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Eliminating racial and ethnic health disparities: opportunities and challenges for the Commonwealth.

Multiple federal health agencies have set a national public health priority to eliminate racial and ethnic health disparities. On a practical level, however, the onus is on states both to develop the infrastructure and to implement the agenda within which to achieve the goals of relieving the disproportionate burden of disease on ethnic, racial and linguistic minority populations. Racial and ethnic population density varies widely among states, presenting challenges in collecting the data to identify disparities, addressing the underlying factors of disparate health status among minorities, and, ultimately, in reducing the disparity of illness and disease among the entire population. There is great value in the information we already have about health disparities. However, on a national and state basis, gaps in research and data collection do exist, and persent challenges to our goals. It is in confronting what we don't know about disparities that we will be able to make progress toward a public health agenda that is responsive to all populations. Once able to understand fully the health status of minorities, new approaches to state and community health planning that cut across all populations will be required, as well as changes in messages about health behavior and prevention. Nationally, as data collection and reporting methodologies are adapted and revised to capture more adequately health disparities and the burden of disease, partnerships and collaborations among various public and private stakeholders are essential to identifying particular needs and strategies to improve the overall health of diverse populations. In Massachusetts, there are a number of new and ongoing initiatives in addressing health and social needs of its diverse population, only some of which are mentioned here. Many of these initiatives preceded the announcement of the Presi-dent's Race and Health Initiative in 1998. Indeed, minority health has been prominent in the discourse on health improvement for all of the Commonwealth's residents for several decades. Successful partnership and collaboration between and among government health agencies, private entities, and community-based organizations is not new in Massachusetts. The past several years of success in expanding access to health insurance for large segments of the population, and the overall good health of the Commonwealth's population contribute to the strength and momentum of a movement to improve it even further. A commitment on the part of all stakeholders is needed to achieve goals of eliminating disparities. State oversight agencies, health care providers, community-based organizations, advocacy groups, and …