July 20, 2000-Improving access to health care will require increasing the number of people with insurance and removing a host of other barriers blocking large numbers of Americans from receiving needed care, according to Increasing Access: Building Working Solutions, a report from the Washington, DC-based Economic and Social Research Institute (ESRI).  The report cites local efforts by Ingham Community Voices to determine the health needs, service patterns, and availability of practitioners in its community.

The report by Jack A. Meyer, Ph.D. and Sharon Silow-Carroll, MBA, MSW notes that the problem of access reaches beyond the 44 million Americans who lack health insurance-a number that is expected to reach 52 to 54 million over the next 10 years.  The growing numbers are of concern because those without coverage tend to delay or forego important preventative and primary care services.  "Community-based efforts are needed to track health problems and assess unmet needs," the report states.

In Ingham County, such an effort has been underway for the past two years through the community planning process funded by the Robert Wood Johnson Foundation and the W.K. Kellogg Foundation.  The process is one component of the Kellogg-funded initiative, "Community Voices: Healthcare for the Underserved."  The work done in Ingham County is featured in the ESRI report, along with that of several other communities nationwide.

The report notes that the design of the health care delivery system has created a variety of obstacles to those seeking care.  Increasing Access suggests that one strategy to address such impediments is improving the primary care system and access to it by conducting community assessments to determine gaps in services and engaging stakeholders in the process of access improvement.  To accomplish this in Ingham County, over 300 participants were engaged in one-on-one interviews, community forums, focus groups with underserved populations, and community learning sessions to develop recommendations for improved coverage and service delivery.  These recommendations can be found in the draft version of "An Action Plan for an Organized System of Care," which is currently available from the Ingham County Health Department and the Capital Area Health Alliance.

In addition to increasing coverage, several other strategies for increasing access to health care are included in the Action Plan.  Community participants called for simplified enrollment procedures, decreasing the stigma associated with public insurance programs like Medicaid, greater attention to health status disparities among racial and ethnic minorities, and better utilization of non-traditional outreach resources like churches, schools, and neighborhood organizations.

Community Voices is already working to make some of those recommendations a reality.  Through Neighborhood Health Summits, Lansing residents have been mobilized to advocate for specific program and policy changes that will impact such things as quality affordable housing, neighborhood schools, and youth engagement.  The African American Health Institute and the Circle of Indigenous Races for Community Leadership and Empowerment are working to illuminate the sources of health status disparity.  And the Data Democratization project is increasing community access to health resources via web-based information systems available to any citizen or agency with access to the internet.