and improve the quality of care for all Marylanders. Under the leadership of Governor O’Malley and Lt. Governor Brown, Maryland has implemented reforms that have expanded health coverage to over 330,000 Marylanders and put the State in position to maximize the Affordable Care Act (ACA).
ANTHONY G. BROWN
100 STATE CIRCLE
ANNAPOLIS, MARYLAND 21401-1925
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