The impact of the Affordable Care Act on behavioral health care for individuals from racial and ethnic communities.

The lack of health care insurance disproportionally affects individuals from racial and ethnic minority communities with chronic, yet in some instances, preventable health conditions. The Affordable Care Act (ACA) will provide insurance coverage to an additional 32 million Americans not currently insured. More than half of these additional insured include racial and ethnic minorities. The ACA not only reduces financial barriers to health care, but also improves access to quality behavioral health care for all. This article describes the benefits and impact of the ACA on individuals from racial and ethnic communities.

The Affordable Care Act and integrated care.

The Patient Protection and Affordable Care Act (ACA) of 2010 offers a comprehensive, integrated health insurance reform program for those who are eligible to enroll. A core feature of the ACA is the integration of primary health, behavioral health, and related services in a new national program for the first time. This article traces the history of past federal services integration efforts and identify varying approaches for implementing them to improve care, especially for underserved populations. The business case for integrated care, reducing escalating health care costs and overcoming barriers to implementation, is also discussed.

Psychocultural influences on health care acceptability among elderly U.S. Pacific Islanders.

There is widespread recognition of the influence of ethnic variation on immigrant response to health care services, but far less is known about source of variation among nonimmigrant ethnic enclaves. Pacific Islander populations under U.S. administration for more than a century illustrate the potential influences of cultural factors on health care. Focus groups among elderly Samoan, Native Hawaiian, and Chamorro residents of southern California in 2002 found ethnic variation in such characteristics as expectations of publicly financed health care and in the willingness to discuss alternative sources of help with clinicians. These variations appear influenced by the colonial health care experience of these U.S. territories and, in the case of Samoan women, in distinctive perceptions of the role of prayer and traditional healing methods in care. Such psychocultural factors appear more potent than English language proficiency as an influence on the acceptability of health care among Pacific Islander elders.