On Thursday, October 6, Health Affairs will hold a briefing to release its October 2011 issue, "Agenda For Fighting Disparities." The issue explores the relationship of social and economic determinants to health disparities; the role of specific environmental factors; disparities in the quality of health care delivered at hospitals; and other relevant topics.

The overall message of the volume is that, although considerable progress has been made in identifying and raising awareness about disparities in health and health care, much remains to be done to narrow and, ultimately, to eliminate them. Health Affairs received support for the issue from the Aetna Foundation.

Please join us for a briefing at the W Hotel on October 6 from 8:30 a.m. - 12:45 p.m. as we unveil the issue.

Among the authors who contributed to the issue and will be speaking are:

• Howard K. Koh, Deputy Secretary for Health, US Department of Health and Human Services
• Dennis P. Andrulis, Senior Research Scientist, Texas Health Institute, and Associate Professor, University of Texas School of Public Health, on opportunities and challenges from national health reform
• J. Emilio Carillo, Vice President, Community Health, New York-Presbyterian Hospital, on the NY Presbyterian Regional Health Collaborative's "Medical Village" and its benefits to poor Hispanic patients
• Peter Cunningham, Senior Fellow and Director of Quantitative Research, Center for Studying Health System Change, on the role of patient activation
• Margaret Takako Hicken, Robert Wood Johnson Health & Society Scholar, University of Michigan, on environmental health disparities as manifested in interactions among lead, stress and hypertension
• Renee Yuen-Jan Hsia, Assistant Professor of Emergency Medicine, University of California San Francisco, on geographical access to trauma centers
• Maxine Brings Him Back-Janis, Assistant Professor, Northern Arizona University College of Health and Human Services, on remedying poor oral health in Indian Country
• Ashish K. Jha, C. Boyden Gray Associate Professor of Health Policy and Management, Harvard University School of Public Health, on the differences between hospitals and the implications for disparities in care
• Janice Probst, Director, South Carolina Rural Health Research Center, on disparities affecting rural minority populations
• Thomas D. Sequist, Associate Professor of Medicine of Health Care Policy, Harvard Medical School, on innovations at the Indian Health Service
• Robin M. Weinick, Associate Director, RAND Health, on the opportunities and challenges in quality improvement in reducing disparities
• Anne Beal, President, Aetna Foundation
• Susan Dentzer, Editor-in-Chief, Health Affairs

Steadily rising health care costs are exacting a heavy financial toll on many families, leaving them with less and less disposable income while increasing the federal deficit, according to a new study in the September issue of Health Affairs. From 1999 to 2009, an average American family of four saw its annual income increase from $76,000 to $99,000 -- but nearly all those income gains were erased by higher health spending, say study authors David Auerbach and Arthur Kellermann of RAND. http://content.healthaffairs.org/content/30/9/1630.abstract

The RAND study is among a cluster of articles in the issue focusing on health care costs. In another article, Patricia Ketsche of Georgia State University and coauthors confirm that growth in health care spending is hitting lower-income families the hardest. They estimate that overall national health spending is in effect consuming 22.7 percent of income for families in the lowest income grouping (those with average annual income in 2004 of $13,450) but no more than 16 percent for families in any other income group. http://content.healthaffairs.org/content/30/9/1637.abstract

Other studies in the issue focus on the drivers of increased health care costs. For example, Charles Roehrig of the Altarum Institute and David Rousseau of the Kaiser Family Foundation conclude that growth in cost per case explains far more of the rise in U.S. health spending than does higher disease prevalence. http://content.healthaffairs.org/content/30/9/1657.abstract

The September 2011 Health Affairs issue is titled "The New Urgency To Lower Costs." http://content.healthaffairs.org/content/30/9.toc It was released at a September 8 briefing in Washington D.C. Video and speaker materials are available on the Health Affairs Web site at http://www.healthaffairs.org/events/2011_09_08_confronting_costs/.

Three Health Affairs Blog posts discuss health insurance exchanges, one of the most important elements of the framework laid out by the Affordable Care Act.

• Steven Lieberman and Kristin Drobac of the National Governors Association discuss the concerns of states -- with tight budgets and strained workforces -- as they face the Affordable Care Act's tight deadlines for the creation of insurance exchanges and related changes to Medicaid.
  http://healthaffairs.org/blog/2011/09/20/state-perspectives-on-implementing-insurance-exchanges/
• Roger Collier warns that the experiences of small-employer exchanges are not encouraging.
  http://healthaffairs.org/blog/2011/09/22/insurance-exchanges-trouble-at-the-shop/
• Leesa Tori offers lessons from the life and death of PacAdvantage, the largest small-employer exchange.
  http://healthaffairs.org/blog/2011/09/22/insurance-exchanges-lessons-from-the-life-and-death-of-pac-advantage/

Austin Frakt analyzes President Obama's debt-reduction recommendations to the congressional "supercommittee."
http://healthaffairs.org/blog/2011/09/19/medicare-policy-and-politics-the-obama-debt-reduction-plan/

Charles Roehrig presents a brief history of health spending since 1965.
http://healthaffairs.org/blog/2011/09/19/a-brief-history-of-health-spending-since-1965/

Diane Archer argues that Medicare is more efficient than private insurance.
http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/

Elizabeth Edsall Kromm and Peter Beilenson describe the health coaching component of the Healthy Howard Health Plan.
http://healthaffairs.org/blog/2011/09/21/coaching-for-prevention-the-healthy-howard-model/

Debra Ness and William Kramer stress the need to preserve the high standards set in the proposed rule on accountable care organizations.
http://healthaffairs.org/blog/2011/09/23/new-approaches-in-a-new-world-starting-with-acos/

Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears each month in print, with additional Web First papers published weekly at www.healthaffairs.org. Health Affairs Blog content is available free to all readers. Under a Creative Commons license, users may link to or share Health Affairs Blog content with others as long as attribution is given, copyright is cited, and a link back to the blog is provided. Health Affairs Blog content may not be altered in any way or used commercially.

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