U.S. Should Create a Federal Entity Responsible for Advancing Racial, Ethnic, and Tribal Health Equity, and Implement a Health Equity Policy Audit and Score Card

New Report from the National Academies of Sciences, Engineering, and Medicine
recommends action steps to address persistent health disparities.

ATLANTA and WASHINGTON, DC – AUGUST 11, 2023 – To improve health equity in the United States (U.S.), the president should create a permanent federal body responsible for improving racial, ethnic, and tribal equity across the federal government, according to a new report from the National Academies of Sciences, Engineering, and Medicine (NASEM). In addition, Congress should create a new score card to assess how all proposed federal legislation might impact health equity in the future. The report also recommends federal agencies conduct an equity audit of their current policies.

Racial, ethnic, and tribal health inequity in the U.S. is widespread and persistent, and federal policy can play a role in reducing health inequities, the report says. Education, income, health care access, and neighborhoods — and the policies that shape them — can all contribute to either hindering or advancing health equity.

“The report shed light on many of the barriers to health equity Morehouse School of Medicine has been working to address,” said Megan D. Douglas, committee member and associate professor at Morehouse School of Medicine. “For example, the report recommends that community voice be incorporated into the policymaking process, which aligns with our history of strong community engagement to advance health equity.”

Morehouse School of Medicine's mission to lead the creation and advancement of health equity to achieve health justice. Much of the research conducted at MSM aligns with the findings of the NASEM report, including the need for more accurate, high-quality data on race and ethnicity and ways to apply a health equity lens in policy formation, implementation, and evaluation.

The NASEM report, Federal Policy to Advance Racial, Ethnic, and Tribal Health Equity, reviews the impact of economic, education, health care, infrastructure, housing, public safety, and other policies on health equity, focusing on policies that affect a large percentage of minoritized communities — including historical policies that continue to cause harm. The report found increases to the federal minimum wage and closing achievement gaps through federal spending on education, for example, can both improve health equity. Medicaid and the Children’s Health Insurance Program are the most important federal policies that address racial and ethnic inequities in access to health care, according to the report.

Racially and ethnically minoritized populations experience higher rates of illness and death for many important health conditions, such as infant mortality, maternal death, and chronic conditions such as heart disease. These populations also have lower life expectancies compared to non-Hispanic white people. In 2019, life expectancy for the non-Hispanic white population was 78.9 compared to 75.3 for the Black population and 73.1 for the American Indian and Alaska Native populations. Health inequities also have consequences for the economy, national security, and businesses. Although the committee that wrote the report was asked to focus on racial, ethnic, and tribal health equity, the report acknowledges that sex, age, disability status, citizenship, and many other factors can also interact to impact health equity.

Recommendations also address collecting more accurate and complete population data for minoritized communities, improving coordination among federal agencies, supporting better inclusion of community input, and increasing federal support and access for state and local programs.

The report pays special attention to American Indian and Alaska Native populations, which are often overlooked in large national reports and in the U.S. are worse off than all other racial and ethnic groups for most measures of health. To improve health equity for American Indian and Alaska Native populations, Congress should authorize funding of the Indian Health Service (IHS) at parity with other health care programs through mandatory advance appropriations. The House of Representatives should reestablish the Indian Affairs Committee, and the director of IHS should be raised to the level of an assistant secretary.

To see the complete NASEM report, click here.

For more information about Morehouse School of Medicine, please visit MSM.edu.

About Morehouse School of Medicine

Founded in 1975, Morehouse School of Medicine (MSM) is among the nation’s leading educators of primary care physicians, biomedical scientists, and public health professionals. An independent and private historically-Black medical school, MSM was recognized by the Annals of Internal Medicine as the nation’s number one medical school in fulfilling a social mission — the creation and advancement of health equity. MSM faculty and alumni are noted for excellence in teaching, research, and public policy, as well as exceptional patient care. MSM is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools to award doctoral and master’s degrees. To learn more about programs and donate today, please visit MSM.edu or call 404-752-1500.


Jamille Bradfield
Morehouse School of Medicine