A planning committee of the National Academies of Sciences, Engineering, and Medicine will plan and host a public workshop on the variety of different experiences with the U.S. healthcare system common to individuals facing barriers,¹ including members of racial or ethnic minorities, and the consequences of those different experiences on an individual’s health status and medical record, which is relevant to the U.S. Social Security Administration (SSA) in disability determinations. The workshop shall include presentations with a focus on how individual’s different experiences can manifest in records, as well as medical advances, developments, and research related to health inequities in the United States.

The workshop will feature invited presentations and panel discussions on topics such as:

• The primary social determinants of health affecting people facing barriers and members of racial or ethnic minorities, how they might be reflected in medical records, and how they differ between and among various groups.
• Societal, systemic, racial, cultural, or personal characteristics that can serve as impediments to people facing barriers and members of racial or ethnic minorities seeking or receiving medical services and, in particular:

  a.

  How those characteristics may be recorded or manifest in traditional and other healthcare records;

  b.

  How the medical records of people with those characteristics might differ from the general population; and

  c.

  How the impact of those impediments can be lessened or averted, particularly in the context of consultative examinations ordered by SSA.

• The lived experiences of people facing barriers and members of racial or ethnic minorities as they interact with SSA, healthcare systems, and alternative sources of medical care, including:

  a.

  How those experiences impact future use of or trust in medical or healthcare services;

  b.

  Disconnects between the health-related reports made by people facing barriers and the information recorded by their healthcare providers;

  c.

  Are there alternative sources of medical care utilized by some people facing barriers; and

  d.

  Areas of difficulty or confusion when making a disability application, providing SSA with medical and other records, or attending a consultative examination.

• An overview of recent or emerging research suggesting particular widely-used tests or procedures are not as accurate or appropriate as traditionally believed for certain sub-populations and, for each, whether alternate tests or procedures exist which have been found to be accurate and appropriate for the population in question.

The planning committee shall develop the agenda for the workshop sessions, select and invite speakers and discussants, and moderate the discussions. The speakers and discussants will have the experience and knowledge to speak to the differences experienced by various racial and ethnic populations and other groups of people facing barriers. A proceedings of the presentations and discussions at the workshop will be prepared by a designated rapporteur in accordance with institutional guidelines.

Footnotes

1

Including people with low income, limited English proficiency, facing homelessness, or with mental illness.