Sustaining the Commitment


"Ten years ago, when Jack Rowe announced that we would be capturing data on people with racial and ethnic disparities, people asked him the question of don't you think it's racist to do so; and his response was: well I actually think it's racist not to, because the belief is that genetic makeup and the socioeconomic factors that impact people's lives every day have a true impact on the way they react to the health care system and use the health care system."

Mark T. Bertolini
Chairman, CEO and President, Aetna Inc.

"At Aetna we serve some 20 million members and those members come from very, very diverse backgrounds. There are issues with health literacy, there are cultural issues with regard to preferences, there are comfort levels as it relates to speaking with doctors and, in fact, challenging advice that has been provided."

Lonny Reisman, MD
Senior Vice President and Chief Medical Officer, Aetna Inc.

"To give you an idea of how this can impact a community, we're right here in New York City and there's two communities next to each other: East Harlem and the Upper East Side. East Harlem is predominantly African-American and Latino, the Upper East Side is predominantly white. Just separated by one street block, East Harlem has eight times the prevalence of diabetes than their immediate neighbors in the Upper East Side. So in communities, we try to screen and find people who have diabetes and then we offer types of educational classes to help them prevent or control their diabetes."

Carol R. Horowitz, MD MPH
Associate Professor, Department of Health Evidence & Policy
Mount Sinai School of Medicine

"It's very important for me and to all the Spanish-speaking to have a doctor that understands our language and our culture. When they told me that they'd bring a Spanish doctor here to Mass General for the Spanish-speaking could understand better, one of my co-workers introduced me to Dr. Betancourt."

Patient, Mass General

"We've got a rich clinical staff consisting of doctors, nurses, behavioral scientists, nutritionists and pharmacists. In addition to the traditional training, one of the things that we've mandated is training in cultural competency."

Lonny Reisman, MD
Senior Vice President and Chief Medical Officer, Aetna Inc.

"It's really important when we're on that call with a member to get a good understanding of their ethnic background, the things that they're dealing with, the issues that they have as we're preparing their care plan with them. The training provides such a critical amount of information and then when we marry that with our knowledge about how to interview and help folks understand the care plan, we play such a critical role in bridging that gap of information and how do I make this fit into my life. When we do that well and we're educated about the possibilities, our members have a better outcome."

Susan M. Kosman, RN, BSN, MS
Chief Nursing Officer, Aetna Inc.

2002: Beginning Right Program begins

2006: African American Diabetes Education Pilot begins

2006: Cultural competency training available for network providers

2007: Latino Diabetes Study begins

2009: Employee Resource Group Survey completed and feedback built into Engagement strategy

2009: Annual Racial and Ethnic Equality Dashboard Report created

2010: Asthma ER Utilization Pilot begins

2010: Provider-focused Diabetes Initiative begins

"I think Aetna has set themselves apart as one of the industry leaders, and as such, they have a lot of people around the country looking at them and looking at their next steps."

Joseph R. Betancourt, MD, MPH
Director, Disparities Solutions Center, Mass. General Hospital
Associate Professor of Medicine, Harvard Medical School

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