United Healthcare Community Plan leaders discuss next steps for health equity in Hawaii – State of Reform
The U.S. health ranking released its 2021 health disparities Report, which provides national and state-specific data on the health disparities leading to the pandemic. United Healthcare Community Plan (UHCP) CEO David Heywood and Senior Medical Director Denise Leonardi, MD, discussed the report’s findings and how they will shape the agency’s future healthcare initiatives. .
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In Hawaii, the report found a 19% decrease in adult smoking, a 21% decrease in Asian and Pacific Islander populations with less than a high school diploma, and a 36% decrease in Hispanic adults avoiding care because of the cost.
The report also found a 40 percent increase in diabetes among adult men and a 16 percent increase in physical activity among adults with a college education. Heywood noted the correlation between the two statistics:
“There is a correlation with the rising obesity rate in Hawaii – which is still below the national average – but of concern at the Department of Health and Human Services. It is also noted that there is an increase in obesity in children. In particular, there is a variation [within the statistics] in the socioeconomic class, and especially with Native Hawaiians and Pacific Islanders.
The report found that Asians and Pacific Islanders had the lowest health status compared to Native American / Alaska Native, Black, Hispanic, Multiracial, and White ethnicities. The Hawaiian natives were not named as a separate group, and Heywood said they were most likely integrated with Asians and Pacific Islanders.
The pandemic has highlighted these disparities. Leonardi gave an overview of state data collected during the pandemic:
“We know that deaths from COVID-19 have reduced average life expectancy and have further exposed and exacerbated long-standing health disparities. We saw in our own data that Native Hawaiians and Pacific Islanders had higher age-adjusted infection rates, severe illness, and death than whites and Asians. When we look at the data we get from the state, we know that all recent reports have reinforced how the underlying disadvantaged social and economic communities are playing an outward role in COVID-19 disease and death. “
Hawaii is in a unique position to address these disparities. Since 1974, when the state adopted the Hawaii Prepaid Health Care Act, employers have been mandated to provide their employees with health insurance, making Hawaii one of the most insured states in the country, according to a 2020 WalletHub report.
While the state ranks well in terms of health insurance coverage, more can be done to ensure health equity across the state, Heywood said.
“The global topic of health disparities is officially recognized by the state. For example, Medicaid health plans, including [UHCP] entered into a contract with the State of Hawaii effective July 1. One aspect of the new contract is a requirement to collect more detailed information on health care disparities – by race, ethnicity, island, gender – and this will really allow… a granular understanding. where the disparities are, so that the state, the health plans, the health care delivery system can find ways to address and resolve these disparities.
Other areas the PSSU is working to address are resuming in-person pediatric visits, supporting postpartum care programs, and studying the impacts of social determinants of health.
An Oahu-based initiative, funded by a grant from the Center for Medicare and Medicaid Innovation (CMMI), found that access to nutritious food was a key issue in communities in Hawaii. Heywood explained that the key to identifying the problem was to work with community health centers.
“It’s a great example of diving and getting the right information in our community. It is a partnership with community health centers and our hospital system.