In a press release from the Agency for Healthcare Research and Quality (AHRQ) on Friday, results of the latest National Healthcare Disparities Report were released. The report showed what should not be a surprise to Network followers - access to health care was not improving for most racial and ethnic groups in the years 2002 through 2008 leading up to enactment of the Affordable Care Act. The congressionally mandated disparities and quality reports, which AHRQ has produced annually since 2003, are based on over 40 different national sources that collect data regularly. The report, which includes about 250 health care measures, show the persistent challenges in access to care, faced by most racial and ethnic groups. Fifty percent of the measures that tracked disparities in health care access showed no improvement between the years 2002 and 2008, while 40 percent of those measures were getting worse.
Specifically, for 2002 through 2008, Latinos, American Indians and Alaska Natives experienced worse access to care than Whites on more than 60 percent of the access measures, while African Americans experienced worse access on slightly more than 30 percent of the access measures. Asian Americans experienced worse access to care than non-Latino Whites on only 17 percent of the access measures. Read the full report here.
Consider these sobering statistics for Champaign, Illinois where there is a current CMHI cooperative agreement in place that is addressing disparities head on. While African Americans make up 22% of the overall county population, they represent 81% of youth suspended more than once in Champaign-Urbana schools during the 2009-2010 school year; in 2009, 74% of Champaign County Department of Juvenile Justice commitments were African American youth; 82% of Champaign County Juvenile Detention Center Admissions were African American youth; and, finally, in 2009, African Americans made up 60% of the children who came into foster care in Champaign County.
Let those statistics sink in for a moment.
Props to the SAMHSA grant effort in Champaign for tackling this most important issue and props to SAMHSA for stressing cultural and linguistic competence as part of the fabric of this community’s effort to improve services and supports for youth with serious emotional and behavioral challenges and their families.
Relevance to the Network and the Child Mental Health Initiative (CMHI)
Across the nation, communities involved with the CMHI address these issues daily by incorporating family, youth and community stakeholder involvement in their decision-making about the type of training and education that is offered to providers of all types (including law enforcement, education, child welfare and mental health) so that individuals providing services and interventions can be a part of reducing the disparity in what is offered to youth with emotional and behavioral challenges and their families. It's a long road to changing statistics like these, but without champions speaking out in communities across the nation, it won't happen. For over 20 years, the CMHI has provided a consistent voice about the importance of being family-driven, youth-guided and culturally and linguistically competent.
But wait a minute. The CMHI as we know it is going away. As I have been saying for some months now, the trend at SAMHSA is to move away from the CMHI and push decision-making about what defines quality programming for children and youth to the states through the block grant program.
- Read our analysis of what we affectionately called “merger mania” back in July, 2011 - http://www.cmhnetwork.org/media-center/blog/merger-mania
- Our small victory in getting language added to the FY 2012 Block Grant application in August, 2011 – http://www.cmhnetwork.org/blog/update-8-2
- And then our analysis of the SAMHSA budget proposal back in February, 2012 - http://www.cmhnetwork.org/media-center/blog/samhsa-fy-2013-budget-proposal-not-a-good-day-for-childrens-mental-health
Morning Zen has me pondering the following questions:
- Without federally funded initiatives that shine a light on the importance of service delivery systems incorporating a culturally competent approach when working with youth who have a serious emotional or behavioral challenge, who is going to do it?
- Who will assume the mantle of ensuring that the values and principles of a system of care approach are vigorously defended if SAMHSA chooses to move in another direction?
- Do you really think we can count on the states to do this?
As always, share your thoughts. Let us know what you are thinking!