end+disparities Learning Exchange Part I: Disparity, a National Priority

Quick Review This presentation is the first in a series of presentations intended to familiarize you with disparities calculation Part I: YOU ARE HERE! Part II: Subpopulations Part III: Calculating Disparity Part IV: Calculation Assumptions Part V: Selecting QI Projects

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” - Martin Luther King, Jr.

Learning Objectives Understand why disparity management is a national priority for HIV service systems Define disparity in HIV service systems

What is a Health Disparity? “Differences in health outcomes or health determinants observed between populations” – Center for Disease Control (CDC)

What is a Health Disparity? “A population is a health disparity population if there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rates in the population as compared to the health status of the general population.” – Minority Health and Health Disparities Research and Education Act, United States Public Law 106-525 (2000)

National HIV/AIDS Strategy - 2015 Office of National AIDS Policy, National HIV/AIDS Strategy. July 2015.

National HIV/AIDS Strategy - 2015 GOAL 1: REDUCING NEW HIV INFECTIONS Intensify HIV prevention efforts in the communities where HIV is most heavily concentrated Expand efforts to prevent HIV infection using a combination of effective evidence-based approaches Educate all Americans with easily accessible, scientifically accurate information about HIV risks, prevention, and transmission GOAL 2: INCREASING ACCESS TO CARE AND IMPROVING HEALTH OUTCOMES FOR PEOPLE LIVING WITH HIV Establish seamless systems to link people to care immediately after diagnosis, and support retention in care to achieve viral suppression that can maximize the benefits of early treatment and reduce transmission risk Take deliberate steps to increase the capacity of systems as well as the number and diversity of available providers of clinical care and related services for people living with HIV Support comprehensive, coordinated, patient-centered care for people living with HIV, including addressing HIV-related co-occurring conditions and challenges meeting basic needs, such as housing GOAL 3: REDUCING HIV-RELATED DISPARITIES AND HEALTH INEQUITIES Reduce HIV-related disparities in communities at high risk for HIV infection Adopt structural approaches to reduce HIV infections and improve health outcomes in high-risk communities Reduce stigma and eliminate discrimination associated with HIV status Office of National AIDS Policy, National HIV/AIDS Strategy. July 2015.

National HIV/AIDS Strategy - 2015 Step 3.A Reduce HIV-related disparities in communities at high risk for HIV infection 3.A.1 Expand services to reduce HIV-related disparities experienced by gay and bisexual men (especially young Black gay and bisexual men), Black women, and persons living in the Southern United States 3.A.2 Support engagement in care for groups with low levels of viral suppression, including youth and persons who inject drugs Office of National AIDS Policy, National HIV/AIDS Strategy. July 2015.

National HIV/AIDS Strategy - 2015 Office of National AIDS Policy, National HIV/AIDS Strategy. July 2015.

National HIV/AIDS Strategy - 2015 Office of National AIDS Policy, National HIV/AIDS Strategy. July 2015.

“It is time to refocus, reinforce, and repeat the message that health disparities exist and that health equity benefits everyone.” - Kathleen Sebelius

HIV Disparities at a Glance 12% of the U.S. population is African-American 44% of new HIV diagnoses are among African-Americans Blacks represent 14% of the U.S. population but account for almost half (46%) of all people living with HIV in the U.S U.S. Population New HIV Diagnoses http://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html

Black lives lost to HIV/AIDS in 2013… …account for 54% of total deaths due to the disease. http://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html

HIV Disparities at a Glance 17% of the U.S. population is at the age of 13-24 26% of new HIV infections are among young persons Young persons aged 15–29 accounted for 39% of all new HIV infections in the U.S. in 2009, while representing only 21% of the U.S. population in 2010. [4] U.S. Population New HIV Infections Office of National AIDS Policy, National HIV/AIDS Strategy. July 2015 http://www.census.gov/popclock/

HIV Disparities at a Glance 1 in 880 white women will be diagnosed with HIV in her lifetime http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf

HIV Disparities at a Glance 1 in 132 white men will be diagnosed with HIV in his lifetime http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf

Ending disparities will end the HIV epidemic.

Next Steps Check out the NQC Disparities Calculator and NQC Guide! Want to check out the NQC Disparities Calculator? Click this link and you’ll be taken there! Want to learn more about the NQC Guide on this topic? Click this link and you’ll be taken there!

Next Steps This presentation is the first in a series of presentations intended to familiarize you with disparities calculation Part I: YOU ARE HERE! Part II: Subpopulations Part III: Calculating Disparity Part IV: Calculation Assumptions Part V: Selecting QI Projects

NationalQualityCenter.org Michael@NationalQualityCenter.org 212-417-4730 NationalQualityCenter.org Michael@NationalQualityCenter.org 21