Dr. Anthony Iton, director and health officer of the Alameda County Public Health Department, testified before Congress today in a hearing on healthcare disparities gavelled by Rep. Pete Stark, D-Fremont, as chairman of the House Ways and Means Health Subcommittee.
The hearing addressed disparities in health and access to health care for women and racial and ethnic minorities; Stark said it was the first hearing in at least a decade on this topic.
“I am grateful to Dr. Iton for bringing his expertise and experience to bear on this critical issue,” said Rep. Stark. “We have a two-tiered health care system in America: one for those who are healthy, well-insured, and have money; and one for everyone else. As we gear up for healthcare reform, we must find solutions that eliminate the disparities in our healthcare system.”
In his testimony, Iton talked about how race, class, wealth, education, geography and employment affect people’s health status, and said a universal health care system would be only a starting point for closing America’s health-care gaps.
“Access to a high quality system of affordable healthcare is an important human right and a necessary strategy for improving health and quality of life and reducing health disparities, but healthcare alone is not sufficient to ‘produce’ health in populations,” Iton said.
America’s healthcare system generally is set up to mitigate chronic disease rather than to prevent it in the first place, he said. So healthcare access doesn’t shape a community’s health, it just helps limit and repair the damage.
“We need to create social policies and health policies that foster greater opportunities for all Americans, and reduce the stress of poverty by reducing its social consequences,” Iton testified. “One obvious example is to create universal access to a high quality and affordable system of healthcare. Other strategies are more complex but eminently achievable and include improving high school graduation rates, access to living wage employment, and affordable housing.”
“Improvements in all of these non-health outcomes will improve health outcomes. If we are serious about eliminating health disparities and preserving the solvency of the Medicare system, we need to begin to recognize these social policies as health policies.”
Iton this year helped produce a report entitled “Life and Death from Unnatural Causes: Health and Social Inequity in Alameda County” which covers some of these very points.
Alameda County runs three public hospitals, several outpatient health clinics, and funds healthcare services for the uninsured at several other community-based health clinics; it also manages a large clinical mental health and substance abuse program, and provides an array of public health and environmental health services. In all, it spends about $1 billion per year on these services.