To showcase what states are doing to address health disparities that the COVID-19 pandemic has laid bare, the National Academy for State Health Policy is highlighting state initiatives through reports and guest blogs, such as this one by Massachusetts Attorney General Office Health Care Analyst Noam Yossefy and Assistant Attorney General Sandra Wolitzky.

A new report, Building Toward Racial Justice and Equity in Health: A Call to Action, released in November 2020 by Massachusetts Attorney General Maura Healey outlines a series of recommendations to address longstanding health disparities and the disproportionate toll that the COVID-19 pandemic has taken on communities of color in Massachusetts.

The report identifies a set of priority areas that are critical to reducing health inequities. The five domains for action include data for identifying and addressing health disparities, equitable distribution of health care resources, telehealth as a tool for expanding equitable access to care, health care workforce diversity, and social determinants of health and root causes of health inequities.

Within each domain, the report offers actionable recommendations, including the following:

Health Care Data

• Improve the collection and reporting of data on patient race, ethnicity, geographic and other demographic characteristics to help stakeholders better understand existing disparities and develop targeted strategies to address them.
• Establish and measure statewide equity benchmarks to demonstrate commitment to advancing health equity and racial justice.

Equitable Distribution of Resources

• Promote equitable health care provider payment rates to ensure that low-income communities and communities of color have access to the same resources available to any other community in order to meet their health needs.
• Reduce patient cost sharing during the pandemic for primary care, behavioral health, and prescription drugs for certain chronic conditions so that underserved patients can get the services they need during the COVID-19 emergency.

Telehealth and Clinical Access

• Address the divide in digital access by increasing the availability of free and low-cost internet plans and devices and making sure that underserved patients are aware of available resources.
• Support coverage and payment parity for telehealth services, including telephonic visits, where clinically appropriate, for the next two years.
• Ensure equitable access for individuals with disabilities and limited English proficiency through standardized provider procedures and accommodation services to minimize existing disparities in clinical care.

Workforce Diversity

• Expand affordable and inclusive educational opportunities to increase access to health professions.
• Include anti-racist and cultural humility training in medical education, licensure, and certification processes.

Social Determinants of Health

• Prioritize investments in key social determinants of health – including education, employment, housing, the environment, and violence – in order to address upstream inequities that lead to health disparities.
• Explore new models to bring together stakeholders who can apply a health equity lens to regional decisions that affect social determinants of health, such as regional health equity authorities.

While some of the recommendations require legislation, many can be implemented immediately by health care stakeholders changing their policies or practices. “Our health care system works well for many, but the disparate effects of the pandemic provide a somber reminder that our system fails to equitably serve communities of color,” Attorney General Healey explained. “The intent of this report is to advance the urgent work that is needed to address these disparities.  COVID-19 has shown us that these actions cannot wait.”