Commission timeline

Professional medical organizations are in a unique position to educate and equip their members to effectively address the issue of disparities in health care. It is clear from the Institute of Medicine (IOM) report that physicians and professional medical associations can be catalysts in improving care for racial and ethnic minorities in the United States.     Agreeing that physicians and physician organizations have a clear moral and professional responsibility to advocate and care for vulnerable populations and to prevent suffering, in December 2002 the American Medical Association’s (AMA) House of Delegates voted to create a program on health disparities. Professional obligations to vulnerable populations are articulated in the AMA’s Principles of Medical Ethics, which call on physicians to support access to medical care for all people and to recognize physicians’ responsibility to contribute to the improvement of the community and the betterment of public health. 

2001
The AMA signed the first-ever Memorandum of Understanding (MOU) between the AMA and US Department of Health and Human Services. which committed the organizations to work cooperatively to achieve the Healthy People 2010 national objectives and eliminate disparities in health care.

2002
The AMA signed an additional MOU with the Kaiser Family Foundation committing the organizations to collaboration on a Foundation initiative to eliminate disparities in cardiac care.

The HOD approved the CSA report on  Ethnic and Racial Disparities in Health Care. In this report disparities was defined as, “…racial and ethnic differences in the quantity or quality of health care that are not due to clinical needs, patient preferences, or the appropriateness of the intervention.”

The HOD approved Resolution 718, Strategies for Eliminating Minority Health Care Disparities which asked the AMA to make the elimination of racial and ethnic disparities in health care an issue of high priority. 

The AMA convened a 1 ½ day meeting of national experts and representatives of AMA Councils to provide direction for the AMA in eliminating disparities in health care. The group concluded that the AMA would benefit by focusing on efforts to: (1) study health system opportunities and barriers to eliminating health care disparities; (2) raise awareness of the issue within the profession and advocate for equity in payment across health plans; (3) increase minority representation within the profession; and (4) equip physicians as leaders in addressing disparities in health care through the development and promotion of tools and training. 

2003
The HOD approved BOT Report #4, Strategies for Eliminating Racial and Ethnic Disparities in Health Care. This report was prepared in response to Resolution 718 (I-02) and provided a review of the IOM report on Unequal Treatment. Included in the report is the following statement, “In summary, the IOM found that health care disparities persist across a number of disease states, independent of access-related factors such as insurance and socioeconomic status.” The BOT report directed the AMA to take action in identifying opportunities and barriers to eliminating racial and ethnic disparities in health care; work with public health and other appropriate agencies to increase medical student, resident physician, and practicing physician awareness of racial and ethnic disparities in health care and the role of professionalism and professional obligations in efforts to reduce health care disparities, and promote diversity within the profession. 

The AMA convened a Federation Task Force on Health Care Disparities with leadership from 24 specialty and state societies.  The following consensus was developed:

• The Task Force should formalize into a more permanent organization. The representatives thought this approach would result in a more coordinated, focused response.
• Although disparities among various sub-groups of patients exit, current attention should focus on elimination of racial and ethnic disparities.
• Attention should focus on health care disparities, recognizing that a wide range of factors, many of which are outside the purview of medicine, affect disparities in health status.
• The focus should be to promote physicians as leaders in eliminating health disparities.
• Strategies should be directed at identifying barriers and effective solutions to providing quality care, such as advocating for appropriate health policies; developing tools for quality improvement and for enhancing the capacity of the health system to deal with population health; developing education and training opportunities for enhancing effective physician-patient communication.

2004
The AMA, in conjunction with the National Medical Association, convened the second meeting of Federation Task Force on Disparities in Health Care. The number of organizations committed to this initiative increased from 24 at the initial meeting in 2003 to 37. The following events occurred:

The group elected to call themselves the Commission to End Health Care Disparities and agreed to  focus on 4 strategies:

• Increasing awareness of disparities
• Promoting better data gathering
• Promoting workforce diversity
• Increasing education and training

The group reaffirmed its commitment to focusing on physician leadership, quality, and system approaches to improvement. Subsequent to this meeting the AMA received a planning grant from The Robert Wood Johnson Foundation to formally establish the Commission.