Mounting health care costs, and new data showing these costs are increasingly borne by public funds (see HABIT, March 8, 2005) have prompted governments to take notice of health disparities data.

“Even in the United States, the most market-oriented of health care economies, a government role in purchasing health care services and many other services that impact health is assured,” said Harvard researcher David Studdert, LLB, M.P.H.

The conference offered viewpoints from government health officials from Sweden, the United Kingdom and Mexico. Several speakers stressed the importance of policies that cut across government agencies rather than programs confined to health ministries. “These cross-sector projects are best, but they are more complicated and require more time (to set up),” according to Irene Nilsson Carlsson, director of Sweden’s Division for Public Health.

Fiona Adshead, M.D., deputy chief medical officer of the United Kingdom’s Department of Health, said “political stroking” can be very important in getting politicians to embrace policies that address social and economic inequalities. She discussed a program that improved heart disease death rates among poorer citizens in one English city in one year as an example of a program that brought popular support to local politicians. Such successes, she said, can convince reluctant officials that health programs “don’t have to follow a glacial time scale to get action.”

Asa Cristina Laurell, M.D., the minister of health for Mexico City, discussed a universal health care plan there. Although the plan was not targeted at the city’s poor, they experienced the most significant improvements in health. “I think that the principle of universality is one of the political principles that makes everybody willing to pay for those services,” Laurell said.

Disparities studies in the United States have revealed an overall poor level of quality care for all Americans, Agency for Healthcare Research and Quality head Carolyn Clancy, M.D, reminded the audience

“It’s really hard to justify that 59 percent of people receiving evidence-based lifesaving treatments represents the Everest of our ambitions,” Clancy said.

The Harvard School of Public Health continues its series of disparities symposia on April 14 with lectures on the National Institutes of Health research agenda. For more information, including free webcasts of each event, go here.