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Sample records for address health disparities

  1. Addressing Health Disparities in Chronic Kidney Disease

    PubMed Central

    Chan, Ta-Chien; Fan, I.-Chun; Liu, Michael Shi-Yung; Su, Ming-Daw; Chiang, Po-Huang

    2014-01-01

    According to the official health statistics, Taiwan has the highest prevalence of end stage renal disease (ESRD) in the world. Each year, around 60,000 ESRD patients in Taiwan consume 6% of the national insurance budget for dialysis treatment. The prevalence of chronic kidney disease (CKD) has been climbing during 2008–2012. However, the spatial disparities and clustering of CKD at the public health level have rarely been discussed. The aims of this study are to explore the possible population level risk factors and identify any clusters of CKD, using the national health insurance database. The results show that the ESRD prevalence in females is higher than that in males. ESRD medical expenditure constitutes 87% of total CKD medical expenditure. Pre-CKD and pre-ESRD disease management might slow the progression from CKD to ESRD. After applying ordinary least-squares regression, the percentages of high education status and the elderly in the townships are positively correlated with CKD prevalence. Geographically weighted regression and Local Moran’s I are used for identifying the clusters in southern Taiwan. The findings can be important evidence for earlier and targeted community interventions and reducing the health disparities of CKD. PMID:25514144

  2. Understanding and Addressing Racial Disparities in Health Care

    PubMed Central

    Williams, David R.; Rucker, Toni D.

    2000-01-01

    Racial disparities in medical care should be understood within the context of racial inequities in societal institutions. Systematic discrimination is not the aberrant behavior of a few but is often supported by institutional policies and unconscious bias based on negative stereotypes. Effectively addressing disparities in the quality of care requires improved data systems, increased regulatory vigilance, and new initiatives to appropriately train medical professionals and recruit more providers from disadvantaged minority backgrounds. Identifying and implementing effective strategies to eliminate racial inequities in health status and medical care should be made a national priority. PMID:11481746

  3. Addressing health disparities: the role of an African American health ministry committee.

    PubMed

    Austin, Sandra; Harris, Gertrude

    2011-01-01

    Healthy People 2010 identified the need to address health disparities among African Americans, Asians, American Indians, Hispanics, Alaskan American, and Pacific Islanders. These are groups disproportionately affected by cancer, cardiovascular disease, diabetes, HIV infection, and AIDSs. Despite the growing body of research on health disparities and effective interventions, there is a great need to learn more about culturally appropriate interventions. Social work professional values and ethics require that service delivery be culturally competent and effective. Social workers can collaborate with community based health promotion services, exploring new ways to ensure that health disparities can be addressed in institutions to which African Americans belong. This article presents findings of an African American health ministry committee's health promotion initiatives and probed the viability of a health ministry committee' role in addressing health disparities through education. The promising role of the Black church in addressing health disparities is explored. PMID:21213192

  4. Addressing Health Disparities through Multi-institutional, Multidisciplinary Collaboratories

    PubMed Central

    Fleming, Erik S.; Perkins, James; Easa, David; Conde, José G.; Baker, Richard S.; Southerland, William M.; Dottin, Robert; Benabe, Julio E.; Ofili, Elizabeth O.; Bond, Vincent C.; McClure, Shelia A.; Sayre, Michael H.; Beanan, Maureen J.; Norris, Keith C.

    2009-01-01

    The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses “cyber workspaces” to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces. PMID:18646341

  5. The Ethical Imperative of Addressing Oral Health Disparities

    PubMed Central

    Lee, J.Y.; Divaris, K.

    2014-01-01

    Health disparities are preventable differences in the burden of disease or opportunities to achieve optimal health that are experienced by socially disadvantaged population groups. Reducing health disparities has been identified as an ethical imperative by the World Health Organization’s Commission on Social Determinants of Health and numerous other national and international bodies. Significant progress has been made over the past years in identifying vulnerable groups, and ‘distal’ factors including political, economic, social, and community characteristics are now considered pivotal. It is thus unsurprising that the remarkable advances in the science and practice of dentistry have not led to notable reductions in oral health disparities. In this review, we summarize recent work and emphasize the need for a solid theoretical framing to guide oral health disparities research. We provide a theoretical framework outlining pathways that operate across the continuum of oral health determinants during the lifecourse and highlight potential areas for intervention. Because oral health disparities emanate from the unequal distribution of social, political, economic, and environmental resources, tangible progress is likely to be realized only by a global movement and concerted efforts by all stakeholders, including policymakers, the civil society, and academic, professional, and scientific bodies. PMID:24189268

  6. Facilitators, Challenges, and Collaborative Activities in Faith and Health Partnerships to Address Health Disparities

    ERIC Educational Resources Information Center

    Kegler, Michelle C.; Hall, Sarah M.; Kiser, Mimi

    2010-01-01

    Interest in partnering with faith-based organizations (FBOs) to address health disparities has grown in recent years. Yet relatively little is known about these types of partnerships. As part of an evaluation of the Institute for Faith and Public Health Collaborations, representatives of 34 faith--health teams (n = 61) completed semi-structured…

  7. Linking Obesity Prevention and Mental Health Promotion to Address Health Disparities.

    PubMed

    Claydon, Elizabeth; Austin, Anna; Smith, Megan V

    2016-05-01

    Considerable racial health disparities exist, especially in mental health and obesity. However, few approaches exist to address obesity and mental health simultaneously in minority groups. An intervention to address mental health in a low-income, minority group of urban mothers was designed using results from a needs assessment. Participating women were asked to rank their top health concerns and personal goals. Along with mental health concerns and basic needs, the majority of mothers desired assistance with improving their physical well-being. These results are surprising, but lend credence to creating interventions that aim to address both mental health and obesity concerns simultaneously. PMID:26303902

  8. NIH Research Addresses Aging Issues and Disparities in Oral Health | NIH MedlinePlus the Magazine

    MedlinePlus

    ... JavaScript on. Feature: Oral Health and Aging NIH Research Addresses Aging Issues and Disparities in Oral Health ... NIH Why is it important to have a research focus on older adults? One reason is that ...

  9. Everyone Swims: A Community Partnership and Policy Approach to Address Health Disparities in Drowning and Obesity

    ERIC Educational Resources Information Center

    Stempski, Sarah; Liu, Lenna; Grow, H. Mollie; Pomietto, Maureen; Chung, Celeste; Shumann, Amy; Bennett, Elizabeth

    2015-01-01

    Well-known disparities exist in rates of obesity and drowning, two public health priorities. Addressing these disparities by increasing access to safe swimming and water recreation may yield benefits for both obesity and injury prevention. "Everyone Swims," a community partnership, brought community health clinics and water recreation…

  10. A Student-Led Health Education Initiative Addressing Health Disparities in a Chinatown Community

    PubMed Central

    Lee, Benjamin J.; So, Chunkit; Chiu, Brandon G.; Polisetty, Radhika; Quiñones-Boex, Ana; Liu, Hong

    2015-01-01

    Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award. PMID:26839422

  11. A Student-Led Health Education Initiative Addressing Health Disparities in a Chinatown Community.

    PubMed

    Lee, Benjamin J; Wang, Sheila K; So, Chunkit; Chiu, Brandon G; Wang, Wesley Y; Polisetty, Radhika; Quiñones-Boex, Ana; Liu, Hong

    2015-11-25

    Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award. PMID:26839422

  12. Addressing Health Disparities in the Undergraduate Curriculum: An Approach to Develop a Knowledgeable Biomedical Workforce

    PubMed Central

    Benabentos, Rocio; Ray, Payal

    2014-01-01

    Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health disparities is crucial for addressing this issue. Establishing undergraduate health disparities courses that are accessible to undergraduate students in the life sciences is necessary to increase students’ understanding and awareness of these issues and motivate them to address these disparities during their careers. The majority of universities do not include courses related to health disparities in their curricula, and only a few universities manage them from their life sciences departments. The figures are especially low for minority-serving institutions, which serve students from communities disproportionally affected by health disparities. Universities should consider several possible approaches to infuse their undergraduate curricula with health disparities courses or activities. Eliminating health disparities will require efforts from diverse stakeholders. Undergraduate institutions can play an important role in developing an aware biomedical workforce and helping to close the gap in health outcomes. PMID:25452486

  13. Local Health Departments’ Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?

    PubMed Central

    Shah, Gulzar H.; Sheahan, John P.

    2015-01-01

    Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement. Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities. Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four activities. LHD characteristics significantly associated (p≤0.05) with the increased likelihood of performing activities to address health disparities were: recent completion of community health assessment, community health improvement plan and agency wide strategic plan. Other significant positive impacts on such activities included per capita expenditures, local governance, having one or more local boards of health, larger population size and metropolitan status of the LHD jurisdiction. Conclusions: Reduced infrastructural capacity of LHDs has resulted in fewer LHDs addressing health disparities in their jurisdictions. LHD characteristics associated with higher performance of activities for health disparity reduction identified by this research have important policy implications. PMID:26703693

  14. Facilitators, challenges, and collaborative activities in faith and health partnerships to address health disparities.

    PubMed

    Kegler, Michelle C; Hall, Sarah M; Kiser, Mimi

    2010-10-01

    Interest in partnering with faith-based organizations (FBOs) to address health disparities has grown in recent years. Yet relatively little is known about these types of partnerships. As part of an evaluation of the Institute for Faith and Public Health Collaborations, representatives of 34 faith-health teams (n = 61) completed semi-structured interviews. Interviews were tape recorded, transcribed, and coded by two members of the evaluation team to identify themes. Major facilitators to faith-health collaborative work were passion and commitment, importance of FBOs in communities, favorable political climate, support from community and faith leaders, diversity of teams, and mutual trust and respect. Barriers unique to faith and health collaboration included discomfort with FBOs, distrust of either health agencies or FBOs, diversity within faith communities, different agendas, separation of church and state, and the lack of a common language. Findings suggest that faith-health partnerships face unique challenges but are capable of aligning resources to address health disparities. PMID:20696884

  15. Narratives and Images Used by Public Communication Campaigns Addressing Social Determinants of Health and Health Disparities

    PubMed Central

    Clarke, Christopher E.; Niederdeppe, Jeff; Lundell, Helen C.

    2012-01-01

    Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation’s Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one’s home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother’s education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means. PMID:23330220

  16. Narratives and images used by public communication campaigns addressing social determinants of health and health disparities.

    PubMed

    Clarke, Christopher E; Niederdeppe, Jeff; Lundell, Helen C

    2012-12-01

    Researchers have increasingly focused on how social determinants of health (SDH) influence health outcomes and disparities. They have also explored strategies for raising public awareness and mobilizing support for policies to address SDH, with particular attention to narrative and image-based information. These efforts will need to overcome low public awareness and concern about SDH; few organized campaigns; and limited descriptions of existing message content. To begin addressing these challenges, we analyzed characteristics of 58 narratives and 135 visual images disseminated by two national SDH awareness initiatives: The Robert Wood Johnson Foundation's Commission to Build a Healthier America and the PBS-produced documentary film Unnatural Causes. Certain types of SDH, including income/wealth and one's home and workplace environment, were emphasized more heavily than others. Solutions for addressing SDH often involved combinations of self-driven motivation (such as changes in personal health behaviors) along with externally-driven factors such as government policy related to urban revitilization. Images, especially graphs and charts, drew connections among SDH, health outcomes, and other variables, such as the relationship between mother's education and infant mortality as well as the link between heart disease and education levels within communities. We discuss implications of these findings for raising awareness of SDH and health disparities in the US through narrative and visual means. PMID:23330220

  17. SHAPING A NEW GENERATION OF HISPANIC CLINICAL AND TRANSLATIONAL RESEARCHERS ADDRESSING MINORITY HEALTH AND HEALTH DISPARITIES

    PubMed Central

    Estape, Estela S.; Segarra, Barbara; Baez, Adriana; Huertas, Aracelis; Diaz, Clemente; Frontera, Walter

    2012-01-01

    In 2011, research educators face significant challenges. Training programs in Clinical and Translational Research need to develop or enhance their curriculum to comply with new scientific trends and government policies. Curricula must impart the skills and competencies needed to help facilitate the dissemination and transfer of scientific advances at a faster pace than current health policy and practice. Clinical and translational researchers are facing also the need of new paradigms for effective collaboration, and resource sharing while using the best educational models. Both government and public policy makers emphasize addressing the goals of improving health quality and elimination of health disparities. To help achieve this goal, our academic institution is taking an active role and striving to develop an environment that fosters the career development of clinical and translational researchers. Consonant with this vision, in 2002 the University of Puerto Rico, Medical Sciences Campus School of Health Professions and School of Medicine initiated a multidisciplinary post-doctoral Master of Science in Clinical Research focused in training Hispanics who will address minority health and health disparities research. Recently, we proposed a curriculum revision to enhance this commitment in promoting competency-based curricula for clinician-scientists in clinical and translational sciences. The revised program will be a post-doctoral Master of Science in Clinical and Translational Research (MCTR), expanding its outreach by actively engaging in establishing new collaborations and partnerships that will increase our capability to diversify our educational efforts and make significant contributions to help reduce and eliminate the gap in health disparities. PMID:22263296

  18. Developing Survey Research Infrastructure At An Historically Black College/University To Address Health Disparities

    PubMed Central

    Howard, Daniel L.; Boyd, Carlton L.; Kalsbeek, Bill; Godley, Paul A.

    2011-01-01

    This article describes the development of the Center for Survey Research at Shaw University, a Historically Black College and University (HBCU), and its efforts to build a data collection infrastructure that addresses issues germane to health disparities research in the African American population. Academic institutions that are similar to Shaw in size, mission, and background can use the Project EXPORT collaboration and the Center for Survey Research as models for establishing their own research infrastructure and subsequent survey center in order to address health disparities through the use of survey methodology. PMID:22090795

  19. Developing Survey Research Infrastructure At An Historically Black College/University To Address Health Disparities.

    PubMed

    Howard, Daniel L; Boyd, Carlton L; Kalsbeek, Bill; Godley, Paul A

    2010-01-01

    This article describes the development of the Center for Survey Research at Shaw University, a Historically Black College and University (HBCU), and its efforts to build a data collection infrastructure that addresses issues germane to health disparities research in the African American population. Academic institutions that are similar to Shaw in size, mission, and background can use the Project EXPORT collaboration and the Center for Survey Research as models for establishing their own research infrastructure and subsequent survey center in order to address health disparities through the use of survey methodology. PMID:22090795

  20. Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities

    PubMed Central

    Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee

    2012-01-01

    Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

  1. Teaching physicians-in-training to address racial disparities in health: a hospital-community partnership.

    PubMed Central

    Jacobs, Elizabeth A.; Kohrman, Claire; Lemon, Maurice; Vickers, Dennis L.

    2003-01-01

    Racial and ethnic disparities in health care continue to be a major impediment to improving the health of many communities in the United States. Efforts must be directed at the multiple social, economic, and historic determinants of health disparities. In addition, health care providers must be aware of these determinants and must have the tools to address them in their individual relationships with patients. This article describes a partnership that arose out of the mutual recognition by a community organization and public hospital of the need to (a) teach physicians how to recognize the root causes of health disparities, (b) improve their cross-cultural understanding and communication, and (c) enhance their awareness of the capacity of community resources to positively impact their patients' lives. PMID:12815083

  2. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care.

    PubMed Central

    Betancourt, Joseph R.; Green, Alexander R.; Carrillo, J. Emilio; Ananeh-Firempong, Owusu

    2003-01-01

    OBJECTIVES: Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care. METHODS: The authors conducted a literature review of academic, foundation, and government publications focusing on sociocultural barriers to care, the level of the health care system at which a given barrier occurs, and cultural competence efforts that address these barriers. RESULTS: Sociocultural barriers to care were identified at the organizational (leadership/workforce), structural (processes of care), and clinical (provider-patient encounter) levels. A framework of cultural competence interventions--including minority recruitment into the health professions, development of interpreter services and language-appropriate health educational materials, and provider education on cross-cultural issues--emerged to categorize strategies to address racial/ethnic disparities in health and health care. CONCLUSIONS: Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans. PMID:12815076

  3. Underserved farmers with disabilities: designing an AgrAbility program to address health disparities.

    PubMed

    Hunter, Elizabeth G; Hancock, John; Weber, Carol; Simon, Marion

    2011-04-01

    Awareness of health disparities is crucial for individuals with disabilities to minimize additional health-related challenges. Adding rural residence and age to disability creates a triple threat in terms of potential health disparities. Kentucky AgrAbility is developing innovative new partnerships with the goal of expanding service provision to underserved populations with disabilities in Kentucky: women, minority, and Appalachian small farmers. Kentucky AgrAbility is evolving to include a more focused approach to the needs of underresourced and underserved regions and populations of farmers in Kentucky. Through new partnerships and a commitment to addressing potential health disparities, farmers and families who can benefit from AgrAbility services will be broadly identified. It is concluded that health disparities need to be recognized and addressed in all health care service provision and education. Kentucky AgrAbility is attempting to develop and implement an innovative, multidisciplinary team of partners with a goal of providing one of a kind service and education to all Kentucky farmers with disabilities. This includes underserved farmers who are at risk of not receiving the appropriate services due to limited resources and lack of awareness. PMID:21462022

  4. Swimming upstream: the challenges and rewards of evaluating efforts to address inequities and reduce health disparities.

    PubMed

    Hughes, Dana; Docto, Lindsay; Peters, Jessica; Lamb, Anne Kelsey; Brindis, Claire

    2013-06-01

    Racial and ethnic disparities in the health of Americans are widespread and persistent in the United States despite improvements in the health of Americans overall. Increasingly, strategies for reducing disparities have focused on addressing the factors that contribute to - if not fundamentally underlie - health disparities: social, economic, and environmental inequities, which limit access to resources and cause unhealthy exposures. As public health shifts to interventions that seek to improve the circumstances of disproportionately affected populations and achieve equity through policy change, alternative methods to evaluate these efforts are also required. This paper presents an example of such approaches to addressing asthma disparities through Regional Asthma Management and Prevention's (RAMP) programmatic efforts and an evaluation of these activities. The paper describes RAMP's targets and strategies, as well as the specific evaluation methods applied to each, including activity tracking, observations, surveys, key informant interviews, and case studies. Preliminary evaluation findings are presented, as are lessons learned about the efficacy of the evaluation design features - both its strengths and shortcomings. Findings discussed are intended to contribute to the growing literature that provides evidence for the application of emerging approaches to evaluation that reflect non-traditional public health and support others interested in expanding or replicating this work. PMID:23416287

  5. A community-academic partnership to address racial/ethnic health disparities through grant-making.

    PubMed

    Ramos, Michelle A; Fox, Ashley; Simon, Ellen P; Horowitz, Carol R

    2013-11-01

    Because they focus on culturally and contextually specific health determinants, participatory approaches are well-recognized strategies to reduce health disparities. Yet, few models exist that use academic and community members equally in the grant funding process for programs aimed at reducing and eliminating these disparities. In 2008, the Communities IMPACT Diabetes Center in East Harlem, New York, developed a partnered process to award grants to community groups that target the social determinants of diabetes-related disparities. Community and academic representatives developed a novel strategy to solicit and review grants. This approach fostered equality in decision-making and sparked innovative mechanisms to award $500,000 in small grants. An evaluation of this process revealed that most reviewers perceived the review process to be fair; were able to voice their perspectives (and those perspectives were both listened to and respected); and felt that being reviewers made them better grant writers. Community-academic partnerships can capitalize on each group's strengths and knowledge base to increase the community's capacity to write and review grants for programs that reduce health disparities, providing a local context for addressing the social determinants of health. PMID:24179281

  6. Developing Research and Community Literacies to Recruit Latino Researchers and Practitioners to Address Health Disparities.

    PubMed

    Granberry, Phillip J; Torres, María Idalí; Allison, Jeroan J; Rosal, Milagros C; Rustan, Sarah; Colón, Melissa; Fontes, Mayara; Cruz, Ivettte

    2016-03-01

    Engaging community residents and undergraduate Latino students in developing research and community literacies can expose both groups to resources needed to address health disparities. The bidirectional learning process described in this article developed these literacies through an ethnographic mapping fieldwork activity that used a learning-by-doing method in combination with reflection on the research experience. The active efforts of research team members to promote reflection on the research activities were integral for developing research and community literacies. Our findings suggest that, through participating in this field research activity, undergraduate students and community residents developed a better understanding of resources for addressing health disparities. Our research approach assisted community residents and undergraduate students by demystifying research, translating scientific and community knowledge, providing exposure to multiple literacies, and generating increased awareness of research as a tool for change among community residents and their organizations. The commitment of the community and university leadership to this pedagogical method can bring out the full potential of mentoring, both to contribute to the development of the next generation of Latino researchers and to assist community members in their efforts to address health disparities. PMID:26896113

  7. The “Long Tail” and Public Health: New Thinking for Addressing Health Disparities

    PubMed Central

    Hovmand, Peter; Pfeiffer, Debbie J.; Fairchild, Maggie; Rath, Suchitra; Golla, Balaji; Casey, Chris

    2014-01-01

    The prevailing approach to improving population health focuses on shifting population means through a few targeted and universal interventions. The success of this approach for eliminating health disparities depends on an assumption about the distribution of demand for such interventions. We explored whether long tail thinking from business might yield greater progress in eliminating disparities. We examined 2011 to 2013 data from 513 state and local health agency representatives in 47 states who used an online system to create 4351 small media and client reminder products promoting colorectal cancer screening. Products in the long tail were more likely to target minority groups with higher rates of colorectal cancer and lower rates of screening than Whites. Long tail thinking could help improve the public's health and eliminate disparities. PMID:25322308

  8. The "long tail" and public health: new thinking for addressing health disparities.

    PubMed

    Kreuter, Matthew W; Hovmand, Peter; Pfeiffer, Debbie J; Fairchild, Maggie; Rath, Suchitra; Golla, Balaji; Casey, Chris

    2014-12-01

    The prevailing approach to improving population health focuses on shifting population means through a few targeted and universal interventions. The success of this approach for eliminating health disparities depends on an assumption about the distribution of demand for such interventions. We explored whether long tail thinking from business might yield greater progress in eliminating disparities. We examined 2011 to 2013 data from 513 state and local health agency representatives in 47 states who used an online system to create 4351 small media and client reminder products promoting colorectal cancer screening. Products in the long tail were more likely to target minority groups with higher rates of colorectal cancer and lower rates of screening than Whites. Long tail thinking could help improve the public's health and eliminate disparities. PMID:25322308

  9. Mental Health Disparities

    PubMed Central

    Mays, Robert A.; Huang, Larke Nahme; McCuan, Ron; Pham, Phuong Kim; Fisher, Sylvia Kay; McDuffie, Kathleen Y.; Trachtenberg, Alan

    2009-01-01

    Mental health disparities have received increased attention in the literature in recent years. After considering 165 different health disparity conditions, the Federal Collaborative for Health Disparities Research chose mental health disparity as one of four topics warranting its immediate national research attention. In this essay, we describe the challenges and opportunities encountered in developing a research agenda to address mental health disparities in the United States. Varying definitions of mental health disparity, the heterogeneity of populations facing such disparity, and the power, complexity, and intertwined nature of contributing factors are among the many challenges. We convey an evolving interagency approach to mental health disparities research and guidance for further work in the field. PMID:19820213

  10. Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health.

    PubMed

    Paskett, Electra; Thompson, Beti; Ammerman, Alice S; Ortega, Alexander N; Marsteller, Jill; Richardson, DeJuran

    2016-08-01

    Multilevel interventions are those that affect at least two levels of influence-for example, the patient and the health care provider. They can be experimental designs or natural experiments caused by changes in policy, such as the implementation of the Affordable Care Act or local policies. Measuring the effects of multilevel interventions is challenging, because they allow for interaction among levels, and the impact of each intervention must be assessed and translated into practice. We discuss how two projects from the National Institutes of Health's Centers for Population Health and Health Disparities used multilevel interventions to reduce health disparities. The interventions, which focused on the uptake of the human papillomavirus vaccine and community-level dietary change, had mixed results. The design and implementation of multilevel interventions are facilitated by input from the community, and more advanced methods and measures are needed to evaluate the impact of the various levels and components of such interventions. PMID:27503968

  11. Toward Culturally Centered Integrative Care for Addressing Mental Health Disparities among Ethnic Minorities

    PubMed Central

    Holden, Kisha; McGregor, Brian; Thandi, Poonam; Fresh, Edith; Sheats, Kameron; Belton, Allyson; Mattox, Gail; Satcher, David

    2014-01-01

    Despite decades of research, recognition and treatment of mental illness and its co-morbidities still remain a significant public health problem in the United States. Ethnic minorities are identified as a population that is vulnerable to mental health disparities and face unique challenges pertaining to mental health care. Psychiatric illness is associated with great physical, emotional, functional, and societal burden. The primary health care setting may be a promising venue for screening, assessment, and treatment of mental illnesses for ethnic minority populations. We propose a comprehensive, innovative, culturally centered integrated care model to address the complexities within the health care system, from the individual level, that includes provider and patient factors, to the system level, which include practice culture and system functionality issues. Our multi-disciplinary investigative team acknowledges the importance of providing culturally tailored integrative healthcare to holistically concentrate on physical, mental, emotional, and behavioral problems among ethnic minorities in a primary care setting. It is our intention that the proposed model will be useful for health practitioners, contribute to the reduction of mental health disparities, and promote better mental health and well-being for ethnic minority individuals, families, and communities. PMID:25383991

  12. Everyone Swims: a community partnership and policy approach to address health disparities in drowning and obesity.

    PubMed

    Stempski, Sarah; Liu, Lenna; Grow, H Mollie; Pomietto, Maureen; Chung, Celeste; Shumann, Amy; Bennett, Elizabeth

    2015-04-01

    Well-known disparities exist in rates of obesity and drowning, two public health priorities. Addressing these disparities by increasing access to safe swimming and water recreation may yield benefits for both obesity and injury prevention. Everyone Swims, a community partnership, brought community health clinics and water recreation organizations together to improve policies and systems that facilitated learning to swim and access to swimming and water recreation for low-income, diverse communities. Based in King County, Washington, Everyone Swims launched with Centers for Disease Control and Prevention grant funding from 2010 to 2012. This partnership led to multiple improvements in policies and systems: higher numbers of clinics screening for swimming ability, referrals from clinics to pools, more scholarship accessibility, and expansion of special swim programs. In building partnerships between community health/public health and community recreation organizations to develop systems that address user needs in low-income and culturally diverse communities, Everyone Swims represents a promising model of a structured partnership for systems and policy change to promote health and physical activity. PMID:25829109

  13. Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health.

    PubMed

    Thornton, Rachel L J; Glover, Crystal M; Cené, Crystal W; Glik, Deborah C; Henderson, Jeffrey A; Williams, David R

    2016-08-01

    The opportunities for healthy choices in homes, neighborhoods, schools, and workplaces can have decisive impacts on health. We review scientific evidence from promising interventions focused on the social determinants of health and discuss how such interventions can improve population health and reduce health disparities. We found sufficient evidence of successful outcomes to support disparity-reducing policy interventions targeted at education and early childhood; urban planning and community development; housing; income enhancements and supplements; and employment. Cost-effectiveness evaluations show that these interventions lead to long-term societal savings, but the interventions require more routine attention to cost considerations. We discuss challenges to implementation, including the need for long-term financing to scale up effective interventions for implementation at the local, state, and national levels. PMID:27503966

  14. Health journalism internships: a social marketing strategy to address health disparities.

    PubMed

    Nguyen, Duy H; Shimasaki, Suzuho; Stafford, Helen Shi; Sadler, Georgia Robins

    2010-09-01

    The USA seeks to eliminate health disparities by stimulating the rapid uptake of health-promoting behaviors within disadvantaged communities. A health journalism internship incorporates social marketing strategies to increase communities' access to cancer information, while helping the interns who are recruited from underrepresented communities gain admission to top graduate schools. Interns are taught basic health journalism skills that enable them to create immediate streams of cancer-related press releases for submission to community newspapers. Interns are charged with the social responsibility of continuing this dissemination process throughout their careers. Intermediate outcomes are measured as mediators of distal behavioral change goals. PMID:20186519

  15. Health Journalism Internships: A Social Marketing Strategy to Address Health Disparities

    PubMed Central

    Nguyen, Duy H.; Shimasaki, Suzuho; Stafford, Helen Shi

    2010-01-01

    The USA seeks to eliminate health disparities by stimulating the rapid uptake of health-promoting behaviors within disadvantaged communities. A health journalism internship incorporates social marketing strategies to increase communities' access to cancer information, while helping the interns who are recruited from underrepresented communities gain admission to top graduate schools. Interns are taught basic health journalism skills that enable them to create immediate streams of cancer-related press releases for submission to community newspapers. Interns are charged with the social responsibility of continuing this dissemination process throughout their careers. Intermediate outcomes are measured as mediators of distal behavioral change goals. PMID:20186519

  16. Moving Upstream: How Interventions that Address the Social Determinants of Health can Improve Health and Reduce Disparities

    PubMed Central

    Williams, David R.; Costa, Manuela V.; Odunlami, Adebola O.; Mohammed, Selina A.

    2012-01-01

    There is considerable scientific and policy interest in reducing socioeconomic and racial/ethnic disparities in healthcare and health status. Currently, much of the policy focus around reducing health disparities has been geared towards improving access, coverage, quality and the intensity of healthcare. However, health is more a function of lifestyles linked to living and working conditions than of healthcare. Accordingly, effective efforts to improve health and reduce gaps in health need to pay greater attention to addressing the social determinants of health within and outside of the healthcare system. This paper highlights research evidence documenting that tackling the social determinants of health can lead to reductions in health disparities. It focuses both on interventions within the healthcare system that address some of the social determinants of health, as well as, interventions in upstream factors such as housing, neighborhood conditions and increased socioeconomic status that can lead to improvements in health. The studies reviewed highlight the importance of systematic evaluation of social and economic policies that might have health consequences and the need for policy makers, healthcare providers, and leaders across multiple sectors of society to apply currently available knowledge to improve the underlying conditions that impact the health of populations. PMID:18843244

  17. Addressing Health Disparities in the Undergraduate Curriculum: An Approach to Develop a Knowledgeable Biomedical Workforce

    ERIC Educational Resources Information Center

    Benabentos, Rocio; Ray, Payal; Kumar, Deepak

    2014-01-01

    Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health…

  18. Translating Life Course Theory to clinical practice to address health disparities.

    PubMed

    Cheng, Tina L; Solomon, Barry S

    2014-02-01

    Life Course Theory (LCT) is a framework that explains health and disease across populations and over time and in a powerful way, conceptualizes health and health disparities to guide improvements. It suggests a need to change priorities and paradigms in our healthcare delivery system. In "Rethinking Maternal and Child Health: The Life Course Model as an Organizing Framework," Fine and Kotelchuck identify three areas of rethinking that have relevance to clinical care: (1) recognition of context and the "whole-person, whole-family, whole-community systems approach;" (2) longitudinal approach with "greater emphasis on early ("upstream") determinants of health"; and (3) need for integration and "developing integrated, multi-sector service systems that become lifelong "pipelines" for healthy development". This paper discusses promising clinical practice innovations in these three areas: addressing social influences on health in clinical practice, longitudinal and vertical integration of clinical services and horizontal integration with community services and resources. In addition, barriers and facilitators to implementation are reviewed. PMID:23677685

  19. Translating Life Course Theory to Clinical Practice to Address Health Disparities

    PubMed Central

    Solomon, Barry S.

    2013-01-01

    Life Course Theory (LCT) is a framework that explains health and disease across populations and over time and in a powerful way, conceptualizes health and health disparities to guide improvements. It suggests a need to change priorities and paradigms in our healthcare delivery system. In “Rethinking Maternal and Child Health: The Life Course Model as an Organizing Framework,” Fine and Kotelchuck identify three areas of rethinking that have relevance to clinical care: (1) recognition of context and the “whole-person, whole-family, whole-community systems approach;” (2) longitudinal approach with “greater emphasis on early (“upstream”) determinants of health”; and (3) need for integration and “developing integrated, multi-sector service systems that become lifelong “pipelines” for healthy development”. This paper discusses promising clinical practice innovations in these three areas: addressing social influences on health in clinical practice, longitudinal and vertical integration of clinical services and horizontal integration with community services and resources. In addition, barriers and facilitators to implementation are reviewed. PMID:23677685

  20. Integrating Education on Addressing Health Disparities into the Graduate Social Work Curriculum

    ERIC Educational Resources Information Center

    Mitchell, Jamie Ann

    2012-01-01

    The purpose of this article is to propose an elective social work course as a means of better preparing social workers entering practice in healthcare to meet the challenges of promoting health and reducing health disparities in minority and underserved communities. Course offerings specifically targeting health or medical social work training…

  1. Addressing Hearing Health Care Disparities among Older Adults in a US-Mexico Border Community

    PubMed Central

    Ingram, Maia; Marrone, Nicole; Sanchez, Daisey Thalia; Sander, Alicia; Navarro, Cecilia; de Zapien, Jill Guernsey; Colina, Sonia; Harris, Frances

    2016-01-01

    Hearing loss is associated with cognitive decline and impairment in daily living activities. Access to hearing health care has broad implications for healthy aging of the U.S. population. This qualitative study investigated factors related to the socio-ecological domains of hearing health in a U.S.–Mexico border community experiencing disparities in access to care. A multidisciplinary research team partnered with community health workers (CHWs) from a Federally Qualified Health Center (FQHC) in designing the study. CHWs conducted interviews with people with hearing loss (n = 20) and focus groups with their family/friends (n = 27) and with members of the community-at-large (n = 47). The research team conducted interviews with FQHC providers and staff (n = 12). Individuals experienced depression, sadness, and social isolation, as well as frustration and even anger regarding communication. Family members experienced negative impacts of deteriorating communication, but expressed few coping strategies. There was general agreement across data sources that hearing loss was not routinely addressed within primary care and assistive hearing technology was generally unaffordable. Community members described stigma related to hearing loss and a need for greater access to hearing health care and broader community education. Findings confirm the causal sequence of hearing impairment on quality of life aggravated by socioeconomic conditions and lack of access to hearing health care. Hearing loss requires a comprehensive and innovative public health response across the socio-ecological framework that includes both individual communication intervention and greater access to hearing health resources. CHWs can be effective in tailoring intervention strategies to community characteristics. PMID:27574602

  2. How Do Integrated Health Care Systems Address Racial and Ethnic Disparities in Colon Cancer?

    PubMed Central

    Rhoads, Kim F.; Patel, Manali I.; Ma, Yifei; Schmidt, Laura A.

    2015-01-01

    Purpose Colorectal cancer (CRC) disparities have persisted over the last two decades. CRC is a complex disease requiring multidisciplinary care from specialists who may be geographically separated. Few studies have assessed the association between integrated health care system (IHS) CRC care quality, survival, and disparities. The purpose of this study was to determine if exposure to an IHS positively affects quality of care, risk of mortality, and disparities. Patients and Methods This retrospective secondary-data analysis study, using the California Cancer Registry linked to state discharge abstracts of patients treated for colon cancer (2001 to 2006), compared the rates of National Comprehensive Cancer Network (NCCN) guideline–based care, the hazard of mortality, and racial/ethnic disparities in an IHS versus other settings. Results More than 30,000 patient records were evaluated. The IHS had overall higher rates of adherence to NCCN guidelines. Propensity score–matched Cox models showed an independent and protective association between care in the IHS and survival (hazard ratio [HR], 0.87; 95% CI, 0.85 to 0.90). This advantage persisted across stage groups. Black race was associated with increased hazard of mortality in all other settings (HR, 1.15; 95% CI, 1.04 to 1.27); however, there was no disparity within the IHS for any minority group (P > .11 for all groups) when compared with white race. Conclusion The IHS delivered higher rates of evidence-based care and was associated with lower 5-year mortality. Racial/ethnic disparities in survival were absent in the IHS. Integrated systems may serve as the cornerstone for developing accountable care organizations poised to improve cancer outcomes and eliminate disparities under health care reform. PMID:25624437

  3. Approaching Health Disparities from a Population Perspective: The NIH Centers for Population Health and Health Disparities

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Addressing health disparities has been a national challenge for decades. The NIH-sponsored Centers for Population Health and Health Disparities (CPHHDs) represent the first federal initiative to support transdisciplinary multilevel research on the determinants of health disparities. Using preliminar...

  4. Building nursing research capacity to address health disparities: engaging minority baccalaureate and master's students.

    PubMed

    Goeppinger, Jean; Miles, Margaret Shandor; Weaver, Wanda; Campbell, Lenora; Roland, E Joyce

    2009-01-01

    In order to decrease health disparities, nursing needs to promote opportunities for minority nursing students to incorporate the conduct, as well as the utilization, of research into their professional careers. This article describes a model program to facilitate minority research career development, the Research Enrichment and Apprenticeship Program (REAP). REAP was developed and implemented by a federally funded partnership between 2 historically Black universities and a research-intensive university. Fifty-five (N = 55) baccalaureate and master's nursing students and 35 faculty members from the 3 schools participated in an intensive research mentorship program guided by learner-centered pedagogical approaches that culminated in the public presentation of students' research projects at a scientific poster session. Student, faculty, and institutional achievements, as well as challenges, were identified and addressed as the partnership evolved. Recognizing and building upon the strengths of both minority-serving and research-intensive institutions allowed the development of an exemplar program. While process measures provided many indicators of success, long-term evaluation of research career-related outcomes are needed. PMID:19447236

  5. Addressing oral health disparities, inequity in access and workforce issues in a developing country.

    PubMed

    Singh, Abhinav; Purohit, Bharathi M

    2013-10-01

    The health sector challenges in India like those in other low and middle income countries are formidable. India has almost one-third of the world's dental schools. However, provisions of oral health-care services are few in rural parts of India where the majority of the Indian population resides. Disparities exist between the oral health status in urban and rural areas. The present unequal system of mainly private practice directed towards a minority of the population and based on reparative services needs to be modified. National oral health policy needs to be implemented as a priority, with an emphasis on strengthening dental care services under public health facilities. A fast-changing demographic profile and its implications needs to be considered while planning for the future oral health-care workforce. Current oral health status in developing countries, including India, is a result of government public health policies, not lack of dentists. The aim of the article is to discuss pertinent issues relating to oral health disparities, equity in health-care access, dental workforce planning and quality concerns pertaining to the present-day dental education and practices in India, which have implications for other developing countries. PMID:24074015

  6. Addressing disparities in maternal health care in Pakistan: gender, class and exclusion

    PubMed Central

    2012-01-01

    Background After more than two decades of the Safe Motherhood Initiative and Millennium Development Goals aimed at reducing maternal mortality, women continue to die in childbirth at unacceptably high rates in Pakistan. While an extensive literature describes various programmatic strategies, it neglects the rigorous analysis of the reasons these strategies have been unsuccessful, especially for women living at the economic and social margins of society. A critical gap in current knowledge is a detailed understanding of the root causes of disparities in maternal health care, and in particular, how gender and class influence policy formulation and the design and delivery of maternal health care services. Taking Pakistan as a case study, this research builds upon two distinct yet interlinked conceptual approaches to understanding the phenomenon of inequity in access to maternal health care: social exclusion and health systems as social institutions. Methods/Design This four year project consists of two interrelated modules that focus on two distinct groups of participants: (1) poor, disadvantaged women and men and (2) policy makers, program managers and health service providers. Module one will employ critical ethnography to understand the key axes of social exclusion as related to gender, class and zaat and how they affect women’s experiences of using maternal health care. Through health care setting observations, interviews and document review, Module two will assess policy design and delivery of maternal health services. Discussion This research will provide theoretical advances to enhance understanding of the power dynamics of gender and class that may underlie poor women’s marginalization from health care systems in Pakistan. It will also provide empirical evidence to support formulation of maternal health care policies and health care system practices aimed at reducing disparities in maternal health care in Pakistan. Lastly, it will enhance inter

  7. Cardiovascular Health Disparities

    PubMed Central

    Davis, Andrew M.; Vinci, Lisa M.; Okwuosa, Tochi M.; Chase, Ayana R.; Huang, Elbert S.

    2008-01-01

    Racial and ethnic disparities in cardiovascular health care are well documented. Promising approaches to disparity reduction are increasingly described in literature published since 1995, but reports are fragmented by risk, condition, population, and setting. The authors conducted a systematic review of clinically oriented studies in communities of color that addressed hypertension, hyperlipidemia, physical inactivity, tobacco, and two major cardiovascular conditions, coronary artery disease and heart failure. Virtually no literature specifically addressed disparity reduction. The greatest focus has been African American populations, with relatively little work in Hispanic, Asian, and Native American populations. The authors found 62 interventions, 27 addressing hypertension, 9 lipids, 18 tobacco use, 8 physical inactivity, and 7 heart failure. Only 1 study specifically addressed postmyocardial infarction care. Data supporting the value of registries, multidisciplinary teams, and community outreach were found across several conditions. Interventions addressing care transitions, using telephonic outreach, and promoting medication access and adherence merit further exploration. PMID:17881625

  8. African American Women and HIV/AIDS: A National Call for Targeted Health Communication Strategies to Address a Disparity

    PubMed Central

    Arya, Monisha; Behforouz, Heidi L.; Viswanath, Kasisomayajula

    2013-01-01

    Dr Arya is assistant professor of medicine in the section of infectious diseases at the Baylor College of Medicine and a health services researcher at the Houston Center for Quality of Care and Utilization Studies in Houston. Dr Behforouz is assistant professor of medicine at Harvard Medical School, medical and executive director of the Prevention and Access to Care and Treatment Project, and associate physician in the Brigham Internal Medicine Associates at Brigham and Women’s Hospital, Boston. Dr Viswanath is associate professor of society, human development and health at the Harvard School of Public Health and director of the Health Communication Core of the Dana-Farber/Harvard Cancer Center, Boston. At the time of manuscript submission, Dr Arya was a fellow in the division of infectious diseases at Beth Israel Deaconess Medical Center and Harvard Medical School. African American women are disproportionately affected by the HIV/AIDS epidemic in the United States. To address this disparity, the CDC released a call for targeted communication campaigns in African American communities. The mass media is an HIV/AIDS information source used by African Americans, and media initiatives can be cost-effective for delivering HIV prevention messages. Needed is research in communities at risk to determine the messages needed and the preferred formats and channels with which to deliver the messages so that targeted communication campaigns can be part of the multifaceted approach to ending the HIV/AIDS disparity affecting African American women. PMID:19271331

  9. Cancer Health Disparities

    Cancer.gov

    Basic information about cancer health disparities in the U.S., factors that contribute to the disproportionate burden of cancer in some groups, and examples of disparities in incidence and mortality among certain populations.

  10. Minority Health and Health Disparities

    MedlinePlus

    ... Minority Health and Health Disparities Certain ethnic and racial minorities as well as other underserved populations experience ... disorders than do non-Hispanic whites, ethnic and racial disparities still exist for alcohol-related diseases, problems, ...

  11. Addressing Health Disparities by Building Organizational Capacity in the Community: A Case Study of the Wai‘anae Coast Comprehensive Health Center

    PubMed Central

    Sehgal, Vija; Wilkinson, Tiana; Voloch, Kelli-Ann; Enos, Rachelle; O'Brien, Joyce

    2014-01-01

    Native Hawaiians and other residents living in economically disadvantaged communities suffer disproportionately from many health conditions, especially chronic diseases. Reversing this trend requires a comprehensive approach encompassing more than just improvement in healthcare delivery. Indeed, societal changes at multiple levels must occur, including environmental, systems, and policy change, in order to bring about sustainable improvements in community health and wellness. A key strategy to accomplish these upstream changes is an increase in the capacity of community-based organizations to provide leadership in health advocacy, support community health promotion, prioritize resource allocation, and participate in community health research. In disadvantaged communities where health disparities are the most severe, community health centers (CHC) are well positioned to take a pivotal role in these efforts. This report is a case study to describe processes taking place at Hawai‘i's largest CHC to build organizational capacity and bring about upstream changes that improve community health and wellness. Ongoing processes at the CHC include (1) Institutional: commitment to address health disparities, expand the CHC research infrastructure, and develop a comprehensive worksite wellness program (2) Collaborative: development of a network of community partners committed to the common goal of improving the health and wellness of community residents, and (3) Systems and Policy: activities to strengthen the CHC's and community's ability to influence systems changes and policies that reduce health disparities. Preliminary results are encouraging although the processes and timelines involved require a long-term commitment in order to affect tangible results that can be measured. PMID:25535600

  12. Addressing health disparities by building organizational capacity in the community: a case study of the Wai'anae Coast Comprehensive Health Center.

    PubMed

    Okihiro, May; Sehgal, Vija; Wilkinson, Tiana; Voloch, Kelli-Ann; Enos, Rachelle; O'Brien, Joyce

    2014-12-01

    Native Hawaiians and other residents living in economically disadvantaged communities suffer disproportionately from many health conditions, especially chronic diseases. Reversing this trend requires a comprehensive approach encompassing more than just improvement in healthcare delivery. Indeed, societal changes at multiple levels must occur, including environmental, systems, and policy change, in order to bring about sustainable improvements in community health and wellness. A key strategy to accomplish these upstream changes is an increase in the capacity of community-based organizations to provide leadership in health advocacy, support community health promotion, prioritize resource allocation, and participate in community health research. In disadvantaged communities where health disparities are the most severe, community health centers (CHC) are well positioned to take a pivotal role in these efforts. This report is a case study to describe processes taking place at Hawai'i's largest CHC to build organizational capacity and bring about upstream changes that improve community health and wellness. Ongoing processes at the CHC include (1) Institutional: commitment to address health disparities, expand the CHC research infrastructure, and develop a comprehensive worksite wellness program (2) Collaborative: development of a network of community partners committed to the common goal of improving the health and wellness of community residents, and (3) Systems and Policy: activities to strengthen the CHC's and community's ability to influence systems changes and policies that reduce health disparities. Preliminary results are encouraging although the processes and timelines involved require a long-term commitment in order to affect tangible results that can be measured. PMID:25535600

  13. Framing a Transdisciplinary Research Agenda in Health Education to Address Health Disparities and Social Inequities: A Road Map for SOPHE Action

    ERIC Educational Resources Information Center

    Gambescia, Stephen F.; Woodhouse, Lynn D.; Auld, M. Elaine; Green, B. Lee; Quinn, Sandra Crouse; Airhihenbuwa, Collins O.

    2006-01-01

    SOPHE leaders continue to challenge us to be true to the call for an "open society." SOPHE has supported the Healthy People 2010 goal of eliminating health disparities through its Strategic Plan. SOPHE held an Inaugural Health Education Research Disparities Summit, Health Disparities and Social Inequities: Framing a Transdisciplinary Research…

  14. Addressing rural health disparities through policy change in the stroke belt

    PubMed Central

    Smith, Tosha W.; Thayer, Linden Maya; Drobka, Sarah; Miller, Cassandra; Keyserling, Thomas C.; Ammerman, Alice S.

    2016-01-01

    Context Obesity prevention policies are needed, particularly in low-income, rural areas of the Southern United States, where obesity and chronic disease prevalence are high. In 2009, the Centers for Disease Control and Prevention issued the “Common Community Measures for Obesity Prevention” (COCOMO), a set of 24 recommended community-level obesity prevention strategies. Objective A variety of stakeholders in Lenoir County, North Carolina were surveyed and interviewed, ranking the winnability, defined as feasibility and acceptability, of each of the 24 COCOMO recommended strategies based upon local culture, infrastructure, funding, and community support. Design Mixed-methods Setting This study was part of the Heart Healthy Lenoir (HHL) project, a community-based project to reduce cardiovascular disease risk and disparities in risk in Lenoir County, North Carolina. Participants COCOMO assessments were conducted with 19 Community Advisory Council members and in-depth interviews were conducted with 11 community stakeholders. HHL lifestyle intervention participants (n =366) completed surveys wherein they ranked their support for seven obesity prevention strategies (based upon the COCOMO strategies). Main Outcome Measures Ranking of obesity prevention strategies. Results Policies to improve physical activity opportunities were deemed the most winnable, whereas policies that would limit advertisement of unhealthy food and beverages were deemed the least winnable. The most winnable food-related strategy was improving mechanisms to procure food from local farms. Stakeholders perceived the public as unfavorably disposed toward government mandates, taxes, and incentives. Among Heart Healthy Lenoir participants, males indicated lower levels of support for COCOMO-related strategies than did females, and African Americans indicated higher levels of support than did white participants. Conclusion The formative work presented here provides insight into the winnability of

  15. Literacy and Health Disparities

    ERIC Educational Resources Information Center

    Prins, Esther; Mooney, Angela

    2014-01-01

    This chapter explores the relationship between literacy and health disparities, focusing on the concept of health literacy. Recommendations are provided for ways to bridge the health literacy gap for learners in adult basic education and family literacy programs.

  16. The Health Sciences and Technology Academy: An Educational Pipeline to Address Health Care Disparities in West Virginia

    PubMed Central

    McKendall, Sherron Benson; Kasten, Kasandra; Hanks, Sara; Chester, Ann

    2014-01-01

    Health and educational disparities are national issues in the United States. Research has shown that health care professionals from underserved backgrounds are more likely than others to work in underserved areas. The Association of American Medical Colleges’ Project 3000 by 2000, to increase the number of underrepresented minorities in medical schools, spurred the West Virginia School of Medicine to start the Health Sciences and Technology Academy (HSTA) in 1994 with the goal of supporting interested underrepresented high school students in pursuing college and health professions careers. The program was based on three beliefs: (1) if underrepresented high school students have potential and the desire to pursue a health professions career and are given the support, they can reach their goals, including obtaining a health professions degree; (2) underserved high school students are able to predict their own success if given the right resources; and (3) community engagement would be key to the program’s success. In this perspective, the authors describe the HSTA and its framework and philosophy, including the underlying theories and pedagogy from research in the fields of education and the behavioral/social sciences. They then offer evidence of the program’s success, specifically for African American students, including graduates’ high college-going rate and overwhelming intention to choose a health professions major. Finally, the authors describe the benefits of the HSTA’s community partnerships, including providing mentors to students, adding legislative language providing tuition waivers and a budgetary line item devoted to the program, and securing program funding from outside sources. PMID:24280836

  17. Leveraging the biology of adversity to address the roots of disparities in health and development

    PubMed Central

    Shonkoff, Jack P.

    2012-01-01

    Extensive evidence that personal experiences and environmental exposures are embedded biologically (for better or for worse) and the cumulative knowledge of more than four decades of intervention research provide a promising opportunity to mobilize evolving scientific insights to catalyze a new era of more effective early childhood policy and practice. Drawing on emerging hypotheses about causal mechanisms that link early adversity with lifelong impairments in learning, behavior, and health, this paper proposes an enhanced theory of change to promote better outcomes for vulnerable, young children by strengthening caregiver and community capacities to reduce or mitigate the impacts of toxic stress, rather than simply providing developmental enrichment for the children and parenting education for their mothers. PMID:23045654

  18. Rural Health Disparities

    MedlinePlus

    ... outcomes; quality; and cost, use, and access. AHRQ publishes an annual National Healthcare Disparities Report that summarizes ... is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and ...

  19. Engendering health disparities.

    PubMed

    Spitzer, Denise L

    2005-01-01

    How is gender implicated in our exploration of health disparities in Canada? Set against the backdrop of federal government policy, this review paper examines the ways in which gender intersects with other health determinants to produce disparate health outcomes. An overview of salient issues including the impact of gender roles, environmental exposures, gender violence, workplace hazards, economic disparities, the costs of poverty, social marginalization and racism, aging, health conditions, interactions with health services, and health behaviours are considered. This review suggests health is detrimentally affected by gender roles and statuses as they intersect with economic disparities, cultural, sexual, physical and historical marginalization as well as the strains of domestic and paid labour. These conditions result in an unfair health burden borne in particular by women whose access to health determinants is--in various degrees--limited. While progress has certainly been made on some fronts, the persistence of health disparities among diverse populations of women and men suggests a postponement of the vision of a just society with health for all that was articulated in the Federal Plan on Gender Equality. Commitment, creativity and collaboration from stakeholders ranging from various levels of government, communities, academics, non-governmental agencies and health professionals will be required to reduce and eliminate health disparities between and among all members of our society. PMID:16078557

  20. Evaluating the effect of a community-based lay health advisor training curriculum to address immigrant children's caries disparities.

    PubMed

    Hsu, Yuan-Jung; Peng, Wu-Der; Chen, Jen-Hao; Lin, Ying-Chun; Chang, Chin-Shun; Chen, Ted; Hu, Chih-Yang; Ho, Pei-Shan; Chen, Fu-Li; Lee, Chien-Hung; Huang, Hsiao-Ling

    2015-01-01

    Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care. PMID:25634314

  1. DEFINING THE “COMMUNITY” FOR A COMMUNITY-BASED PUBLIC HEALTH INTERVENTION ADDRESSING LATINO IMMIGRANT HEALTH DISPARITIES: AN APPLICATION OF ETHNOGRAPHIC METHODS

    PubMed Central

    Edberg, Mark; Cleary, Sean; Simmons, Lauren B.; Cubilla-Batista, Idalina; Andrade, Elizabeth L.; Gudger, Glencora

    2015-01-01

    Although Latino and other immigrant populations are the driving force behind population increases in the U.S., there are significant gaps in knowledge and practice on addressing health disparities in these populations. The Avance Center for the Advancement of Immigrant/Refugee Health, a health disparities research center in the Washington, DC area, includes as part of its mission a multi-level, participatory community intervention (called Adelante) to address the co-occurrence of substance abuse, violence and sex risk among Latino immigrant youth and young adults. Research staff and community partners knew that the intervention community had grown beyond its Census-designated place (CDP) boundaries, and that connection and attachment to community were relevant to an intervention. Thus, in order to understand current geographic and social boundaries of the community for sampling, data collection, intervention design and implementation, the research team conducted an ethnographic study to identify self-defined community boundaries, both geographic and social. Beginning with preliminary data from a pilot intervention and the original CDP map, the research included: geo-mapping de-identified addresses of service clients from a major community organization; key informant interviews; and observation and intercept interviews in the community. The results provided an expanded community boundary profile and important information about community identity. PMID:25892743

  2. The Moral Problem of Health Disparities

    PubMed Central

    2010-01-01

    Health disparities exist along lines of race/ethnicity and socioeconomic class in US society. I argue that we should work to eliminate these health disparities because their existence is a moral wrong that needs to be addressed. Health disparities are morally wrong because they exemplify historical injustices. Contractarian ethics, Kantian ethics, and utilitarian ethics all provide theoretical justification for viewing health disparities as a moral wrong, as do several ethical principles of primary importance in bioethics. The moral consequences of health disparities are also troubling and further support the claim that these disparities are a moral wrong. The Universal Declaration of Human Rights provides additional support that health disparities are a moral wrong, as does an analogy with the generally accepted duty to provide equal access to education. In this article, I also consider and respond to 3 objections to my thesis. PMID:20147677

  3. Addressing Breast Cancer Health Disparities in the Mississippi Delta Through an Innovative Partnership for Education, Detection, and Screening.

    PubMed

    Mayfield-Johnson, Susan; Fastring, Danielle; Fortune, Melody; White-Johnson, Freddie

    2016-06-01

    Projects to reduce disparities in cancer treatment and research include collaborative partnerships and multiple strategies to promote community awareness, education, and engagement. This is especially needed in underserved areas such as the Mississippi Delta where more women are diagnosed at regional and distant stages of breast cancer. The purpose for this project was to increase the relatively low screening rate for African American women in the Mississippi Delta through a partnership between the Mississippi Network for Cancer Control and Prevention at The University of Southern Mississippi, The Fannie Lou Hamer Cancer Foundation and the Mississippi State Department of Health to decrease health disparities in breast cancer through increased awareness on self-early detection methods, leveraging resources to provide mammography screenings, and adequate follow-up with services and treatment for abnormal findings. Through this collaborative effort, over 500 women in three rural Mississippi Delta counties were identified, provided community education on early self-detection, and given appointments for mammography screenings within one fiscal year. PMID:26578349

  4. Addressing health disparities through patient education: the development of culturally-tailored health education materials at Puentes de Salud.

    PubMed

    Harvey, Isobel; O'Brien, Matthew

    2011-10-01

    The availability of culturally appropriate written health information is essential for promoting health in diverse populations. Lack of English fluency has been shown to negatively impact health outcomes for Latinos in the United States. The authors conducted a needs assessment at a clinic serving Latino immigrants, focusing on patients' health and previous experiences with written health information. Based on these results and a literature review, we developed 10 Spanish language brochures to better serve the target population. This article outlines the process of developing and implementing this intervention, which can serve as a model for similar projects targeting diverse populations. PMID:22053763

  5. The 4th Bi-annual international African-Caribbean Cancer Consortium conference: building capacity to address cancer health disparities in populations of African descent.

    PubMed

    Blackman, Elizabeth; Campbell, Jasmine; Bowen, Carlene; Delmoor, Ernestine; Jean-Louis, Gilda; Noumbissi, Raphiatou; O'Garro, Yvonne; Richards-Waritay, Oni; Straughter, Stanley; Tolbert, Vera; Wilson, Barbara; Ragin, Camille

    2014-01-01

    This is a brief summary of the 4(th) International Meeting of the African-Caribbean Cancer Consortium (AC3), organized and sponsored by Fox Chase Cancer Center (FCCC), and held on July 21-22, 2012 at the Lincoln University Graduate Center, Lincoln Plaza, Philadelphia, Pennsylvania. AC3 investigators gathered in Philadelphia, PA to present the results of our ongoing collaborative research efforts throughout the African Diaspora. The general theme addressed cancer health disparities and presentations represented all cancer types. However, there was particular emphasis on women's cancers, related to human papillomavirus (HPV) and human immunodeficiency virus (HIV) infections. PMID:26422007

  6. Role of genomics in eliminating health disparities

    PubMed Central

    Kashyap, Meghana V; Nolan, Michael; Sprouse, Marc; Chakraborty, Ranajit; Cross, Deanna; Roby, Rhonda; Vishwanatha, Jamboor K

    2015-01-01

    The Texas Center for Health Disparities, a National Institute on Minority Health and Health Disparities Center of Excellence, presents an annual conference to discuss prevention, awareness education, and ongoing research about health disparities both in Texas and among the national population. The 2014 Annual Texas Conference on Health Disparities brought together experts in research, patient care, and community outreach on the “Role of Genomics in Eliminating Health Disparities.” Rapid advances in genomics and pharmacogenomics are leading the field of medicine to use genetics and genetic risk to build personalized or individualized medicine strategies. We are at a critical juncture of ensuring such rapid advances benefit diverse populations. Relatively few forums have been organized around the theme of the role of genomics in eliminating health disparities. The conference consisted of three sessions addressing “Gene-Environment Interactions and Health Disparities,” “Personalized Medicine and Elimination of Health Disparities,” and “Ethics and Public Policy in the Genomic Era.” This article summarizes the basic science, clinical correlates, and public health data presented by the speakers. PMID:26435701

  7. Reducing Refugee Mental Health Disparities: A Community-Based Intervention to Address Post-Migration Stressors With African Adults

    PubMed Central

    Goodkind, Jessica R.; Hess, Julia M.; Isakson, Brian; LaNoue, Marianna; Githinji, Ann; Roche, Natalie; Vadnais, Kathryn; Parker, Danielle P.

    2014-01-01

    Refugees resettled in the United States have disproportionately high rates of psychological distress. Research has demonstrated the roles of post-migration stressors, including lack of meaningful social roles, poverty, unemployment, lack of environmental mastery, discrimination, limited English proficiency, and social isolation. We report a multi-method, within-group longitudinal pilot study involving the adaptation for African refugees of a community-based advocacy and learning intervention to address post-migration stressors. We found the intervention to be feasible, acceptable and appropriate for African refugees. Growth trajectory analysis revealed significant decreases in participants’ psychological distress and increases in quality of life, and also provided preliminary evidence of intervention mechanisms of change through the detection of mediating relationships whereby increased quality of life was mediated by increases in enculturation, English proficiency, and social support. Qualitative data helped to support and explain the quantitative data. Results demonstrate the importance of addressing the sociopolitical context of resettlement to promote the mental health of refugees and suggest a culturally-appropriate, and replicable model for doing so. PMID:24364594

  8. Using Peer Ethnography to Address Health Disparities Among Young Urban Black and Latino Men Who Have Sex With Men

    PubMed Central

    McKay, Tara; McDavitt, Bryce; Gordon, Kristie K.

    2013-01-01

    Objectives. We examined the effectiveness of peer ethnography to gain insider views on substance use and sex among a diverse range of high-risk substance-using Black and Latino young men who have sex with men. Methods. We recruited 9 peer ethnographers aged 21 to 24 years from youth programs for the lesbian, gay, bisexual, and transgender community in Los Angeles, California, and trained them in ethnography, study protocol, and human participant protection. Peer ethnographers collected 137 single-spaced pages of field notes in 2009 and 2010 derived from observation of 150 members of the target population. Results. Peer ethnography revealed local language and phrasing and provided a window into new and different social contexts. Peers provided valuable information on current trends in substance use, revealing themes that needed to be addressed in further research, such as the use of substances during sex to “clock coin” (exchange sex for money and substances). These data enabled us to refine our recruitment strategies and ask more culturally relevant questions in a later phase of the study. Conclusions. The peer ethnography method can provide a sound basis for further research phases in multistage studies on numerous other social issues and with other hard-to-reach populations. PMID:23488490

  9. Reaching for Health Equity and Social Justice in Baltimore: The Evolution of an Academic-Community Partnership and Conceptual Framework to Address Hypertension Disparities.

    PubMed

    Cooper, Lisa A; Purnell, Tanjala S; Ibe, Chidinma A; Halbert, Jennifer P; Bone, Lee R; Carson, Kathryn A; Hickman, Debra; Simmons, Michelle; Vachon, Ann; Robb, Inez; Martin-Daniels, Michelle; Dietz, Katherine B; Golden, Sherita Hill; Crews, Deidra C; Hill-Briggs, Felicia; Marsteller, Jill A; Boulware, L Ebony; Miller, Edgar R Iii; Levine, David M

    2016-01-01

    Cardiovascular health disparities persist despite decades of recognition and the availability of evidence-based clinical and public health interventions. Racial and ethnic minorities and adults in urban and low-income communities are high-risk groups for uncontrolled hypertension (HTN), a major contributor to cardiovascular health disparities, in part due to inequitable social structures and economic systems that negatively impact daily environments and risk behaviors. This commentary presents the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities as a case study for highlighting the evolution of an academic-community partnership to overcome HTN disparities. Key elements of the iterative development process of a Community Advisory Board (CAB) are summarized, and major CAB activities and engagement with the Baltimore community are highlighted. Using a conceptual framework adapted from O'Mara-Eves and colleagues, the authors discuss how different population groups and needs, motivations, types and intensity of community participation, contextual factors, and actions have shaped the Center's approach to stakeholder engagement in research and community outreach efforts to achieve health equity. PMID:27440977

  10. Socioeconomic Disparities in Health Behaviors

    PubMed Central

    Pampel, Fred C.; Krueger, Patrick M.; Denney, Justin T.

    2011-01-01

    The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in health behaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and health behaviors can do more to design studies that better test for the importance of the varied mechanisms. PMID:21909182

  11. Creating a Cadre of Junior Investigators to Address the Challenges of Cancer-Related Health Disparities: Lessons Learned from the Community Networks Program

    PubMed Central

    Felder, Tisha M.; Brandt, Heather M.; Armstead, Cheryl; Cavicchia, Philip P.; Braun, Kathryn L.; Adams, Swann A.; Friedman, Daniela B.; Tanjasiri, Sora; Steck, Susan E.; Smith, Emily R.; Daguisé, Virginie G.; Hébert, James R.

    2012-01-01

    Community-based participatory research (CBPR) initiatives such as the National Cancer Institute’s Community Networks Program (CNP) (2005–2010) often emphasize training of junior investigators from underrepresented backgrounds to address health disparities. From July to October 2010, a convenience sample of 80 participants from the 25 CNP national sites completed our 45-item, web-based survey on the training and mentoring of junior investigators. This study assessed the academic productivity and CBPR-related experiences of the CNP junior investigators (n=37). Those from underrepresented backgrounds reported giving more presentations in non-academic settings (9 vs. 4 in last 5 years, p=0.01), having more co-authored publications (8 vs. 3 in last 5 years, p=0.01), and spending more time on CBPR-related activities than their non-underrepresented counterparts. Regardless of background, junior investigators shared similar levels of satisfaction with their mentors and CBPR experiences. This study provides support for the success of the CNP’s training program, especially effort directed at underrepresented investigators. PMID:22528636

  12. Health disparities among health care workers.

    PubMed

    Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann

    2010-01-01

    In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field. PMID:19940090

  13. Environmental Health Disparities in Housing

    PubMed Central

    2011-01-01

    The physical infrastructure and housing make human interaction possible and provide shelter. How well that infrastructure performs and which groups it serves have important implications for social equity and health. Populations in inadequate housing are more likely to have environmental diseases and injuries. Substantial disparities in housing have remained largely unchanged. Approximately 2.6 million (7.5%) non-Hispanic Blacks and 5.9 million Whites (2.8%) live in substandard housing. Segregation, lack of housing mobility, and homelessness are all associated with adverse health outcomes. Yet the experience with childhood lead poisoning in the United States has shown that housing-related disparities can be reduced. Effective interventions should be implemented to reduce environmental health disparities related to housing. PMID:21551378

  14. Physicians' ethical responsibilities in addressing racial and ethnic healthcare disparities.

    PubMed Central

    Bostick, Nathan; Morin, Karine; Benjamin, Regina; Higginson, Daniel

    2006-01-01

    Patients belonging to racial and ethnic minority populations continue to receive lesser-quality healthcare relative to other patients, even when controlling for relevant demographic variables. Such disparities represent a significant challenge for physicians who are ethically committed to serving all patients equally, irrespective of personal characteristics. Accordingly, this report explores the ethical obligations of individual physicians and the medical profession as they pertain to racial and ethnic disparities in healthcare. To address these disparities, the AMA Council on Ethical and Judicial Affairs recommends that physicians customize the provision of medial care to meet the needs and preferences of individual patients. Moreover, physicians must learn to recognize racial and ethnic healthcare disparities and critically examine their own practices to ensure that inappropriate considerations do not affect clinical judgment. Physicians can also work to eliminate racial and ethnic healthcare disparities by encouraging diversity within the profession, continuing to investigate healthcare disparities, and supporting the development of appropriate quality measures. PMID:16916132

  15. Toward Explaining Mental Health Disparities

    ERIC Educational Resources Information Center

    Aneshensel, Carol S.

    2009-01-01

    Mental health disparities refer to the disproportionate amount of psychopathology found among persons of disadvantageous social standing, such as persons of low socioeconomic status (SES). Although social and self selection cannot entirely be ruled out as explanations for these differences, the accumulation of evidence supports a social causation…

  16. Disparities in Oral Health

    MedlinePlus

    ... 70.1% have periodontal disease. Periodontal Disease is higher in men than women, and greatest among Mexican Americans and Non-Hispanic blacks, and those with less than a high school education. Healthy People 2020 Works to Eliminate Oral Health ...

  17. Addressing Breastfeeding Disparities in Social Work

    ERIC Educational Resources Information Center

    Hurst, Carol Grace

    2007-01-01

    This article examines social justice issues affecting breastfeeding in the United States. Public health goals for breastfeeding initiation and duration and barriers to breastfeeding among low-income groups are discussed. Suggestions are made about ways social workers may more assertively support breastfeeding in the context of social work practice.

  18. Transdisciplinary Cardiovascular and Cancer Health Disparities Training: Experiences of the Centers for Population Health and Health Disparities

    PubMed Central

    Ferketich, Amy; Boyington, Josephine; Dugan, Sheila; Garroutte, Eva; Kaufmann, Peter G.; Krok, Jessica; Kuo, Alice; Ortega, Alexander N.; Purnell, Tanjala; Srinivasan, Shobha

    2015-01-01

    The Centers for Population Health and Health Disparities program promotes multilevel and multifactorial health equity research and the building of research teams that are transdisciplinary. We summarized 5 areas of scientific training for empowering the next generation of health disparities investigators with research methods and skills that are needed to solve disparities and inequalities in cancer and cardiovascular disease. These areas include social epidemiology, multilevel modeling, health care systems or health care delivery, community-based participatory research, and implementation science. We reviewed the acquisition of the skill sets described in the training components; these skill sets will position trainees to become leaders capable of effecting significant change because they provide tools that can be used to address the complexities of issues that promote health disparities. PMID:25905828

  19. When identifying health disparities as a problem is a problem: pedagogical strategies for examining racialized contexts.

    PubMed

    Browne, Teri; Pitner, Ronald; Freedman, Darcy A

    2013-01-01

    The current study presents a critical discussion on community responses to health disparity research and the need for utilizing pedagogical strategies to prepare students to understand and address health disparities in racialized contexts. Qualitative research methods were used to examine community responses to media stories on two health disparity research projects, and four themes emerged: naming health disparities is a tool for dividing, structural racism does not exist, naming of health disparities is a political act, and health disparities exist because of individual-level deficiencies. The implications for teaching students about racial health disparities are presented and discussed. PMID:24010559

  20. Food Systems and Public Health Disparities

    PubMed Central

    Neff, Roni A.; Palmer, Anne M.; Mckenzie, Shawn E.; Lawrence, Robert S.

    2009-01-01

    The United States has set a national goal to eliminate health disparities. This article emphasizes the importance of food systems in generating and exacerbating health disparities in the United States and suggests avenues for reducing them. It presents a conceptual model showing how broad food system conditions interplay with community food environments—and how these relationships are filtered and refracted through prisms of social disparities to generate and exacerbate health disparities. Interactions with demand factors in the social environment are described. The article also highlights the separate food systems pathway to health disparities via environmental and occupational health effects of agriculture. PMID:23173027

  1. Addressing Disparities in Stroke Prevention for Atrial Fibrillation: Educational Opportunities.

    PubMed

    Karcher, Rachel; Berman, Adam E; Gross, Hartmut; Hess, David C; Jauch, Edward C; Viser, Paul E; Solenski, Nina J; Wolf, Andrew M D

    2016-07-01

    Disparities in atrial fibrillation (AF)-related stroke and mortality persist, especially racial disparities, within the US "Stroke Belt." This study identified barriers to optimal stroke prevention to develop a framework for clinician education. A comprehensive educational needs assessment was developed focusing on clinicians within the Stroke Belt. The mixed qualitative-quantitative approach included regional surveys and one-on-one clinician interviews. Identified contributors to disparities included implicit racial biases, lack of awareness of racial disparities in AF stroke risk, and lack of effective multicultural awareness and training. Additional barriers affecting disparities included patient medical mistrust and clinician-patient communication challenges. General barriers included lack of consistency in assessing stroke and anticoagulant-related bleeding risk, underuse of standardized risk assessment tools, discomfort with novel anticoagulants, and patient education deficiencies. Effective cultural competency training is one strategy to reduce disparities in AF-related stroke and mortality by improving implicit clinician bias, addressing medical mistrust, and improving clinician-patient communication. PMID:25788477

  2. Scalable Combinatorial Tools for Health Disparities Research

    PubMed Central

    Langston, Michael A.; Levine, Robert S.; Kilbourne, Barbara J.; Rogers, Gary L.; Kershenbaum, Anne D.; Baktash, Suzanne H.; Coughlin, Steven S.; Saxton, Arnold M.; Agboto, Vincent K.; Hood, Darryl B.; Litchveld, Maureen Y.; Oyana, Tonny J.; Matthews-Juarez, Patricia; Juarez, Paul D.

    2014-01-01

    Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual’s genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size and heterogeneity of available data needed to illuminate latent gene x environment interactions. This has prompted the adaptation and application of scalable combinatorial methods, many from genome science research, to the study of population health. Most of these powerful tools are algorithmically sophisticated, highly automated and mathematically abstract. Their utility motivates the main theme of this paper, which is to describe real applications of innovative transdisciplinary models and analyses in an effort to help move the research community closer toward identifying the causal mechanisms and associated environmental contexts underlying health disparities. The public health exposome is used as a contemporary focus for addressing the complex nature of this subject. PMID:25310540

  3. Minority Health and Health Disparities

    MedlinePlus

    ... groups. But those who do drink consume more alcohol and often have higher rates of binge drinking. Alcohol and health consequences ... Hispanic whites. 1 Hispanics and Blacks have a higher risk for developing alcohol-related liver disease than whites. 2 Alcohol-related ...

  4. Child Health Disparities: What Can a Clinician Do?

    PubMed Central

    Cheng, Tina L.; Emmanuel, Mickey; Levy, Daniel J.; Jenkins, Renee R.

    2016-01-01

    Pediatric primary and specialty practice has changed with more to do, more regulation and more family needs. Similarly, the needs of patients have changed with more demographic diversity, family stress and continued health disparities by race, ethnicity and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This paper outlines specific, practical, actionable and evidence-based activities for clinicians to assess and address health disparities in practice. These tools may also support Patient Centered Medical Home recognition, national and state cultural and linguistic competency standards and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in 1) diagnosing disparities in one’s community and practice; 2) innovating new models to address social determinants of health; 3) addressing health literacy of families; 4) ensuring cultural competence and a culture of workplace equity; 5) advocating on issues that address the root causes of health disparities. Culturally competent care that is sensitive to family needs, their health literacy and health beliefs can increase satisfaction, improve quality of care and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include 1) screening for new health vital signs and connecting families to resources; 2) enhancing the comprehensiveness of services; 3) addressing family health in pediatric encounters; 4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity. PMID:26459644

  5. The persistence of American Indian health disparities.

    PubMed

    Jones, David S

    2006-12-01

    Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes working to relieve them, sometimes taking advantage of the ill health of American Indians. Economic and political interests have always affected both explanations of health disparities and responses to them, influencing which explanations were emphasized and which interventions were pursued. Tensions also appear in ongoing debates about the contributions of genetic and socioeconomic forces to the pervasive health disparities. Understanding how these economic and political forces have operated historically can explain both the persistence of the health disparities and the controversies that surround them. PMID:17077399

  6. The Persistence of American Indian Health Disparities

    PubMed Central

    Jones, David S.

    2006-01-01

    Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes working to relieve them, sometimes taking advantage of the ill health of American Indians. Economic and political interests have always affected both explanations of health disparities and responses to them, influencing which explanations were emphasized and which interventions were pursued. Tensions also appear in ongoing debates about the contributions of genetic and socioeconomic forces to the pervasive health disparities. Understanding how these economic and political forces have operated historically can explain both the persistence of the health disparities and the controversies that surround them. PMID:17077399

  7. Addressing Health Disparities in the Mental Health of Refugee Children and Adolescents Through Community-Based Participatory Research: A Study in 2 Communities

    PubMed Central

    Frounfelker, Rochelle; Mishra, Tej; Hussein, Aweis; Falzarano, Rita

    2015-01-01

    Objectives. We sought to understand the problems, strengths, and help-seeking behaviors of Somali Bantu and Bhutanese refugees and determine local expressions of mental health problems among youths in both communities. Methods. We used qualitative research methods to develop community needs assessments and identify local terms for child mental health problems among Somali Bantu and Bhutanese refugees in Greater Boston and Springfield, Massachusetts, between 2011 and 2014. A total of 56 Somali Bantu and 93 Bhutanese refugees participated in free list and key informant interviews. Results. Financial and language barriers impeded the abilities of families to assist youths who were struggling academically and socially. Participants identified resources both within and outside the refugee community to help with these problems. Both communities identified areas of distress corresponding to Western concepts of conduct disorders, depression, and anxiety. Conclusions. There are numerous challenges faced by Somali Bantu and Bhutanese youths, as well as strengths and resources that promote resilience. Future steps include using culturally informed methods for identifying those in need of services and developing community-based prevention programs. PMID:25905818

  8. Integrating Research and Action: A Systematic Review of Community-based Participatory Research To Address Health Disparities In Environmental and Occupational Health in the United States

    PubMed Central

    Cook, Won Kim

    2009-01-01

    Introduction Integrating research and action represents a goal and key principles of CBPR, but there has been little effort to synthesize the literature to evaluate if such integration is occurring. Objectives 1) To examine the extent to which CBPR integrates action to effect community-level change; and 2) to ascertain factors that facilitates such integration. Methods Original articles reporting on CBPR in environmental and occupational health in the United States were identified primarily through a MEDLINE search. Inceptions, processes, methods, and outcomes of the projects were reviewed. Results In fourteen of the twenty studies reviewed, CBPR led to community-level action to improve the health and well-being of the community members. Observational studies that investigated problems posed by the affected community and that incorporated qualitative methods were more likely to lead to action. The collaboration among government scientists, university researchers, and community partners emerged as a new model of CBPR partnerships that effectively integrates research and action. Conclusions To help CBPR better integrate research and action, a shift towards community-initiated and action-oriented observational studies might be needed. PMID:18621950

  9. Racial/Ethnic Disparities in Men's Health: Examining Psychosocial Mechanisms.

    PubMed

    Brown, Tyson H; Hargrove, Taylor W; Griffith, Derek M

    2015-01-01

    This study uses data from the Health and Retirement Study and an approach informed by the Biopsychosocial Model of Racism as a Stressor to examine the extent to which socioeconomic status, stressors, discrimination, and neighborhood conditions are mechanisms underlying racial/ethnic disparities in functional limitations among men. Results reveal that racial/ethnic differences in socioeconomic status, stressors, discrimination, and neighborhood conditions-individually and collectively-account for a substantial proportion of racial/ethnic disparities in functional limitations. Findings suggest that the social determinants of health for men of color need to be more seriously considered in investigations of and efforts to address health disparities. PMID:26291191

  10. Global health disparities: crisis in the diaspora.

    PubMed Central

    Cox, Raymond L.

    2004-01-01

    The United States spends more than the rest of the world on healthcare. In 2000, the U.S. health bill was 1.3 trillion dollars, 14.5% of its gross domestic product. Yet, according to the WHO World Health Report 2000, the United States ranked 37th of 191 member nations in overall health system performance. Racial/ethnic disparities in health outcomes are the most obvious examples of an unbalanced healthcare system. This presentation will examine health disparities in the United States and reveal how health disparities among and within countries affect the health and well-being of the African Diaspora. PMID:15101675

  11. Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities

    PubMed Central

    Carter-Pokras, Olivia; Offutt-Powell, Tabatha; Kaufman, Jay S.; Giles, Wayne; Mays, Vickie

    2013-01-01

    Purpose Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the U.S. and abroad through a “social determinants of health” lens. Methods To identify examples of how epidemiologic research has been applied to reduce health disparities, we queried epidemiologists engaged in disparities research in the U.S., Canada, and New Zealand, and drew upon the scientific literature. Results Resulting examples covered a wide range of topic areas. Three areas selected for their contributions to policy were: 1) epidemiology's role in definition and measurement, 2) the study of housing and asthma, and 3) the study of food policy strategies to reduce health disparities. While epidemiologic research has done much to define and quantify health inequalities, it has generally been less successful at producing evidence that would identify targets for health equity intervention. Epidemiologists have a role to play in measurement and basic surveillance, etiologic research, intervention research, and evaluation research. However, our training and funding sources generally place greatest emphasis on surveillance and etiologic research. Conclusions: The complexity of health disparities requires better training for epidemiologists to effectively work in multidisciplinary teams. Together we can evaluate contextual and multilevel contributions to disease and study intervention programs in order to gain better insights into evidenced-based health equity strategies. PMID:22626003

  12. Health Disparities and Gaps in School Readiness

    ERIC Educational Resources Information Center

    Currie, Janet

    2005-01-01

    The author documents pervasive racial disparities in the health of American children and analyzes how and how much those disparities contribute to racial gaps in school readiness. She explores a broad sample of health problems common to U.S. children, such as attention deficit hyperactivity disorder, asthma, and lead poisoning, as well as maternal…

  13. Health Disparities and Discrimination: Three Perspectives

    PubMed Central

    Ndiaye, Khadidiatou; Krieger, Janice R.; Warren, Jennifer R.; Hecht, Michael L.; Okuyemi, Kola

    2010-01-01

    This article presents three perspectives on health discrimination and disparities, organized around different conceptualizations of the way “space” perpetuates health disparities. The first two perspectives are grounded in conceptualizing space in a physical sense by exploring the manifestation of discrimination as a problem both among and within nations. The third perspective juxtaposes geographical space with cyberspace. The internet, with its ability to blur sense of place, social demarcations, and behavior is often considered a panacea that can eliminate the health disparities. The internet, however, may not be fulfilling its promise as an equal source of health information for all and disparities related to international and rural geography remain problematic. Solutions are proposed for reducing health disparities based on The Principle of Cultural Grounding (Hecht & Krieger, 2006; Hecht & Miller-Day, in press). PMID:20694161

  14. Health Disparities and Discrimination: Three Perspectives.

    PubMed

    Ndiaye, Khadidiatou; Krieger, Janice R; Warren, Jennifer R; Hecht, Michael L; Okuyemi, Kola

    2008-10-01

    This article presents three perspectives on health discrimination and disparities, organized around different conceptualizations of the way "space" perpetuates health disparities. The first two perspectives are grounded in conceptualizing space in a physical sense by exploring the manifestation of discrimination as a problem both among and within nations. The third perspective juxtaposes geographical space with cyberspace. The internet, with its ability to blur sense of place, social demarcations, and behavior is often considered a panacea that can eliminate the health disparities. The internet, however, may not be fulfilling its promise as an equal source of health information for all and disparities related to international and rural geography remain problematic. Solutions are proposed for reducing health disparities based on The Principle of Cultural Grounding (Hecht & Krieger, 2006; Hecht & Miller-Day, in press). PMID:20694161

  15. Partnering health disparities research with quality improvement science in pediatrics.

    PubMed

    Lion, K Casey; Raphael, Jean L

    2015-02-01

    Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. PMID:25560436

  16. EGRP-Supported Health Disparities Research

    Cancer.gov

    The National Cancer Institute has targeted the reduction of cancer-related health disparities, differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions, as an important challenge.

  17. The 2014 Minority Health and Health Disparities Grantees’ Conference

    PubMed Central

    Edberg, Mark; Hayes, Barbara E.; Montgomery-Rice, Valerie; Tchounwou, Paul B.

    2015-01-01

    Health disparities have been defined as a particular type of health difference closely linked with social, economic and/or environmental disadvantage. The National Institute on Minority Health and Health Disparities (NIMHD) at the National Institutes of Health, has a comprehensive portfolio of grants that fund scientific research to improve racial/ethnic minority health and eliminate health disparities. The 2014 Minority Health and Health Disparities Grantees’ Conference highlighted excellence and innovation in biological, environmental, sociocultural, clinical and behavioral research supported by NIMHD. This special issue of the International Journal of Environmental Research and Public Health includes peer-reviewed publications from investigators who participated in this conference.

  18. Addressing Environmental Health Inequalities.

    PubMed

    Gouveia, Nelson

    2016-01-01

    Environmental health inequalities refer to health hazards disproportionately or unfairly distributed among the most vulnerable social groups, which are generally the most discriminated, poor populations and minorities affected by environmental risks. Although it has been known for a long time that health and disease are socially determined, only recently has this idea been incorporated into the conceptual and practical framework for the formulation of policies and strategies regarding health. In this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH), "Addressing Environmental Health Inequalities-Proceedings from the ISEE Conference 2015", we incorporate nine papers that were presented at the 27th Conference of the International Society for Environmental Epidemiology (ISEE), held in Sao Paulo, Brazil, in 2015. This small collection of articles provides a brief overview of the different aspects of this topic. Addressing environmental health inequalities is important for the transformation of our reality and for changing the actual development model towards more just, democratic, and sustainable societies driven by another form of relationship between nature, economy, science, and politics. PMID:27618906

  19. Racial and Ethnic Disparities in Pediatric Mental Health

    PubMed Central

    Alegria, Margarita; Vallas, Melissa; Pumariega, Andres

    2010-01-01

    Disparities remain in mental health status and care for racial and ethnic minority youth, despite national attention to disparity reduction. This paper offers a comprehensive picture of the status of pediatric disparities, by addressing the major areas affecting minority youth mental health, including: prevention of problems, need for services, access to care, mental health treatment types and treatment outcomes. It addresses relevant factors in the family, community and socioeconomic context, and describes various local and national programs that aim to tackle the obstacles and fill the gaps in high quality care for racial/ethnic minority youth. It concludes by offering recommendations for improvement which acknowledge the importance of understanding preferences and attitudes towards treatment, ensuring that screening and diagnosis is appropriate to minority youth, and ensuring that evidence-based programs are available at multiple levels to best service children and succeed in addressing their needs. PMID:21056345

  20. Health Disparities: Bridging the Gap. From Cells to Selves.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    This document details the strategic plan of the National Institute of Child Health and Human Development to address disparities in health and developmental outcomes among Americans, particularly between and among racial and ethnic groups. Following a description of the plan's development, scientific areas of interest, and important themes, the…

  1. CHALLENGES OF HEALTH MEASUREMENT IN STUDIES OF HEALTH DISPARITIES

    PubMed Central

    Burgard, Sarah A.; Chen, Patricia V.

    2014-01-01

    Health disparities are increasingly studied in and across a growing array of societies. While novel contexts and comparisons are a promising development, this commentary highlights four challenges to finding appropriate and adequate health measures when making comparisons across groups within a society or across distinctive societies. These challenges affect the accuracy with which we characterize the degree of inequality, limiting possibilities for effectively targeting resources to improve health and reduce disparities. First, comparisons may be challenged by different distributions of disease and second, by variation in the availability and quality of vital events and census data often used to measure health. Third, the comparability of self-reported information about specific health conditions may vary across social groups or societies because of diagnosis bias or diagnosis avoidance. Fourth, self-reported overall health measures or measures of specific symptoms may not be comparable across groups if they use different reference groups or interpret questions or concepts differently. We explain specific issues that make up each type of challenge and show how they may lead to underestimates or inflation of estimated health disparities. We also discuss approaches that have been used to address them in prior research, note where further innovation is needed to solve lingering problems, and make recommendations for improving future research. Many of our examples are drawn from South Africa or the United States, societies characterized by substantial socioeconomic inequality across ethnic groups and wide disparities in many health outcomes, but the issues explored throughout apply to a wide variety of contexts and inquiries. PMID:24561776

  2. The Nursing Research Center on HIV/AIDS Health Disparities.

    PubMed

    Holzemer, William L; Méndez, Marta Rivero; Portillo, Carmen; Padilla, Geraldine; Cuca, Yvette; Vargas-Molina, Ricardo L

    2004-01-01

    This report describes the partnership between the schools of nursing at the University of California San Francisco and the University of Puerto Rico to address the need for nursing research on HIV/AIDS health disparities. The partnership led to the creation of the Nursing Research Center on HIV/AIDS Health Disparities with funding from the National Institutes of Health/National Institute of Nursing Research. We provide background information on the disproportionate impact of the HIV/AIDS epidemic on racial and ethnic minorities, describe the major predictors of health disparities in persons at risk for or diagnosed with HIV/AIDS using the Outcomes Model for Health Care Research, and outline the major components of the Nursing Research Center. The center's goal is to improve health outcomes for people living with and affected by HIV/AIDS by enhancing the knowledge base for HIV/AIDS care. PMID:15499311

  3. Cancer Health Disparities | Did You Know?

    Cancer.gov

    How does cancer affect people from different populations and groups? Cancer health disparities happen when there are higher rates of new diagnoses and cancer death rates among certain races, ethnicities, or other population groups.

  4. Reducing Oral Health Disparities: A Focus on Social and Cultural Determinants

    PubMed Central

    Patrick, Donald L; Lee, Rosanna Shuk Yin; Nucci, Michele; Grembowski, David; Jolles, Carol Zane; Milgrom, Peter

    2006-01-01

    Oral health is essential to the general health and well-being of individuals and the population. Yet significant oral health disparities persist in the U.S. population because of a web of influences that include complex cultural and social processes that affect both oral health and access to effective dental health care. This paper introduces an organizing framework for addressing oral health disparities. We present and discuss how the multiple influences on oral health and oral health disparities operate using this framework. Interventions targeted at different causal pathways bring new directions and implications for research and policy in reducing oral health disparities. PMID:16934121

  5. Child Health Disparities: What Can a Clinician Do?

    PubMed

    Cheng, Tina L; Emmanuel, Mickey A; Levy, Daniel J; Jenkins, Renee R

    2015-11-01

    Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued health disparities by race, ethnicity, and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This article outlines specific, practical, actionable, and evidence-based activities to help clinicians assess and address health disparities in practice. These tools may also support patient-centered medical home recognition, national and state cultural and linguistic competency standards, and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in (1) diagnosing disparities in one's community and practice, (2) innovating new models to address social determinants of health, (3) addressing health literacy of families, (4) ensuring cultural competence and a culture of workplace equity, and (5) advocating for issues that address the root causes of health disparities. Culturally competent care that is sensitive to the needs, health literacy, and health beliefs of families can increase satisfaction, improve quality of care, and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include (1) screening for new health "vital signs" and connecting families to resources, (2) enhancing the comprehensiveness of services, (3) addressing family health in pediatric encounters, and (4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity. PMID:26459644

  6. A community-based approach to translational research addressing breast cancer disparities.

    PubMed

    Yeary, Karen Hye-Cheon Kim; Mason, Mondi; Turner, Jerome; Kieber-Emmons, Thomas; Chow, Marie; Hine, R Jean; Henry-Tillman, Ronda; Greene, Paul

    2011-06-01

    Disparities in breast cancer survival rates suggest that biological processes contribute. Translational research addressing health disparities would benefit from using a community-based participatory approach (CBPR) to examine biological processes commonly seen as the proximal causes of illness as well as behavioral and social-ecological "causes of the causes" within an integrated conceptual framework. This paper describes a CBPR study that explored perceptions regarding breast cancer relevant behaviors, and the application of the study's results to develop translational research. Data from eight focus groups of African American (n = 29) and Caucasian women (n = 27) were analyzed, using the framework of the social-ecological model. Nutrition and physical activity were valued over screening and research participation. Treatment of illness was emphasized over prevention. Women's perspectives are presented within a framework that facilitated the collaborative development of translational research to examine associations among biological, behavioral, and societal processes contributing to disparities. PMID:24073047

  7. Sleep as a Potential Fundamental Contributor to Cardiovascular Health Disparities

    PubMed Central

    Jackson, Chandra L.; Redline, Susan; Emmons, Karen M.

    2016-01-01

    Optimal sleep is integral to health but is commonly not obtained. Despite its wide ranging public health impact, sleep health is under-appreciated by the general public and is only rarely considered by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. Inadequate sleep duration and quality are prevalent in minority and low-income populations and may play a fundamental role in racial and socioeconomic status (SES) inequities for a wide range of health conditions including cardiovascular disease (CVD).The goal of this review is to examine the relationship between sleep and CVD health disparities. To this end, we describe the overall public health importance of sleep and the role of sleep duration as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We then focus on the potential link between sleep and CVD disparities. A multilevel model developed for the analysis of population health and health disparities as a part of the National Cancer Institute’s Centers on Population Health and Health Disparities served as our conceptual framework. It is based on the notion that individual behaviors, like sleep, are influenced by complex and dynamic interrelations among the individual and his or her physical and social environments across the lifespan. Using this model, we describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g. neighborhoods, schools, workplaces) that address social structures that contribute to disparities, and conclude by recommending critical areas for future sleep research. We ultimately suggest that integrating sleep into public health research will identify novel approaches for closing the gap in health disparities, such as CVD. PMID:25785893

  8. Using Community Health Assessment to Teach and Explore Health Status Disparities

    ERIC Educational Resources Information Center

    Sullivan, Marianne; Levine, Jack

    2014-01-01

    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  9. CDC Health Disparities and Inequalities Report--U.S. 2013

    MedlinePlus

    ... to Community Health Tribal Support Women's Health CDC Health Disparities & Inequalities Report (CHDIR) Recommend on Facebook Tweet Share Compartir ... Sheets 2011 Report More Information CDC Releases Second Health Disparities & Inequalities Report - United States, 2013 CDC and its partners ...

  10. Addressing Disparities in Sudden Cardiac Arrest Care and the Under-Utilization of Effective Therapies

    PubMed Central

    Kong, Melissa H.; Peterson, Eric D.; Fonarow, Gregg C.; Sanders, Gillian D.; Yancy, Clyde W.; Russo, Andrea M.; Curtis, Anne B.; Sears, Samuel F.; Thomas, Kevin L.; Campbell, Susan; Carlson, Mark D.; Chiames, Chris; Cook, Nakela L.; Hayes, David L.; LaRue, Michelle; Hernandez, Adrian F.; Lyons, Edward L.; Al-Khatib, Sana M.

    2010-01-01

    Sudden cardiac arrest (SCA) is the most common cause of death in the Unites States. Despite its major impact on public health, significant challenges exist at the patient, provider, public, and policy levels with respect to raising more widespread awareness and understanding of SCA risks, identifying patients at risk for SCA, addressing barriers to SCA care, and eliminating disparities in SCA care and outcomes. To address many of these challenges, the Duke Center for the Prevention of Sudden Cardiac Death at the Duke Clinical Research Institute (Durham, NC) held a think tank meeting on December 7, 2009, convening experts on this issue from clinical cardiology, cardiac electrophysiology, health policy and economics, the US Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Agency for Health Care Research and Quality, and device and pharmaceutical manufacturers. The specific goals of the meeting were to examine existing educational tools on SCA for patients, health care providers and the public and explore ways to enhance and disseminate these tools, to propose a framework for improved identification of patients at risk of SCA, and to review the latest data on disparities in SCA care and explore ways to reduce these disparities. This paper summarizes the discussions that occurred at the meeting. PMID:20934553

  11. Asian Indian views on diet and health in the United States: importance of understanding cultural and social factors to address disparities.

    PubMed

    Mukherjea, Arnab; Underwood, Kelsey Clark; Stewart, Anita L; Ivey, Susan L; Kanaya, Alka M

    2013-01-01

    This study describes Asian Indian immigrant perspectives surrounding dietary beliefs and practices to identify intervention targets for diabetes and heart disease prevention. Participants were asked about conceptualizations of relationships between culture, food, and health during 4 focus groups (n = 38). Findings reveal influences of beliefs from respondents' native India, preservation of cultural practices within the US social structure, conflicts with subsequent generations, and reinterpretation of health-related knowledge through a lens, hybridizing both "native" and "host" contexts. Galvanization of ethnically valued beliefs incorporating family and community structures is needed for multipronged approaches to reduce disproportionate burdens of disease among this understudied minority community. PMID:23986072

  12. Persons With Disabilities as an Unrecognized Health Disparity Population

    PubMed Central

    Walker, Deborah Klein; Correa-De-Araujo, Rosaly

    2015-01-01

    Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness. PMID:25689212

  13. Persons with disabilities as an unrecognized health disparity population.

    PubMed

    Krahn, Gloria L; Walker, Deborah Klein; Correa-De-Araujo, Rosaly

    2015-04-01

    Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness. PMID:25689212

  14. Making a business case for small medical practices to maintain quality while addressing racial healthcare disparities.

    PubMed

    Dunston, Frances J; Eisenberg, Andrew C; Lewis, Evelyn L; Montgomery, John M; Ramos, Diana; Elster, Arthur

    2008-11-01

    Various reports have documented variations in quality of care that occur among racial and ethnic populations, even after accounting for socioeconomic factors and health insurance status. Although quality improvement initiatives are often touted as the answer to healthcare disparities, researchers have questioned whether a business case exists that supports this notion. We assess various barriers and incentives for using quality improvement to address racial and ethnic healthcare disparities in small-to-medium-sized practices. We believe that although both indirect and direct cost incentives may exist, a favorable business case for small private practices cannot be made unless there are additional financial incentives. The business community can work with health plans to provide these incentives. PMID:19024229

  15. Prioritizing health disparities in medical education to improve care

    PubMed Central

    Awosogba, Temitope; Betancourt, Joseph R.; Conyers, F. Garrett; Estapé, Estela S.; Francois, Fritz; Gard, Sabrina J.; Kaufman, Arthur; Lunn, Mitchell R.; Nivet, Marc A.; Oppenheim, Joel D.; Pomeroy, Claire; Yeung, Howa

    2015-01-01

    Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. PMID:23659676

  16. Prioritizing health disparities in medical education to improve care.

    PubMed

    Awosogba, Temitope; Betancourt, Joseph R; Conyers, F Garrett; Estapé, Estela S; Francois, Fritz; Gard, Sabrina J; Kaufman, Arthur; Lunn, Mitchell R; Nivet, Marc A; Oppenheim, Joel D; Pomeroy, Claire; Yeung, Howa

    2013-05-01

    Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. PMID:23659676

  17. Characterizing, modeling, and addressing gender disparities in introductory college physics

    NASA Astrophysics Data System (ADS)

    Kost-Smith, Lauren Elizabeth

    2011-12-01

    -affirmation was strongest for females who endorsed the stereotype that men do better than women in physics. The findings of this thesis suggest that there are multiple factors that contribute to the underperformance of females in physics. Establishing this model of gender differences is a first step towards increasing females' participation and performance in physics, and can be used to guide future interventions to address the disparities.

  18. Can pictorial warning labels on cigarette packages address smoking-related health disparities?: Field experiments in Mexico to assess warning label content

    PubMed Central

    Thrasher, James F.; Arillo-Santillán, Edna; Villalobos, Victor; Pérez-Hernández, Rosaura; Hammond, David; Carter, Jarvis; Sebrié, Ernesto; Sansores, Raul; Regalado-Piñeda, Justino

    2012-01-01

    Objective This study aimed to determine the most effective content of pictorial health warning labels (HWLs) and whether educational attainment moderates these effects. Methods Field experiments were conducted with 529 adult smokers and 530 young adults (258 nonsmokers; 271 smokers), wherein participants reported responses to different HWLs printed on cigarette packages. One experiment involved manipulating textual form (testimonial narrative vs didactic) and the other involved manipulating imagery type (diseased organs vs human suffering). Results Tests of mean ratings and rankings indicated that HWLs with didactic textual forms had equivalent or significantly higher credibility, relevance, and impact than HWLs with testimonial forms. Results from mixed-effects models confirmed these results. However, responses differed by participant educational attainment: didactic forms were consistently rated higher than testimonials among participants with higher education, whereas the difference between didactic and testimonial narrative forms was weaker or not statistically significant among participants with lower education. In the second experiment, with textual content held constant, greater credibility, relevance and impact was found for graphic imagery of diseased organs than imagery of human suffering. Conclusions Pictorial HWLs with didactic textual forms appear to work better than with testimonial narratives. Future research should determine which pictorial HWL content has the greatest real-world impact among consumers from disadvantaged groups, including assessment of how HWL content should change to maintain its impact as tobacco control environments strengthen and consumer awareness of smoking-related risks increases. PMID:22350859

  19. Health policy, disparities, and the kidney.

    PubMed

    Williams, Amy W

    2015-01-01

    Kidney care and public policy have been linked for 40 years, with various consequences to outcomes. The 1972 Social Security Amendment, Section 2991, expanded Medicare coverage for all modalities of dialysis and transplant services and non-kidney-related care to those with end-stage renal disease (ESRD) regardless of age. This first and only disease-specific entitlement program was a step toward decreasing disparities in access to care. Despite this, disparities in kidney disease outcomes continue as they are based on many factors. Over the last 4 decades, policies have been enacted to understand and improve the delivery of ESRD care. More recent policies include novel shared-risk payment models to ensure quality and decrease costs. This article discusses the impact or potential impact of selected policies on health disparities in advanced chronic kidney disease and ESRD. Although it is too early to know the consequences of newer policies (Affordable Care Act, ESRD Prospective Payment System, Quality Incentive Program, Accountable Care Organizations), their goal of improving access to timely patient-centered appropriate affordable and quality care should lessen the disparity gap. The Nephrology community must leverage this dynamic state of care-delivery model redesign to decrease kidney-related health disparities. PMID:25573513

  20. Using Genetic Technologies To Reduce, Rather Than Widen, Health Disparities.

    PubMed

    Smith, Caren E; Fullerton, Stephanie M; Dookeran, Keith A; Hampel, Heather; Tin, Adrienne; Maruthur, Nisa M; Schisler, Jonathan C; Henderson, Jeffrey A; Tucker, Katherine L; Ordovás, José M

    2016-08-01

    Evidence shows that both biological and nonbiological factors contribute to health disparities. Genetics, in particular, plays a part in how common diseases manifest themselves. Today, unprecedented advances in genetically based diagnoses and treatments provide opportunities for personalized medicine. However, disadvantaged groups may lack access to these advances, and treatments based on research on non-Hispanic whites might not be generalizable to members of minority groups. Unless genetic technologies become universally accessible, existing disparities could be widened. Addressing this issue will require integrated strategies, including expanding genetic research, improving genetic literacy, and enhancing access to genetic technologies among minority populations in a way that avoids harms such as stigmatization. PMID:27503959

  1. Socioeconomic Disparities and Health: Impacts and Pathways

    PubMed Central

    Kondo, Naoki

    2012-01-01

    Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997–98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society. PMID:22156290

  2. The Clinician's Role in Addressing Disparities in Tobacco Use.

    PubMed

    St Claire, Ann W; Boyle, Raymond G

    2015-10-01

    Although the overall smoking rate in Minnesota is now less than 15%, the rates among certain populations are much higher. For example, 60% of American Indian adults smoke. The rates are also higher for people with low incomes and little education, those who have a mental illness or are substance abusers, and those who are transgender or identify as lesbian, gay, bisexual, transgender or queer. With more people covered by health insurance and smoking-cessation treatment now included in insurance plans thanks to recent health care reforms, physicians and other members of the health care team have a new opportunity to address tobacco use This article discusses ways they can tailor the discussion as they seek to help patients in populations with the highest smoking rates. PMID:26596076

  3. Health disparities and gaps in school readiness.

    PubMed

    Currie, Janet

    2005-01-01

    The author documents pervasive racial disparities in the health of American children and analyzes how and how much those disparities contribute to racial gaps in school readiness. She explores a broad sample of health problems common to U.S. children, such as attention deficit hyperactivity disorder, asthma, and lead poisoning, as well as maternal health problems and health-related behaviors that affect children's behavioral and cognitive readiness for school. If a health problem is to affect the readiness gap, it must affect many children, it must be linked to academic performance or behavior problems, and it must show a racial disparity either in its prevalence or in its effects. The author focuses not only on the black-white gap in health status but also on the poor-nonpoor gap because black children tend to be poorer than white children. The health conditions Currie considers seriously impair cognitive skills and behavior in individual children. But most explain little of the overall racial gap in school readiness. Still, the cumulative effect of health differentials summed over all conditions is significant. Currie's rough calculation is that racial differences in health conditions and in maternal health and behaviors together may account for as much as a quarter of the racial gap in school readiness. Currie scrutinizes several policy steps to lessen racial and socioeconomic disparities in children's health and to begin to close the readiness gap. Increasing poor children's eligibility for Medicaid and state child health insurance is unlikely to be effective because most poor children are already eligible for public insurance. The problem is that many are not enrolled. Even increasing enrollment may not work: socioeconomic disparities in health persist in Canada and the United Kingdom despite universal public health insurance. The author finds more promise in strengthening early childhood programs with a built-in health component, like Head Start; family

  4. Addressing Geographic Disparities in Liver Transplantation through Redistricting

    PubMed Central

    Gentry, Sommer E.; Massie, Allan B.; Cheek, Sidney W.; Lentine, Krista L.; Chow, Eric K. H.; Wickliffe, Corey E.; Dzebashvili, Nino; Salvalaggio, Paolo R.; Schnitzler, Mark A.; Axelrod, David A.; Segev, Dorry L.

    2015-01-01

    Severe geographic disparities exist in liver transplantation; for patients with comparable disease severity, 90-day transplant rates range from 18%–86% and death rates range from 14%–82% across donor service areas (DSAs). Broader sharing has been proposed to resolve geographic inequity; however, we hypothesized that the efficacy of broader sharing depends on the geographic partitions used. To determine the potential impact of redistricting on geographic disparity in disease severity at transplantation, we combined existing DSAs into novel regions using mathematical redistricting optimization. Optimized maps and current maps were evaluated using the Liver Simulated Allocation Model. Primary analysis was based on 6700 deceased donors, 28,063 liver transplant candidates, and 242,727 Model of End-Stage Liver Disease (MELD) changes in 2010. Fully regional sharing within the current regional map would paradoxically worsen geographic disparity (variance in MELD at transplantation increases from 11.2 to 13.5, p=0.021), although it would decrease waitlist deaths (from 1368 to 1329, p=0.002). In contrast, regional sharing within an optimized map would significantly reduce geographic disparity (to 7.0, p=0.002) while achieving a larger decrease in waitlist deaths (to 1307, p=0.002). Redistricting optimization, but not broader sharing alone, would reduce geographic disparity in allocation of livers for transplant across the United States. PMID:23837931

  5. Achieving Health Equity: Closing The Gaps In Health Care Disparities, Interventions, And Research.

    PubMed

    Purnell, Tanjala S; Calhoun, Elizabeth A; Golden, Sherita H; Halladay, Jacqueline R; Krok-Schoen, Jessica L; Appelhans, Bradley M; Cooper, Lisa A

    2016-08-01

    In the United States, racial/ethnic minority, rural, and low-income populations continue to experience suboptimal access to and quality of health care despite decades of recognition of health disparities and policy mandates to eliminate them. Many health care interventions that were designed to achieve health equity fall short because of gaps in knowledge and translation. We discuss these gaps and highlight innovative interventions that help address them, focusing on cardiovascular disease and cancer. We also provide recommendations for advancing the field of health equity and informing the implementation and evaluation of policies that target health disparities through improved access to care and quality of care. PMID:27503965

  6. Complex systems thinking and current impasses in health disparities research.

    PubMed

    Diez Roux, Ana V

    2011-09-01

    Complex systems approaches have received increasing attention in public health because reductionist approaches yield limited insights in the context of dynamic systems. Most discussions have been highly abstract. There is a need to consider the application of complex systems approaches to specific research questions. I review the features of population health problems for which complex systems approaches are most likely to yield new insights, and discuss possible applications of complex systems to health disparities research. I provide illustrative examples of how complex systems approaches may help address unanswered and persistent questions regarding genetic factors, life course processes, place effects, and the impact of upstream policies. The concepts and methods of complex systems may help researchers move beyond current impasse points in health disparities research. PMID:21778505

  7. Bridging the healthcare divide with patient navigation: development of a research program to address disparities.

    PubMed

    Schwaderer, Karen A; Itano, Joanne K

    2007-10-01

    Americans who live in poverty as well as certain ethnic and racial groups have higher cancer death rates than other populations. Patient navigators have been identified as an important weapon against these disparities. Navigators can address insurance, financial, and logistical issues (e.g., transportation, appointment scheduling, child or elder care). They can provide understandable health education that may lessen fears of cancer diagnosis and treatment. This article describes the development and implementation of a multisite patient navigator program involving five cancer institutions in Western Pennsylvania. Navigator programs have great potential to enhance cancer care by reaching underserved populations and opening the door for future research. PMID:17962171

  8. Reducing asthma disparities by addressing environmental inequities: a case study of regional asthma management and prevention's advocacy efforts.

    PubMed

    Lamb, Anne Kelsey; Ervice, Joel; Lorenzen, Kathryn; Prentice, Bob; White, Shannon

    2011-01-01

    Regional Asthma Management and Prevention describes its collaborative approach to address a social determinant of health--air quality--and the associated inequities that have led to asthma disparities impacting African American and Latino communities in the San Francisco Bay Area. The strategies, aimed at decreasing diesel pollution in disproportionately impacted communities, span the levels of the socioecological model, with an emphasis on policy outcomes. Regional Asthma Management and Prevention describes how this work fits within a larger comprehensive approach to address asthma disparities encompassing several components, ranging from clinical management to environmental protection. PMID:21160331

  9. The challenges of transdisciplinary research in health disparities: the early experiences of the centers for population health and health disparities

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In 2003, NIH funded 8 Centers for Population Health and Health Disparities (CPHHD). The mission of these centers is to understand and reduce health disparities using a transdisciplinary approach with community partners as co-investigators. The present study aims to identify early challenges experi...

  10. Disparities in access to reproductive health options for female adolescents.

    PubMed

    Ely, Gretchen E; Dulmus, Catherine N

    2010-05-01

    Fifty percent of female adolescents in the United States have intercourse by age 17, yet they do not have the autonomy under the law to access reproductive healthcare services that can address and prevent the negative consequences often associated with adolescent involvement in sexual activity. This article discusses disparities in access to reproductive health services for adolescents in three areas: abortion, over-the-counter emergency contraception, and the provision of the human papillomavirus vaccine. Suggestions for advocacy efforts necessary to eliminate such health disparities are also presented in an effort to elevate female adolescents to a status where they have the same access to health services that are available to adult women. PMID:20446180

  11. The A's, G's, C's, and T's of health disparities

    PubMed Central

    Ramos, Edward; Rotimi, Charles

    2009-01-01

    In order to eliminate health disparities in the United States, more efforts are needed to address the breadth of social issues directly contributing to the healthy divide observed across racial and ethnic groups. Socioeconomic status, education, and the environment are intimately linked to health outcomes. However, with the tremendous advances in technology and increased investigation into human genetic variation, genomics is poised to play a valuable role in bolstering efforts to find new treatments and preventions for chronic conditions and diseases that disparately affect certain ethnic groups. Promising studies focused on understanding the genetic underpinnings of diseases such as prostate cancer or beta-blocker treatments for heart failure are illustrative of the positive contribution that genomics can have on improving minority health. PMID:19463148

  12. Finding a place for genomics in health disparities research.

    PubMed

    Fullerton, S M; Knerr, S; Burke, W

    2012-01-01

    The existence of pronounced differences in health outcomes between US populations is a problem of moral significance and public health urgency. Pursuing research on genetic contributors to such disparities, despite striking data on the fundamental role of social factors, has been controversial. Still, advances in genomic science are providing an understanding of disease biology at a level of precision not previously possible. The potential for genomic strategies to help in addressing population-level disparities therefore needs to be carefully evaluated. Using 3 examples from current research, we argue that the best way to maximize the benefits of population-based genomic investigations, and mitigate potential harms, is to direct research away from the identification of genetic causes of disparities and instead focus on applying genomic methodologies to the development of clinical and public health tools with the potential to ameliorate healthcare inequities, direct population-level health interventions or inform public policy. Such a transformation will require close collaboration between transdisciplinary teams and community members as well as a reorientation of current research objectives to better align genomic discovery efforts with public health priorities and well-recognized barriers to fair health care delivery. PMID:22488458

  13. Maryland's Special Populations Cancer Network: cancer health disparities reduction model.

    PubMed

    Baquet, Claudia R; Mack, Kelly M; Bramble, Joy; DeShields, Mary; Datcher, Delores; Savoy, Mervin; Hummel, Kery; Mishra, Shiraz I; Brooks, Sandra E; Boykin-Brown, Stephanie

    2005-05-01

    Cancer in Maryland is a serious health concern for minority and underserved populations in rural and urban areas. This report describes the National Cancer Institute (NCI) supported Maryland Special Populations Cancer Network (MSPN), a community-academic partnership. The MSPN's priority populations include African Americans, Native Americans, and other medically underserved residents of rural and urban areas. The MSPN has established a community infrastructure through formal collaborations with several community partners located in Baltimore City, the rural Eastern Shore, and Southern and Western Maryland, and among the Piscataway Conoy Tribe and the other 27 Native American Tribes in Maryland. Key partners also include the University of Maryland Eastern Shore and the University of Maryland Statewide Health Network. The MSPN has implemented innovative and successful programs in cancer health disparities research, outreach, and training; clinical trials education, health disparities policy, and resource leveraging. The MSPN addresses the goal of the NCI and the Department of Health and Human Services (DHHS) to reduce and eventually eliminate cancer health disparities. Community-academic partnerships are the foundation of this successful network. PMID:15937382

  14. The human face of health disparities.

    PubMed

    Green, Alexander R

    2003-01-01

    In the last 20 years, the issue of disparities in health between racial/ethnic groups has moved from the realm of common sense and anecdote to the realm of science. Hard, cold data now force us to consider what many had long taken for granted. Not only does health differ by race/ethnicity, but our health care system itself is deeply biased. From lack of diversity in the leadership and workforce, to ethnocentric systems of care, to biased clinical decision-making, the American health care system is geared to treat the majority, while the minority suffers. The photos shown here are of patients and scenes that recall some of the important landmarks in research on racial/ethnic disparities in health. The purpose is to put faces and humanity onto the numbers. While we now have great bodies of evidence upon which to lobby for change, in the end, each statistic still represents a personal tragedy or an individual triumph. PMID:12815077

  15. National newspaper coverage of minority health disparities.

    PubMed Central

    Amzel, Anouk; Ghosh, Chandak

    2007-01-01

    OBJECTIVES: To assess American newspaper coverage regarding racial and ethnic minority health disparities (MHDs). METHODS: LexisNexis was queried with specific word combinations to elicit all MHD articles printed in 257 newspapers from 2000-2004. The full texts were read and articles categorized by racial/ethnic group and specific MHD topics mentioned. RESULTS: In the five years from 2000-2004, 1188 MHD articles were published, representing 0.09% of all articles about health. Newspapers gave much attention to MHD when discussed in conferences and meetings and speeches by senior health officials and politicians. Cancer, cardiovascular disease and HIV/AIDS were most frequent among disease-specific mentions. Articles about African Americans comprised 60.4% of all race/ethnicity-mentioning articles. CONCLUSIONS: Despite the release of major organizational reports and the publication of many studies confirming the prevalence of MHD, few newspaper articles have been published explaining MHD to the public. Because of the general public's low rate of health literacy, the health world should collaborate with the media to present a consistent, simple message concerning gaps in care experienced by all racial/ethnic minority groups. In a time of consumer-directed healthcare, if Americans understand that MHDs exist, they may galvanize to advocate for disparity elimination and quality improvement. PMID:17987915

  16. Reparable Harm: Assessing and Addressing Disparities Faced by Boys and Men of Color in California. Monograph

    ERIC Educational Resources Information Center

    Davis, Lois M.; Kilburn, M. Rebecca; Schultz, Dana J.

    2009-01-01

    The study identifies some of the greatest disparities for boys and men of color relative to their white counterparts across specific socioeconomic, health, safety, and school readiness indicators in California and provides information about different strategies for reducing the disparities--including effective programs, practices, and…

  17. Partnerships to Address Obesity Disparities in Hawai`i: The PILI `Ohana Project

    PubMed Central

    Nacapoy, Andrea H.; Kaholokula, Joseph Keawe`aimoku; West, Margaret R.; Dillard, Adrienne Y.; Leake, Anne; Kekauoha, B. Puni; Palakiko, Donna-Marie; Siu, Andrea; Mosier, Sean W.; Mau, Marjorie K.

    2008-01-01

    Community-based participatory research (CBPR) is an approach to scientific research that is gaining broader application to address persistent problems in health care disparities and other hypothesis-driven research. However, information on how to form CBPR community-academic partnerships and how to best involve community partners in scientific research is not well-defined. The purpose of this paper is to share the experience of the Partnership for Improving Lifestyle Interventions (PILI) `Ohana Project in forming a co-equal CBPR community-academic partnership that involved 5 different community partners in a scientific research study to address obesity disparities in Native Hawaiians and other Pacific Peoples (i.e., Samoans, Chuukese, and Filipinos). Specifically, the paper discusses 1) the formation of our community-academic partnership including identification of the research topic; 2) the development of the CBPR infrastructure to foster a sustainable co-equal research environment; and 3) the collaboration in designing a community-based and community-led intervention. The paper concludes with a brief summary of the authors' thoughts about CBPR partnerships from both the academic and community perspectives. PMID:18853898

  18. Measuring Early Childhood Health and Health Disparities: A New Approach

    PubMed Central

    Hillemeier, Marianne M.; Lanza, Stephanie T.; Landale, Nancy S.; Oropesa, R. S.

    2012-01-01

    Objective Efforts to improve the health of U.S. children and reduce disparities have been hampered by lack of a rigorous way to summarize the multi-dimensional nature of children’s health. This research employed a novel statistical approach to measurement to provide an integrated, comprehensive perspective on early childhood health and disparities. Methods Nationally-representative data (n=8,800) came from the Early Childhood Longitudinal Study, Birth Cohort. Latent class analysis (LCA) was used to classify health at 48 months, incorporating health conditions, functioning, and aspects of physical, cognitive, and emotional development. Health disparities by gender, poverty, race/ethnicity, and birthweight were examined. Results Over half of all children were classified as healthy using multidimensional latent class methodology; others fell into one of seven less optimal health statuses. The analyses highlighted pervasive disparities in health, with poor children at increased risk of being classified into the most disadvantaged health status consisting of chronic conditions and a cluster of developmental problems including low cognitive achievement, poor social skills, and behavior problems. Children with very low birthweight had the highest rate of being in the most disadvantaged health status (25.2%), but moderately low birthweight children were also at elevated risk (7.9% versus 3.4% among non-low birthweight children). Conclusions Latent class analysis provides a uniquely comprehensive picture of child health and health disparities that identifies clusters of problems experienced by some groups. The findings underscore the importance of continued efforts to reduce preterm birth, and to ameliorate poverty’s effects on children’s health through access to high-quality healthcare and other services. PMID:23225206

  19. Improving Service Coordination and Reducing Mental Health Disparities Through Adoption of Electronic Health Records

    PubMed Central

    McGregor, Brian; Mack, Dominic; Wrenn, Glenda; Shim, Ruth S.; Holden, Kisha; Satcher, David

    2015-01-01

    Despite widespread support for removing barriers to the use of electronic health records (EHRs) in behavioral health care, adoption of EHRs in behavioral health settings lags behind adoption in other areas of health care. The authors discuss barriers to use of EHRs among behavioral health care practitioners, suggest solutions to overcome these barriers, and describe the potential benefits of EHRs to reduce behavioral health care disparities. Thoughtful and comprehensive strategies will be needed to design EHR systems that address concerns about policy, practice, costs, and stigma and that protect patients’ privacy and confidentiality. However, these goals must not detract from continuing to challenge the notion that behavioral health and general medical health should be treated as separate and distinct. Ultimately, utilization of EHRs among behavioral health care providers will improve the coordination of services and overall patient care, which is essential to reducing mental health disparities. PMID:25975885

  20. Confronting Health Disparities: Latin American Social Medicine in Venezuela

    PubMed Central

    Mantini-Briggs, Clara

    2009-01-01

    Objectives. We explored the emergence and effectiveness of Venezuela's Misión Barrio Adentro, “Inside the Neighborhood Mission,” a program designed to improve access to health care among underserved residents of the country, hoping to draw lessons to apply to future attempts to address acute health disparities. Methods. We conducted our study in 3 capital-region neighborhoods, 2 small cities, and 2 rural areas, combining systematic observations with interviews of 221 residents, 41 health professionals, and 28 government officials. We surveyed 177 female and 91 male heads of household. Results. Interviews suggested that Misión Barrio Adentro emerged from creative interactions between policymakers, clinicians, community workers, and residents, adopting flexible, problem-solving strategies. In addition, data indicated that egalitarian physician–patient relationships and the direct involvement of local health committees overcame distrust and generated popular support for the program. Media and opposition antagonism complicated physicians’ lives and clinical practices but heightened the program's visibility. Conclusions. Top-down and bottom-up efforts are less effective than “horizontal” collaborations between professionals and residents in underserved communities. Direct, local involvement can generate creative and dynamic efforts to address acute health disparities in these areas. PMID:19150916

  1. The Current Scope of Health Disparities in the U.S.: A Review of Literature

    ERIC Educational Resources Information Center

    Pettit, Michele L.; Nienhaus, Alyson R.

    2010-01-01

    This review of literature examines leading contributors and mediators of health disparities in the United States. Specifically, poverty, education, and health are addressed. Special emphasis is placed on implications of health risk behaviors and health education for select populations and settings. Existing and suggested strategies for addressing…

  2. Knowledge and Behavioral Effects in Cardiovascular Health: Community Health Worker Health Disparities Initiative, 2007–2010

    PubMed Central

    Hurtado, Margarita; Yang, Manshu; Evensen, Christian; Windham, Amy; Ortiz, Gloria; Tracy, Rachel; Ivy, Edward Donnell

    2014-01-01

    Introduction Cardiovascular disease is the leading cause of death in the United States, and disparities in cardiovascular health exist among African Americans, American Indians, Hispanics, and Filipinos. The Community Health Worker Health Disparities Initiative of the National Heart, Lung, and Blood Institute (NHLBI) includes culturally tailored curricula taught by community health workers (CHWs) to improve knowledge and heart-healthy behaviors in these racial/ethnic groups. Methods We used data from 1,004 community participants in a 10-session curriculum taught by CHWs at 15 sites to evaluate the NHLBI’s health disparities initiative by using a 1-group pretest–posttest design. The curriculum addressed identification and management of cardiovascular disease risk factors. We used linear mixed effects and generalized linear mixed effects models to examine results. Results Average participant age was 48; 75% were female, 50% were Hispanic, 35% were African American, 8% were Filipino, and 7% were American Indian. Twenty-three percent reported a history of diabetes, and 37% reported a family history of heart disease. Correct pretest to posttest knowledge scores increased from 48% to 74% for heart healthy knowledge. The percentage of participants at the action or maintenance stage of behavior change increased from 41% to 85%. Conclusion Using the CHW model to implement community education with culturally tailored curricula may improve heart health knowledge and behaviors among minorities. Further studies should examine the influence of such programs on clinical risk factors for cardiovascular disease. PMID:24524426

  3. Biomarkers of psychological stress in health disparities research

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Health disparities in the United States have been documented in population groups defined by SES, ethnicity and/or race. The etiology of these health disparities is multifacted and complex. While some factors, such as access to care, may have obvious effects on health, the contribution of psycholo...

  4. Expanding the frame of understanding health disparities: from a focus on health systems to social and economic systems.

    PubMed

    Smedley, Brian D

    2006-08-01

    Policy makers are increasingly attending to the problem of racial and ethnic health disparities, but much of this focus has been on evidence of inequality in health care systems. This attention is important and laudable, but eliminating inequality in the health care system would be insufficient to eliminate racial and ethnic disparities and improve the health of all Americans. Social and economic factors, such as disadvantaged socioeconomic status, racism, discrimination, and geographic inequality shape virtually all risks for poor health. Interventions that focus solely on improving access to health care, or on reducing individual behavioral and psychosocial risks, therefore have limited potential to reduce racial and ethnic health disparities. The elimination of health disparities requires comprehensive, intensive strategies that address inequality in many sectors, including housing, education, employment, and health systems. These interventions must be targeted at many levels, including individuals and families, workplaces, schools, and communities. PMID:16878351

  5. Ethnicity and Health Disparities in Alcohol Research

    PubMed Central

    Chartier, Karen; Caetano, Raul

    2010-01-01

    Recent advances in alcohol research continue to build our understanding of alcohol consumption and related consequences for U.S. ethnic minority groups. National surveys show variations across ethnicities in drinking, alcohol use disorders, alcohol problems, and treatment use. Higher rates of high-risk drinking among ethnic minorities are reported for Native Americans and Hispanics, although within-ethnic group differences (e.g., gender, age-group, and other subpopulations) also are evident for ethnicities. Whites and Native Americans have a greater risk for alcohol use disorders relative to other ethnic groups. However, once alcohol dependence occurs, Blacks and Hispanics experience higher rates than Whites of recurrent or persistent dependence. Furthermore, the consequences of drinking appear to be more profound for Native Americans, Hispanics, and Blacks. Disparities in alcohol treatment utilization are most apparent for Hispanics. Explanations for these differences are complex, likely affected by risky drinking behaviors, immigration experiences, racial/ethnic discrimination, economic and neighborhood disadvantage, and variations in alcohol-metabolizing genes. Research must maintain a systematic, strong, and growing focus on ethnic minorities. A more complete understanding of these effects for ethnic minority groups is needed to enable researchers to face the challenges of reducing and ultimately eliminating health disparities in the alcohol field. PMID:21209793

  6. Disparities in Health Care Quality among Minority Women

    MedlinePlus

    ... 3-EF Go to Online Store Disparities in Health Care Quality Among Minority Women Selected Findings From the ... race and ethnicity are combined. Return to Contents Health Care Delivery and Systems Information about health care delivery ...

  7. Where health disparities begin: the role of social and economic determinants--and why current policies may make matters worse.

    PubMed

    Woolf, Steven H; Braveman, Paula

    2011-10-01

    Health disparities by racial or ethnic group or by income or education are only partly explained by disparities in medical care. Inadequate education and living conditions-ranging from low income to the unhealthy characteristics of neighborhoods and communities-can harm health through complex pathways. Meaningful progress in narrowing health disparities is unlikely without addressing these root causes. Policies on education, child care, jobs, community and economic revitalization, housing, transportation, and land use bear on these root causes and have implications for health and medical spending. A shortsighted political focus on reducing spending in these areas could actually increase medical costs by magnifying disease burden and widening health disparities. PMID:21976326

  8. Racial and Ethnic Disparities in the Quality of Health Care.

    PubMed

    Fiscella, Kevin; Sanders, Mechelle R

    2016-01-01

    The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities. PMID:26789384

  9. A New Online Strategy in Teaching Racial and Ethnic Health and Health Disparities to Public Health Professionals.

    PubMed

    Bailey, Eric; Moore, Justin; Joyner, Shanekia

    2016-09-01

    In the fall 2010, East Carolina University's Department of Public Health in the Brody School of Medicine introduced a new graduate certificate online program to its curriculum-the Ethnic and Rural Health Disparities (ERHD) program. By the spring 2014, the Ethnic and Rural Health Disparities (ERHD) program graduated 20 public health professionals with expertise in ethnic and rural health disparities. In order to examine its effectiveness, we conducted a qualitative and quantitative study of our graduates. The major objectives of our ERHD alumni study were: (1) to evaluate the effectiveness of the ERHD program, and (2) to assess new strategies for improving our ERHD program. Quantitative and qualitative results from our small sample of alumni indicate that the ERHD program is fulfilling its objectives. The ERHD program has developed a new online strategy in teaching racial and ethnic health and health disparities for public health professionals who are ready to not only address health disparities in a different approach but also ready to develop new culturally competent public health programs for increasing diverse racial, ethnic, and rural populations in the U.S.A. PMID:27294738

  10. Reducing Health Disparities: The Perfect Fit for Counseling Psychology

    ERIC Educational Resources Information Center

    Buki, Lydia P.

    2007-01-01

    This reaction to the Major Contribution presents a conceptualization of health disparities as another form of oppression of marginalized populations in our society. Consistent with this view, health disparities are then situated within a larger, national context, showing that counseling psychologists' involvement is an integral part of a…

  11. Leveraging Health IT to Reduce Disparities in Three Underserved Beacon Communities.

    PubMed

    Des Jardins, Terrisca; Drone, Shenetta A; Hashisaka, Susan; Hazzard, Jobyna; Hunt, Susan B; Massey, Kimberly; Rein, Alison; Schachter, Abigail; Turske, Scott

    2016-01-01

    Using health information technology (IT) can potentially address health disparities by increasing access to care, delivering higher-quality care, improving patient-provider communication, and enhancing patient safety. It describes challenges encountered by three underserved Beacon Communities that implemented health IT interventions, including inadequate connectivity infrastructure, technical support, expertise, and financial resources; provider shortages and staff turnover; and equipment theft. PMID:27180682

  12. Health disparities and culturally specific treatment: perspectives and expectancies of African American smokers.

    PubMed

    Webb, Monica S; Francis, Joan; Hines, Bill C; Quarles, Frankie B

    2007-06-01

    Researchers suggest that culturally specific (CS) interventions are important in addressing smoking-related health disparities. Yet, little research has examined the perspectives of African American smokers regarding these efforts. This qualitative study sought to gain insight into perceptions related to (a) the smoking prevalence among African Americans, (b) smoking-related health disparities, (c) expectancies for CS interventions, (d) methods of recruiting research participants, and (e) key intervention components. Six focus groups were conducted with 41 African American smokers (aged 21-64) at a community health center. Content analyses revealed several themes, including the perception that smoking is normative among African Americans, limited knowledge of racial health disparities, mixed perceptions regarding race as a risk factor for illness, and mixed expectancies for the efficacy of CS interventions. In conclusion, individual differences, such as smoking norms, knowledge of health disparities, and intervention expectations may influence receptivity to CS treatments. Implications for tobacco interventions among African Americans are discussed. PMID:17457845

  13. Quality of care and racial health disparities: a strategic overview.

    PubMed

    Chassin, Mark R; Anderson, Rebecca M

    2008-01-01

    Substantial racial and ethnic disparities in health and health care exist in the United States. The Department of Health Policy at the Mount Sinai School of Medicine has developed a strategy for reducing those disparities that builds upon its quality improvement experience. This article discusses the utility of applying quality improvement principles to the development of interventions to eliminate underuse of effective treatments and reduce the disparities that may arise from this quality problem. We present a conceptual model of racial disparities in health and our underuse hypothesis. Parallels between our disparities research strategy and six sigma quality improvement methods are described. Finally, the article provides an example of how we have been able to successfully implement proven-effective health improvement programs in the Harlem community even after grant funding has ended. PMID:18306237

  14. Sociopsychological Tailoring to Address Colorectal Cancer Screening Disparities: A Randomized Controlled Trial

    PubMed Central

    Jerant, Anthony; Kravitz, Richard L.; Sohler, Nancy; Fiscella, Kevin; Romero, Raquel L.; Parnes, Bennett; Tancredi, Daniel J.; Aguilar-Gaxiola, Sergio; Slee, Christina; Dvorak, Simon; Turner, Charles; Hudnut, Andrew; Prieto, Francisco; Franks, Peter

    2014-01-01

    PURPOSE Interventions tailored to sociopsychological factors associated with health behaviors have promise for reducing colorectal cancer screening disparities, but limited research has assessed their impact in multiethnic populations. We examined whether an interactive multimedia computer program (IMCP) tailored to expanded health belief model sociopsychological factors could promote colorectal cancer screening in a multiethnic sample. METHODS We undertook a randomized controlled trial, comparing an IMCP tailored to colorectal cancer screening self-efficacy, knowledge, barriers, readiness, test preference, and experiences with a nontailored informational program, both delivered before office visits. The primary outcome was record-documented colorectal cancer screening during a 12-month follow-up period. Secondary outcomes included postvisit sociopsychological factor status and discussion, as well as clinician recommendation of screening during office visits. We enrolled 1,164 patients stratified by ethnicity and language (49.3% non-Hispanic, 27.2% Hispanic/English, 23.4% Hispanic/Spanish) from 26 offices around 5 centers (Sacramento, California; Rochester and the Bronx, New York; Denver, Colorado; and San Antonio, Texas). RESULTS Adjusting for ethnicity/language, study center, and the previsit value of the dependent variable, compared with control patients, the IMCP led to significantly greater colorectal cancer screening knowledge, self-efficacy, readiness, test preference specificity, discussion, and recommendation. During the followup period, 132 (23%) IMCP and 123 (22%) control patients received screening (adjusted difference = 0.5 percentage points, 95% CI −4.3 to 5.3). IMCP effects did not differ significantly by ethnicity/language. CONCLUSIONS Sociopsychological factor tailoring was no more effective than nontailored information in encouraging colorectal cancer screening in a multiethnic sample, despite enhancing sociopsychological factors and visit

  15. Use of Evidence-Based Interventions to Address Disparities in Colorectal Cancer Screening.

    PubMed

    Joseph, Djenaba A; Redwood, Diana; DeGroff, Amy; Butler, Emily L

    2016-02-12

    Colorectal cancer (CRC) is the second leading cause of cancer death among cancers that affect both men and women. Despite strong evidence of their effectiveness, CRC screening tests are underused. Racial/ethnic minority groups, persons without insurance, those with lower educational attainment, and those with lower household income levels have lower rates of CRC screening. Since 2009, CDC's Colorectal Cancer Control Program (CRCCP) has supported state health departments and tribal organizations in implementing evidence-based interventions (EBIs) to increase use of CRC screening tests among their populations. This report highlights the successful implementation of EBIs to address disparities by two CRCCP grantees: the Alaska Native Tribal Health Consortium (ANTHC) and Washington State's Breast, Cervical, and Colon Health Program (BCCHP). ANTHC partnered with regional tribal health organizations in the Alaska Tribal Health System to implement provider and client reminders and use patient navigators to increase CRC screening rates among Alaska Native populations. BCCHP identified patient care coordinators in each clinic who coordinated staff training on CRC screening and integrated client and provider reminder systems. In both the Alaska and Washington programs, instituting provider reminder systems, client reminder systems, or both was facilitated by use of electronic health record systems. Using multicomponent interventions in a single clinical site or facility can support more organized screening programs and potentially result in greater increases in screening rates than relying on a single strategy. Organized screening systems have an explicit policy for screening, a defined target population, a team responsible for implementation of the screening program, and a quality assurance structure. Although CRC screening rates in the United States have increased steadily over the past decade, this increase has not been seen equally across all populations. Increasing the

  16. Measuring trends in racial/ ethnic health care disparities.

    PubMed

    Lê Cook, Benjamin; McGuire, Thomas G; Zuvekas, Samuel H

    2009-02-01

    Monitoring disparities over time is complicated by the varying disparity definitions applied in the literature. This study used data from the 1996-2005 Medical Expenditure Panel Survey (MEPS) to compare trends in disparities by three definitions of racial/ethnic disparities and to assess the influence of changes in socioeconomic status (SES) among racial/ethnic minorities on disparity trends. This study prefers the Institute of Medicine's (IOM) definition, which adjusts for health status but allows for mediation of racial/ethnic disparities through SES factors. Black-White disparities in having an office-based or outpatient visit and medical expenditure were roughly constant and Hispanic-White disparities increased for office-based or outpatient visits and for medical expenditure between 1996-1997 and 2004-2005. Estimates based on the independent effect of race/ethnicity were the most conservative accounting of disparities and disparity trends, underlining the importance of the role of SES mediation in the study of trends in disparities. PMID:18796581

  17. The role that graduate medical education must play in ensuring health equity and eliminating health care disparities.

    PubMed

    Maldonado, Maria E; Fried, Ethan D; DuBose, Thomas D; Nelson, Consuelo; Breida, Margaret

    2014-05-01

    Despite the 2002 Institute of Medicine report that described the moral and financial impact of health care disparities and the need to address them, it is evident that health care disparities persist. Recommendations for addressing disparities include collecting and reporting data on patient race and ethnicity, supporting language interpretation services, increasing awareness of health care disparities through education, requiring cultural competency training for all health care professionals, and increasing diversity among those delivering health care. The Accreditation Council on Graduate Medical Education places strong emphasis on graduate medical education's role in eliminating health care disparities by asking medical educators to objectively evaluate and report on their trainees' ability to practice patient-centered, culturally competent care. Moreover, one of the objectives of the Accreditation Council on Graduate Medical Education Clinical Learning Environment Review visits as part of the Next Accreditation System is to identify how sponsoring institutions engage residents and fellows in the use of data to improve systems of care, reduce health care disparities, and improve patient outcomes. Residency and fellowship programs should ensure the delivery of meaningful curricula on cultural competency and health care disparities, for which there are numerous resources, and ensure resident assessment of culturally competent care. Moreover, training programs and institutional leadership need to collaborate on ensuring data collection on patient satisfaction, outcomes, and quality measures that are broken down by patient race, cultural identification, and language. A diverse physician workforce is another strategy for mitigating health care disparities, and using strategies to enhance faculty diversity should also be a priority of graduate medical education. Transparent data about institutional diversity efforts should be provided to interested medical students

  18. Intervention Approaches for Addressing Breast Cancer Disparities among African American Women

    PubMed Central

    Coughlin, Steven S

    2014-01-01

    African American women in the U.S. have a higher mortality rate from breast cancer than white women. Black-white differences in survival persist even after accounting for disease stage and tumor characteristics suggesting that the higher rates of breast cancer mortality are due to social factors. Several factors may account for racial differences in breast cancer mortality including socioeconomic factors, access to screening mammography and timely treatment, and biological factors. Efforts to prevent deaths from breast cancer and to address breast cancer disparities have focused on early detection through routine mammography and timely referral for treatment. There is a need for culturally appropriate, tailored health messages for African American women to increase their knowledge and awareness of health behaviors for the early detection of breast cancer. Several promising intervention approaches are reviewed in this article including: 1) the use of cell phone text messaging and smart phone apps to increase breast cancer screening; 2) the use of radio stations that target African American audiences (“black radio”) for health promotion activities; and 3) church-based behavioral interventions to promote breast cancer screening among African American women. PMID:25568890

  19. Overcoming the Triad of Rural Health Disparities: How Local Culture, Lack of Economic Opportunity, and Geographic Location Instigate Health Disparities

    ERIC Educational Resources Information Center

    Thomas, Tami L.; DiClemente, Ralph; Snell, Samuel

    2014-01-01

    Objective: To discuss how the effects of culture, economy, and geographical location intersect to form a gestalt triad determining health-related disparities in rural areas. Methods: We critically profile each component of the deterministic triad in shaping current health-related disparities in rural areas; evaluate the uniquely composed…

  20. Establishing the Infrastructure to Comprehensively Address Cancer Disparities: A Model for Transdisciplinary Approaches

    PubMed Central

    Green, B. Lee; Rivers, Desiree A.; Kumar, Nagi; Baldwin, Julie; Rivers, Brian M.; Sultan, Dawood; Jacobsen, Paul; Gordon, Leslene E.; Davis, Jenna; Roetzheim, Richard

    2014-01-01

    Summary The Center for Equal Health (CEH), a transdisciplinary Center of Excellence, was established to investigate cancer disparities comprehensively and achieve health equity through research, education, training, and community outreach. This paper discusses challenges faced by CEH, strategies employed to foster collaborations, lessons learned, and future considerations for establishing similar initiatives. PMID:24185157

  1. Disparities in academic achievement and health: the intersection of child education and health policy.

    PubMed

    Fiscella, Kevin; Kitzman, Harriet

    2009-03-01

    Recent data suggest that that the United States is failing to make significant progress toward the Healthy People 2010 goal of eliminating health disparities. One missing element from the US strategy for achieving this goal is a focus on gaps in child development and achievement. Academic achievement and education seem to be critical determinants of health across the life span and disparities in one contribute to disparities in the other. Despite these linkages, national policy treats child education and health as separate. Landmark education legislation, the No Child Left Behind Act of 2001, is due for Congressional reauthorization. It seeks to eliminate gaps in academic child achievement by 2014. It does so by introducing accountability for states, school districts, and schools. In this special article, we review health disparities and contributors to child achievement gaps. We review changes in achievement gaps over time and potential contributors to the limited success of the No Child Left Behind Act of 2001, including its unfunded mandates and unfounded assumptions. We conclude with key reforms, which include addressing gaps in child school readiness through adequate investment in child health and early education and reductions in child poverty; closing the gap in child achievement by ensuring equity in school accountability standards; and, importantly, ensuring equity in school funding so that resources are allocated on the basis of the needs of the students. This will ensure that schools, particularly those serving large numbers of poor and minority children, have the resources necessary to promote optimal learning. PMID:19255042

  2. Tailored Interactive Multimedia Computer Programs to Reduce Health Disparities: Opportunities and Challenges

    PubMed Central

    Jerant, Anthony; Sohler, Nancy; Fiscella, Kevin; Franks, Becca; Franks, Peter

    2010-01-01

    Objective To review the theory and research evidence suggesting that tailored interactive multimedia computer programs (IMCPs) aimed at optimizing patient health behaviors could lessen socio-demographic health disparities. Methods Selective critical review of research regarding IMCPs tailored to psychological mediators of behavior and their effects on health behavior and outcomes among socio-demographically disadvantaged patients. Results Tailored IMCPs can address patient factors (e.g. language barriers, low self-efficacy) and buffer provider (e.g. cognitive bias) and health system (e.g. office visit time constraints) factors that contribute to poor provider-patient communication and, thereby, suboptimal health behaviors. Research indicates disadvantaged individuals' interactions with providers are disproportionately affected by such factors, and that their behaviors respond favorably to tailored information, thus suggesting tailored IMCPs could mitigate disparities. However, no randomized controlled trials (RCTs) have examined this question. The optimal design and deployment of tailored IMCPs for disadvantaged patients also requires further study. Conclusion Preliminary research suggests tailored IMCPs have the potential to reduce health disparities. RCTs designed expressly to examine this issue are warranted. Practice Implications Many socio-demographic health disparities exist, and there is a dearth of proven disparity-reducing interventions. Thus, if tailored IMCPs were shown to lessen disparities, the public health implications would be considerable. PMID:21146950

  3. Summary of CDC consultation to address social determinants of health for prevention of disparities in HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis. December 9-10, 2008.

    PubMed

    Sharpe, Tanya Telfair; Harrison, Kathleen McDavid; Dean, Hazel D

    2010-01-01

    In December 2008, the Centers for Disease Control and Prevention (CDC) convened a meeting of national public health partners to identify priorities for addressing social determinants of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB). The consultants were divided into four working groups: (1) public health policy, (2) data systems, (3) agency partnerships and prevention capacity building, and (4) prevention research and evaluation. Groups focused on identifying top priorities; describing activities, methods, and metrics to implement priorities; and identifying partnerships and resources required to implement priorities. The meeting resulted in priorities for public health policy, improving data collection methods, enhancing existing and expanding future partnerships, and improving selection criteria and evaluation of evidence-based interventions. CDC is developing a national communications plan to guide and inspire action for keeping social determinants of HIV/AIDS, viral hepatitis, STDs, and TB in the forefront of public health activities. PMID:20626189

  4. Development of a dynamic model to guide health disparities research.

    PubMed

    Rew, Lynn; Hoke, Mary M; Horner, Sharon D; Walker, Lorraine

    2009-01-01

    Various populations experience health disparities related to risk factors such as gender, race or ethnicity, educational level, income level, and geographic location. These populations often experience barriers to access and utilization of services, which can lead to adverse health outcomes. Health promotion interventions developed within the context of communities represent resources that may offer protection to these populations. The purpose of this article is to describe the evolution of a conceptual model for the study of health disparities. The model, based on a review of literature, was developed to guide 19 pilot studies funded by the Texas-New Mexico P20 Southwest Partnership Center for Nursing Research on Health Disparities. Reflection on these studies, their respective methodologies, and findings resulted in a revised model to guide further studies of communities experiencing health disparities. PMID:19447233

  5. The urban context: a place to eliminate health disparities and build organizational capacity.

    PubMed

    Gilbert, Keon L; Quinn, Sandra Crouse; Ford, Angela F; Thomas, Stephen B

    2011-01-01

    This study seeks to examine the process of building the capacity to address health disparities in several urban African American neighborhoods. An inter-organizational network consisting of a research university, community members, community organizations, media partners, and foundations was formed to develop a community-based intervention designed to provide health promotion and disease prevention strategies for type 2 diabetes and hypertension. In-depth qualitative interviews (n = 18) with foundation executives and project directors, civic organization leadership, community leaders, county epidemiologist, and university partners were conducted. Our study contextualizes a process to build a public health partnership using cultural, community, organizational, and societal factors necessary to address health disparities. Results showed 5 important factors to build organizational capacity: leadership, institutional commitment, trust, credibility, and inter-organizational networks. These factors reflected other important organizational and community capacity indicators such as: community context, organizational policies, practices and structures, and the establishment of new commitments and partnerships important to comprehensively address urban health disparities. Understanding these factors to address African American health disparities will provide lessons learned for health educators, researchers, practitioners, foundations, and communities interested in building and sustaining capacity efforts through the design, implementation, and maintenance of a community-based health promotion intervention. PMID:21271434

  6. Social Determinants of Racial/Ethnic Health Disparities in Children and Adolescents

    ERIC Educational Resources Information Center

    Price, James H.; McKinney, Molly A.; Braun, Robert E.

    2011-01-01

    Too many racial/ethnic minorities do not reach their full potential for a healthy and rewarding life. This paper addresses the social determinants that impact, either directly or indirectly, child and adolescent health disparities. Understanding the role social determinants play in the life course of health status can help guide educational…

  7. Racial and Ethnic Health Disparities and the Affordable Care Act: a Status Update.

    PubMed

    Sealy-Jefferson, Shawnita; Vickers, Jasmine; Elam, Angela; Wilson, M Roy

    2015-12-01

    Persistent racial and ethnic health disparities exist in the USA, despite decades of research and public health initiatives. Several factors contribute to health disparities, including (but not limited to) implicit provider bias, access to health care, social determinants, and biological factors. Disparities in health by race/ethnicity are unacceptable and correctable. The Patient Protection and Affordable Care Act is a comprehensive legislation that is focused on improving health care access, quality, and cost control. This health care reform includes specific provisions which focus on preventive care, the standardized collection of data on race, ethnicity, primary language and disability status, and health information technology. Although some provisions of the Patient Protection and Affordable Care Act have not been implemented, such as funding for the U.S. Public Health Sciences track, which would have addressed the shortage of medical professionals in the USA who are trained to use patient-centered, interdisciplinary, and care coordination approaches, this legislation is still poised to make great strides toward eliminating health disparities. The purpose of this manuscript is to highlight the unprecedented opportunities that exist for the Patient Protection and Affordable Care Act to reduce racial and ethnic disparities in health in the USA. PMID:26668787

  8. Understanding ethnic/racial health disparities in youth and families in the US.

    PubMed

    Carlo, Gustavo; Crockett, Lisa J; Carranza, Miguel A; Martinez, Miriam M

    2011-01-01

    .g., social competence) rather than focusing solely on risk and protective factors associated with health-related problems. We cannot assume that the relative absence of negative pathology and risk equals the presence of health and well being-thus research is needed that includes both positive and negative health outcomes. More attention to positive health indicators will further our understanding of normative, positive health outcomes and lead us away from traditional deficit and pathology-focused models of ethnic minorities. Finally, the scholars in this volume all present findings that have important implications for policy and intervention efforts-the lessons learned from their efforts should be heeded if we are to comprehensively and effectively address the existing health disparities in the US. PMID:21166302

  9. Asthma and Health Disparities | NIH MedlinePlus the Magazine

    MedlinePlus

    ... page please turn Javascript on. Feature: Breathing Easier Asthma and Health Disparities Past Issues / Fall 2013 Table ... under 18 years of age, who currently have asthma, 2010 Non-Hispanic Black Non-Hispanic White Non- ...

  10. Racial and Ethnic Disparities in the Use of Health Services

    PubMed Central

    Ashton, Carol M; Haidet, Paul; Paterniti, Debora A; Collins, Tracie C; Gordon, Howard S; O'Malley, Kimberly; Petersen, Laura A; Sharf, Barbara F; Suarez-Almazor, Maria E; Wray, Nelda P; Street, Richard L

    2003-01-01

    African Americans and Latinos use services that require a doctor's order at lower rates than do whites. Racial bias and patient preferences contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and health behaviors. Research has shown that doctors have poorer communication with minority patients than with others, but problems in doctor-patient communication have received little attention as a potential cause, a remediable one, of health disparities. We evaluate the evidence that poor communication is a cause of disparities and propose some remedies drawn from the communication sciences. PMID:12542590

  11. Can Racial Disparity in Health between Black and White Americans Be Attributed to Racial Disparities in Body Weight and Socioeconomic Status?

    ERIC Educational Resources Information Center

    Kahng, Sang Kyoung

    2010-01-01

    Few studies have examined to what extent racial disparities in chronic health conditions (CHCs) are attributable to racial differences in body weight (measured as body mass index [BMI]) and socioeconomic status (SES) among older adults. To address this gap, using longitudinal data from the Health and Retirement Study, the current study examined…

  12. 75 FR 9421 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities...

  13. Explaining Racial Disparities in Infant Health in Brazil

    PubMed Central

    Nyarko, Kwame A.; Lopez-Camelo, Jorge; Castilla, Eduardo E.

    2013-01-01

    Objectives. We sought to quantify how socioeconomic, health care, demographic, and geographic effects explain racial disparities in low birth weight (LBW) and preterm birth (PTB) rates in Brazil. Methods. We employed a sample of 8949 infants born between 1995 and 2009 in 15 cities and 7 provinces in Brazil. We focused on disparities in LBW (< 2500 g) and PTB (< 37 gestational weeks) prevalence between infants of African ancestry alone or African mixed with other ancestries, and European ancestry alone. We used a decomposition model to quantify the contributions of conceptually relevant factors to these disparities. Results. The model explained 45% to 94% of LBW and 64% to 94% of PTB disparities between the African ancestry groups and European ancestry. Differences in prenatal care use and geographic location were the most important contributors, followed by socioeconomic differences. The model explained the majority of the disparities for mixed African ancestry and part of the disparity for African ancestry alone. Conclusions. Public policies to improve children’s health should target prenatal care and geographic location differences to reduce health disparities between infants of African and European ancestries in Brazil. PMID:23409894

  14. Explaining Racial Disparities in Infant Health in Brazil

    PubMed Central

    Nyarko, Kwame A.; Lopez-Camelo, Jorge; Castilla, Eduardo E.

    2015-01-01

    Objectives. We sought to quantify how socioeconomic, health care, demographic, and geographic effects explain racial disparities in low birth weight (LBW) and preterm birth (PTB) rates in Brazil. Methods. We employed a sample of 8949 infants born between 1995 and 2009 in 15 cities and 7 provinces in Brazil. We focused on disparities in LBW (< 2500 g) and PTB (< 37 gestational weeks) prevalence between infants of African ancestry alone or African mixed with other ancestries, and European ancestry alone. We used a decomposition model to quantify the contributions of conceptually relevant factors to these disparities. Results. The model explained 45% to 94% of LBW and 64% to 94% of PTB disparities between the African ancestry groups and European ancestry. Differences in prenatal care use and geographic location were the most important contributors, followed by socioeconomic differences. The model explained the majority of the disparities for mixed African ancestry and part of the disparity for African ancestry alone. Conclusions. Public policies to improve children’s health should target prenatal care and geographic location differences to reduce health disparities between infants of African and European ancestries in Brazil. PMID:26313046

  15. Finding Synergy: Reducing Disparities in Health by Modifying Multiple Determinants

    PubMed Central

    Olden, Kenneth

    2010-01-01

    Although researchers acknowledge that health disparities have multiple determinants, most recommendations for reducing inequities focus on a single approach. We suggest integrating 2 approaches for reducing disparities: improving access to primary care and updating and more vigorously enforcing consumer and environmental protection laws. This strategy could reduce the main causes of disparities, such as chronic diseases and injuries; win public and policymaker support; and provide a cost-effective start for achieving equity. Most of the scientific knowledge needed to implement this strategy exists, thus years of additional research would not be needed. Developing targeted regulatory and health care policies to reduce deaths from chronic diseases and injuries would be a major step forward in eliminating health disparities in the United States. PMID:20147690

  16. Disparities in Social Health by Sexual Orientation and the Etiologic Role of Self-Reported Discrimination.

    PubMed

    Doyle, David Matthew; Molix, Lisa

    2016-08-01

    Some past work indicates that sexual minorities may experience impairments in social health, or the perceived and actual availability and quality of one's social relationships, relative to heterosexuals; however, research has been limited in many ways. Furthermore, it is important to investigate etiological factors that may be associated with these disparities, such as self-reported discrimination. The current work tested whether sexual minority adults in the United States reported less positive social health (i.e., loneliness, friendship strain, familial strain, and social capital) relative to heterosexuals and whether self-reported discrimination accounted for these disparities. Participants for the current study (N = 579) were recruited via Amazon's Mechanical Turk, including 365 self-identified heterosexuals (105 women) and 214 sexual minorities (103 women). Consistent with hypotheses, sexual minorities reported impaired social health relative to heterosexuals, with divergent patterns emerging by sexual orientation subgroup (which were generally consistent across sexes). Additionally, self-reported discrimination accounted for disparities across three of four indicators of social health. These findings suggest that sexual minorities may face obstacles related to prejudice and discrimination that impair the functioning of their relationships and overall social health. Moreover, because social health is closely related to psychological and physical health, remediating disparities in social relationships may be necessary to address other health disparities based upon sexual orientation. Expanding upon these results, implications for efforts to build resilience among sexual minorities are discussed. PMID:26566900

  17. Exploring the role of Natural Helpers in efforts to address disparities for children with conduct problems

    PubMed Central

    Acevedo-Polakovich, I. David; Niec, Larissa N.; Barnett, Miya L.; Bell, Katrina M.; Aguilar, Gerardo; Vilca, Jeanette; Abbenante-Honold, Emily S.; Christian, Allison S.; Peer, Samuel O.

    2014-01-01

    The incorporation of natural helpers into services has been suggested as an innovative strategy to address disparities for historically underserved children with conduct problems. In order to inform incorporation efforts, this study examined the perceptions of natural helpers serving one U.S. Latina/o community regarding need for services for children with conduct problems, their reactions to a specific parent training intervention, and the training and support needed to deliver this intervention successfully. Participants identified a need for culturally-responsive services for children with conduct problems, and felt that parent training would be appropriate for the families they serve. Participants further identified specific training and support that they would require in order to deliver parent training with fidelity and effectiveness. Findings support the suggestion that natural helpers have the potential to address service disparities among Latina/o children with conduct problems. Recommendations from natural helpers should guide the development of culturally-adapted preventive interventions that help address existing service disparities. PMID:24910488

  18. Building a funded research program in cancer health disparities: considerations for young investigators.

    PubMed

    Ochs-Balcom, Heather M; Phillips, Lynette S; Nichols, Hazel B; Martinez, Elena; Thompson, Beti; Ojeifo, John; Rebbeck, Timothy R

    2015-05-01

    A workshop entitled "Building a funded research program in cancer health disparities" was held at the 38th Annual American Society of Preventive Oncology (ASPO) Meeting. Organized by the Junior Members Interest Group, the session addressed topics relevant to career development for cancer disparities investigators. Such considerations include the development of research programs on a backdrop of existing multi- and transdisciplinary teams, recognizing opportunities for advancing their research, given the growth of consortia-related research, and development of effective community-based partnerships. Key strategies for developing a sustainable career in cancer health disparities in the current environment include the need to effectively engage with communities, appreciate the value of team science and develop cross-discipline collaborations, and navigate the use and utility of consortia for disparities research. Academic considerations related to earning tenure and promotion that may be faced by the junior investigator in cancer health disparities were also discussed. This report may serve to both educate and provide lessons for early-stage investigators who wish to tackle complex scientific questions while developing their careers in cancer health disparities. PMID:25934837

  19. The Relationship between Health Literacy and Health Disparities: A Systematic Review

    PubMed Central

    Mantwill, Sarah; Monestel-Umaña, Silvia; Schulz, Peter J.

    2015-01-01

    Objectives Health literacy is commonly associated with many of the antecedents of health disparities. Yet the precise nature of the relationship between health literacy and disparities remains unclear. A systematic review was conducted to better understand in how far the relationship between health literacy and health disparities has been systematically studied and which potential relationships and pathways have been identified. Methods Five databases, including PubMed/MEDLINE and CINAHL, were searched for peer-reviewed studies. Publications were included in the review when they (1) included a valid measure of health literacy, (2) explicitly conceived a health disparity as related to a social disparity, such as race/ethnicity or education and (3) when results were presented by comparing two or more groups afflicted by a social disparity investigating the effect of health literacy on health outcomes. Two reviewers evaluated each study for inclusion and abstracted relevant information. Findings were ordered according to the disparities identified and the role of health literacy in explaining them. Results 36 studies were included in the final synthesis. Most of the studies investigated racial/ethnic disparities, followed by some few studies that systematically investigated educational disparities. Some evidence was found on the mediating function of health literacy on self-rated health status across racial/ethnic and educational disparities, as well as on the potential effect of health literacy and numeracy on reducing racial/ethnic disparities in medication adherence and understanding of medication intake. Conclusion Overall the evidence on the relationship between health literacy and disparities is still mixed and fairly limited. Studies largely varied with regard to health(-related) outcomes under investigation and the health literacy assessments used. Further, many studies lacked a specific description of the nature of the disparity that was explored and a clear

  20. Understanding Racial/Ethnic Disparities in Youth Mental Health Services: Do Disparities Vary by Problem Type?

    ERIC Educational Resources Information Center

    Gudino, Omar G.; Lau, Anna S.; Yeh, May; McCabe, Kristen M.; Hough, Richard L.

    2009-01-01

    The authors examined racial/ethnic disparities in mental health service use based on problem type (internalizing/externalizing). A diverse sample of youth in contact with public sectors of care and their families provided reports of youth's symptoms and functional impairment during an initial interview. Specialty and school-based mental health…

  1. AAHD's Health Promotion and Wellness, Part 3: Health Disparities and People with Disabilities

    ERIC Educational Resources Information Center

    Exceptional Parent, 2011

    2011-01-01

    This article is the third of a 4-part series on "Health Promotion and Wellness" from the American Association on Health and Disability (AAHD). It focuses on health disparities and people with disabilities. Health disparities are differences in health outcomes between groups that reflect social inequalities. Disability rates vary by ethnicity, age,…

  2. Community-partnered needs assessment: a strategy to teach college students about health disparities.

    PubMed

    Jacquez, Farrah; Ghantous, Stephanie

    2013-01-01

    Partnering with communities to provide service-learning opportunities for undergraduates can be an effective strategy to teach college students about health disparities. In the current study, undergraduates partnered with a public K-8 school to conduct a participatory needs assessment. College students worked directly with teachers, parents, public school students, and key stakeholders to identify and prioritize health needs, and they awarded the partnership school a grant to address physical activity and bullying. Undergraduates rated the class highly favorably and reported a deeper understanding of health disparities resulting from the service-learning activity. Health disparities research is increasingly becoming a national priority and service learning can attract future talent by providing undergraduates with the opportunity to engage in the material in a meaningful way with clear community benefit. PMID:23480282

  3. The potential to reduce mental health disparities through the comprehensive community mental health services for children and their families program.

    PubMed

    Miech, Richard; Azur, Melissa; Dusablon, Tracy; Jowers, Keri; Goldstein, Amy B; Stuart, Elizabeth A; Walrath, Christine; Leaf, Philip J

    2008-07-01

    Few service systems are currently in place with the explicit purpose to reduce youth mental health disparities across socioeconomic status and race-ethnicity, despite substantial interest by the federal government and other institutions to redress health disparities. This study examines the potential for the Comprehensive Community Mental Health Services for Children and Their Families Program to address health disparities, even though this program was not explicitly designed for disparity reduction. Specifically, this study examines whether program sites disproportionately provide services within their catchment areas for youth who come from poor families, who are Black, and who are Hispanic. Data for this study come from 45 sites and 19,189 youth who were enrolled in program sites from 1997 to 2005. Meta-analysis was used to generate Forest plots and to obtain single, pooled estimates of risk ratios and their standard errors across all Children's Mental Health Initiative communities. The results indicate that in comparison to the targeted catchment area (a) the percentage poor youth in the programs was almost three times higher, (b) the percentage Black in the programs was about twice as high, and (c) the percentage Hispanic in the programs was about the same. These results indicate that the program successfully reaches disadvantaged youth and can bring substantial infrastructure to address youth mental health disparities. In fact, to the extent that the program successfully improves mental health among enrollees it may be serving as one of the largest initiatives to redress health disparities, although its role in disparity reduction is not widely recognized. PMID:18543110

  4. Do wealth disparities contribute to health disparities within racial/ethnic groups?

    PubMed Central

    Pollack, Craig Evan; Cubbin, Catherine; Sania, Ayesha; Hayward, Mark; Vallone, Donna; Flaherty, Brian; Braveman, Paula A.

    2013-01-01

    Background Though wide disparities in wealth have been documented across racial/ethnic groups, it is largely unknown whether differences in wealth are associated with health disparities within racial/ethnic groups. Methods Data from the Survey of Consumer Finances (2004, ages 25–64) and the Health and Retirement Survey (2004, ages 50+), containing a wide range of assets and debts variables, was used to calculate net worth (a standard measure of wealth). Among non-Hispanic black, Hispanic, and non-Hispanic white populations, we tested whether wealth was associated with self-reported poor/fair health status after accounting for income and education. Results Except among the younger Hispanic population, net worth was significantly associated with poor/fair health status within each racial/ethnic group in both datasets. Adding net worth attenuated the association between education and poor/fair health (in all racial/ethnic groups) and between income and poor/fair health (except among older Hispanics). Conclusions The results add to literature indicating the importance of including measures of wealth in health research for what they may reveal about disparities not only between but also within different racial/ethnic groups. PMID:23427209

  5. Part II: Multisystemic Therapy--Addressing Racial Disparity and Its Effectiveness with Families from Diverse Racial and Ethnic Backgrounds

    ERIC Educational Resources Information Center

    Painter, Kirstin; Scannapieco, Maria

    2009-01-01

    Disparities in health and mental health care delivered to racial and ethnic minorities became a focus of national policy following reports of the Institute of Medicine (IOM, 2002) and the Surgeon General (USDHHS, 2001). The Surgeon General (USDHHS, 2001) reported racial and ethnic minorities experience disparities in availability and quality of…

  6. 76 FR 21748 - Health Disparities Subcommittee (HDS), Advisory Committee to the Director, Centers for Disease...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Health Disparities Subcommittee (HDS... on strategic and other health disparities and health equity issues and provide guidance...

  7. The Potential to Reduce Mental Health Disparities Through the Comprehensive Community Mental Health Services for Children and Their Families Program

    PubMed Central

    Miech, Richard; Azur, Melissa; Dusablon, Tracy; Jowers, Keri; Goldstein, Amy B.; Stuart, Elizabeth; Walrath, Christine; Leaf, Philip J.

    2009-01-01

    Few service systems are currently in place with the explicit purpose to reduce youth mental health disparities across socioeconomic status and race/ethnicity, despite substantial interest by the federal government and other institutions to redress health disparities. This study examines the potential for the Comprehensive Community Mental Health Services for Children and Their Families Program to address health disparities, even though this program was not explicitly designed for disparity reduction. Specifically, this study examines whether program sites disproportionately provide services within their catchment areas for youth who come from poor families, who are Black, and who are Hispanic. Data for this study come from 45 sites and 19,189 youth who were enrolled in program sites from 1997-2005. Meta-analysis was used to generate Forest plots and to obtain single, pooled estimates of risk ratios and their standard errors across all CMHI communities. The results indicate that in comparison to the targeted catchment area (a) the percentage poor youth in the programs was almost three times higher, (b) the percentage Black in the programs was about twice as high, and (c) the percentage Hispanic in the programs was about the same. These results indicate that the program successfully reaches disadvantaged youth and can bring substantial infrastructure to address youth mental health disparities. In fact, to the extent that the program successfully improves mental health among enrollees it may be serving as one of the largest initiatives to redress health disparities, although its role in disparity reduction is not widely recognized. PMID:18543110

  8. Behavioral pathways explaining oral health disparity in children.

    PubMed

    Gao, X-L; Hsu, C-Y S; Xu, Y C; Loh, T; Koh, D; Hwarng, H B

    2010-09-01

    Policymakers' understanding of and ability to reduce health disparities are pivotal for health promotion worldwide. This study aimed to verify the behavioral pathways leading to oral health disparities. Oral examinations were conducted for 1782 randomly selected preschoolers (3-6 yrs), and 1576 (88.4%) participants were followed up after 12 months. Parents were surveyed on their knowledge (K), attitude (A), and practices (P) regarding their children's oral health homecare (infant feeding, diet, and oral hygiene) and dental attendance. Structural equation modeling substantiated the links between specific KAs and corresponding practices, while generic KA did not affect practices. KAP pathways partly explained the ethnic and socio-economic disparities in oral health. Deprivation had a direct effect (not mediated by KA) on dental attendance, but not on oral health homecare. Ethnicity directly influenced oral health homecare practices, but not dental attendance. These behavioral pathways, furthering our understanding of health disparity, may have practical implications for health promotion and policy-making. PMID:20554887

  9. Reducing Cancer Health Disparities in the US-associated Pacific

    PubMed Central

    Tsark, JoAnn U.; Braun, Kathryn L.

    2010-01-01

    Purpose To assess cancer prevention and control capacity in the US-associated Pacific Islands (USAPI, including American Samoa, Northern Mariana Islands, Micronesia, Guam, Marshall Islands, and Palau) and to support indigenous leadership in reducing cancer health disparities. Methods Jurisdiction-specific needs assessments were conducted to assess cancer prevention and control capacity and challenges, The Cancer Council of the Pacific islands (CCPI), an indigenous health leadership team from public health and medicine, was supported to review assessment findings, develop priorities, and build capacity to address recommendations. Results Capacity varied across jurisdictions, but generally there is limited ability to measure cancer burden and a lack of programs, equipment, and trained personnel to detect and treat cancer. Most cancers are diagnosed in late stages when survival is compromised and care is most costly. Jurisdictions also are challenged by geographic, social, and political constraints and multiple in-country demands for funding. Based on findings, strategies were developed by the CCPI to guide efforts, including fund seeking, to expand cancer prevention and control capacity in regionally appropriate ways. Conclusions Concerted planning, training, and funding efforts are needed to overcome challenges and upgrade capacity in cancer education, prevention, detection, and treatment in the USAPI. Indigenous leadership and local capacity building are essential to this process. PMID:17149100

  10. African Americans: Disparities in Health Care Access and Utilization

    ERIC Educational Resources Information Center

    Copeland, Valire Carr

    2005-01-01

    Despite remarkable improvements in the overall health of the nation during the past two decades, compelling evidence suggests that the nation's racial and ethnic minority Americans suffer increasing disparities in the incidence, prevalence, mortality, and burden of diseases and adverse health outcomes compared with white Americans. The 1998…

  11. Editorial: 2nd Special Issue on behavior change, health, and health disparities.

    PubMed

    Higgins, Stephen T

    2015-11-01

    This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policy makers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. PMID:26257372

  12. Editorial: 2nd Special Issue on behavior change, health, and health disparities

    PubMed Central

    Higgins, Stephen T.

    2016-01-01

    This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. PMID:26257372

  13. Service learning: a vehicle for building health equity and eliminating health disparities.

    PubMed

    Sabo, Samantha; de Zapien, Jill; Teufel-Shone, Nicolette; Rosales, Cecilia; Bergsma, Lynda; Taren, Douglas

    2015-03-01

    Service learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection on the broader social, economic, and political contexts of health. We describe the elements and impact of five distinct week-long intensive SL courses focused on the context of urban, rural, border, and indigenous health contexts. Students involved in these SL courses demonstrated a commitment to community-engaged scholarship and practice in both their student and professional lives. SL is directly in line with the core public health value of social justice and serves as a venue to strengthen community-campus partnerships in addressing health disparities through sustained collaboration and action in vulnerable communities. PMID:25706014

  14. A Human Capital Approach to Reduce Health Disparities

    PubMed Central

    Glover, Saundra H.; Xirasagar, Sudha; Jeon, Yunho; Elder, Keith T.; Piper, Crystal N.; Pastides, Harris

    2010-01-01

    Objective To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research. Methods The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), a level 1 research institution to build expertise at a minority serving institution. The elements of Project EXPORT were created to advance the science base of disparities reduction, increase trained minority researchers, and engage the African American community at all stages of research. Conclusion Building upon past collaborations between HBCU’s in South Carolina and USC, this project holds promise for a public health human capital approach to reduce health disparities. PMID:21814634

  15. A Human Capital Approach to Reduce Health Disparities.

    PubMed

    Glover, Saundra H; Xirasagar, Sudha; Jeon, Yunho; Elder, Keith T; Piper, Crystal N; Pastides, Harris

    2009-04-01

    OBJECTIVE: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research. METHODS: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), a level 1 research institution to build expertise at a minority serving institution. The elements of Project EXPORT were created to advance the science base of disparities reduction, increase trained minority researchers, and engage the African American community at all stages of research. CONCLUSION: Building upon past collaborations between HBCU's in South Carolina and USC, this project holds promise for a public health human capital approach to reduce health disparities. PMID:21814634

  16. The Role of Health Education Advocacy in Removing Disparities in Health Care.

    ERIC Educational Resources Information Center

    Allegrante, John P.; Morisky, Donald E.; Sharif, Behjat A.

    1999-01-01

    Summarizes evidence regarding disparities in health status and access to health services across disadvantaged U.S. populations, reviewing major contributing factors to these disparities, highlighting examples of advocacy approaches that have been conceptualized and implemented in health education efforts, and discussing the role of advocacy aimed…

  17. A selected, annotated list of materials that support the development of policies designed to reduce racial and ethnic health disparities

    PubMed Central

    Donatiello, Joann E.; Droese, Peter W.; Kim, Soo H.

    2004-01-01

    Research documents the existence of racial and ethnic health disparities. As a result, policy makers are seeking to address these disparities. This list is a starting point for building or updating a collection that supports this policy development process. It is written for health policy librarians and researchers and includes annotated recommendations for books, periodicals, government publications, and Websites. Entries for print publications are primarily from 1998 to 2003. PMID:15098056

  18. Promoting Community Health and Eliminating Health Disparities Through Community-Based Participatory Research.

    PubMed

    Xia, Ruiping; Stone, John R; Hoffman, Julie E; Klappa, Susan G

    2016-03-01

    In physical therapy, there is increasing focus on the need at the community level to promote health, eliminate disparities in health status, and ameliorate risk factors among underserved minorities. Community-based participatory research (CBPR) is the most promising paradigm for pursuing these goals. Community-based participatory research stresses equitable partnering of the community and investigators in light of local social, structural, and cultural elements. Throughout the research process, the CBPR model emphasizes coalition and team building that joins partners with diverse skills/expertise, knowledge, and sensitivities. This article presents core concepts and principles of CBPR and the rationale for its application in the management of health issues at the community level. Community-based participatory research is now commonly used to address public health issues. A literature review identified limited reports of its use in physical therapy research and services. A published study is used to illustrate features of CBPR for physical therapy. The purpose of this article is to promote an understanding of how physical therapists could use CBPR as a promising way to advance the profession's goals of community health and elimination of health care disparities, and social responsibility. Funding opportunities for the support of CBPR are noted. PMID:26251479

  19. Reducing Racial Health Care Disparities: A Social Psychological Analysis

    PubMed Central

    Penner, Louis A.; Blair, Irene V.; Albrecht, Terrance L.; Dovidio, John F.

    2015-01-01

    Large health disparities persist between Black and White Americans. The social psychology of intergroup relations suggests some solutions to health care disparities due to racial bias. Three paths can lead from racial bias to poorer health among Black Americans. First is the already well-documented physical and psychological toll of being a target of persistent discrimination. Second, implicit bias can affect physicians’ perceptions and decisions, creating racial disparities in medical treatments, although evidence is mixed. The third path describes a less direct route: Physicians’ implicit racial bias negatively affects communication and the patient–provider relationship, resulting in racial disparities in the outcomes of medical interactions. Strong evidence shows that physician implicit bias negatively affects Black patients’ reactions to medical interactions, and there is good circumstantial evidence that these reactions affect health outcomes of the interactions. Solutions focused on the physician, the patient, and the health care delivery system; all agree that trying to ignore patients’ race or to change physicians’ implicit racial attitudes will not be effective and may actually be counterproductive. Instead, solutions can minimize the impact of racial bias on medical decisions and on patient–provider relationships. PMID:25705721

  20. Health Disparities Calculator: A Methodologically Rigorous Tool for Analyzing Inequalities in Population Health

    PubMed Central

    Scott, Susan; Percy-Laurry, Antoinette; Lewis, Denise; Glasgow, Russell

    2014-01-01

    Historically, researchers and policy planners have selected a single indicator to measure trends in social inequalities. A more rigorous approach is to review the literature and data, select appropriate inequality measures to address the research question, compute results from various indices, and graphically compare resulting trends. The Health Disparities Calculator (HD*Calc, version 1.2.4; National Cancer Institute, Bethesda, MD) computes results from different indices and graphically displays them, making an arduous task easier, more transparent, and more accessible. PMID:25033114

  1. Preventing Filipino Mental Health Disparities: Perspectives from Adolescents, Caregivers, Providers, and Advocates

    PubMed Central

    Javier, Joyce R.; Supan, Jocelyn; Lansang, Anjelica; Beyer, William; Kubicek, Katrina; Palinkas, Lawrence A.

    2014-01-01

    Filipino Americans are the second largest immigrant population and second largest Asian ethnic group in the U.S. Disparities in youth behavioral health problems and the receipt of mental health services among Filipino youth have been documented previously. However, few studies have elicited perspectives from community stakeholders regarding how to prevent mental health disparities among Filipino youth. The purpose of the current study is to identify intervention strategies for implementing mental health prevention programs among Filipino youth. We conducted semi-structured interviews (n=33) with adolescents, caregivers, advocates, and providers and focus groups (n=18) with adolescents and caregivers. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed using a methodology of “coding consensus, co-occurrence, and comparison” and was rooted in grounded theory. Four recommendations were identified when developing mental health prevention strategies among Filipino populations: address the intergenerational gap between Filipino parents and children, provide evidence-based parenting programs, collaborate with churches in order to overcome stigma associated with mental health, and address mental health needs of parents. Findings highlight the implementation of evidence-based preventive parenting programs in faith settings as a community-identified and culturally appropriate strategy to prevent Filipino youth behavioral health disparities. PMID:25667725

  2. How Resource Dynamics Explain Accumulating Developmental and Health Disparities for Teen Parents’ Children

    PubMed Central

    Mollborn, Stefanie; Lawrence, Elizabeth; James-Hawkins, Laurie; Fomby, Paula

    2014-01-01

    This study examines the puzzle of disparities experienced by U.S. teen parents’ young children, whose health and development increasingly lag behind those of peers while their parents are simultaneously experiencing socioeconomic improvements. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001–2007; N ≈ 8,600), we assess four dynamic patterns in socioeconomic resources that might account for these growing developmental and health disparities throughout early childhood and then test them in multilevel growth curve models. Persistently low socioeconomic resources constituted the strongest explanation, given that consistently low income, maternal education, and assets fully or partially account for growth in cognitive, behavioral, and health disparities experienced by teen parents’ children from infancy through kindergarten. That is, although teen parents gained socioeconomic resources over time, those resources remained relatively low, and the duration of exposure to limited resources explains observed growing disparities. Results suggest that policy interventions addressing the time dynamics of low socioeconomic resources in a household, in terms of both duration and developmental timing, are promising for reducing disparities experienced by teen parents’ children. PMID:24802282

  3. How resource dynamics explain accumulating developmental and health disparities for teen parents' children.

    PubMed

    Mollborn, Stefanie; Lawrence, Elizabeth; James-Hawkins, Laurie; Fomby, Paula

    2014-08-01

    This study examines the puzzle of disparities experienced by U.S. teen parents' young children, whose health and development increasingly lag behind those of peers while their parents are simultaneously experiencing socioeconomic improvements. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001-2007; N ≈ 8,600), we assess four dynamic patterns in socioeconomic resources that might account for these growing developmental and health disparities throughout early childhood and then test them in multilevel growth curve models. Persistently low socioeconomic resources constituted the strongest explanation, given that consistently low income, maternal education, and assets fully or partially account for growth in cognitive, behavioral, and health disparities experienced by teen parents' children from infancy through kindergarten. That is, although teen parents gained socioeconomic resources over time, those resources remained relatively low, and the duration of exposure to limited resources explains observed growing disparities. Results suggest that policy interventions addressing the time dynamics of low socioeconomic resources in a household, in terms of both duration and developmental timing, are promising for reducing disparities experienced by teen parents' children. PMID:24802282

  4. Using evidence-based internet interventions to reduce health disparities worldwide.

    PubMed

    Muñoz, Ricardo F

    2010-01-01

    Health disparities are a persistent problem worldwide. A major obstacle to reducing health disparities is reliance on "consumable interventions," that is, interventions that, once used, cannot be used again. To reduce health disparities, interventions are required that can be used again and again without losing their therapeutic power, that can reach people even if local health care systems do not provide them with needed health care, and that can be shared globally without taking resources away from the populations where the interventions were developed. This paper presents the argument that automated self-help evidence-based Internet interventions meet the above criteria and can contribute to the reduction of health disparities worldwide. Proof-of-concept studies show that evidence-based Internet interventions can reach hundreds of thousands of people worldwide and could be used in public sector settings to augment existing offerings and provide services not currently available (such as prevention interventions). This paper presents a framework for systematically filling in a matrix composed of columns representing common health problems and rows representing languages. To bring the benefits of evidence-based Internet interventions to the underserved, public sector clinics should establish eHealth resource centers, through which patients could be screened online for common disorders and provided with evidence-based Internet intervention services not currently available at the clinics. These resources should be available in the patients' languages, in formats that do not require literacy, and that can be accessed with mobile devices. Such evidence-based Internet interventions should then be shared with public sector clinics as well as individuals anywhere in the world. Finally, this paper addresses sustainability and describes a continuum of evidence-based Internet interventions to share nationally and across the world. This approach to expanding health service

  5. Health disparities between island and mainland Puerto Ricans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective of this study was to detect health disparities among three populations—Puerto Ricans living in Puerto Rico as well as Puerto Ricans and non-Hispanic whites living on the United States (U.S.) mainland. Data from two similarly designed surveys conducted in 1999-2000 were analyzed. The Be...

  6. Measurement of socioeconomic status in health disparities research.

    PubMed Central

    Shavers, Vickie L.

    2007-01-01

    Socioeconomic status (SES) is frequently implicated as a contributor to the disparate health observed among racial/ ethnic minorities, women and elderly populations. Findings from studies that examine the role of SES and health disparities, however, have provided inconsistent results. This is due in part to the: 1) lack of precision and reliability of measures; 2) difficulty with the collection of individual SES data; 3) the dynamic nature of SES over a lifetime; 4) the classification of women, children, retired and unemployed persons; 5) lack of or poor correlation between individual SES measures; and 6) and inaccurate or misleading interpretation of study results. Choosing the best variable or approach for measuring SES is dependent in part on its relevance to the population and outcomes under study. Many of the commonly used compositional and contextual SES measures are limited in terms of their usefulness for examining the effect of SES on outcomes in analyses of data that include population subgroups known to experience health disparities. This article describes SES measures, strengths and limitations of specific approaches and methodological issues related to the analysis and interpretation of studies that examine SES and health disparities. PMID:17913111

  7. Intergroup Relations and Health Disparities: A Social Psychological Perspective

    PubMed Central

    Major, Brenda; Mendes, Wendy Berry; Dovidio, John F.

    2014-01-01

    Objective This article considers how the social psychology of intergroup processes helps to explain the presence and persistence of health disparities between members of socially advantaged and disadvantaged groups. Method Social psychological theory and research on intergroup relations, including prejudice, discrimination, stereotyping, stigma, prejudice concerns, social identity threat, and the dynamics of intergroup interactions, is reviewed and applied to understand group disparities in health and health care. Potential directions for future research are considered. Results Key features of group relations and dynamics, including social categorization, social hierarchy, and the structural positions of groups along dimensions of perceived warmth and competence, influence how members of high status groups perceive, feel about, and behave toward members of low status groups, how members of low status groups construe and cope with their situation, and how members of high and low status groups interact with each other. These intergroup processes, in turn, contribute to health disparities by leading to differential exposure to and experiences of chronic and acute stress, different health behaviors, and different quality of health care experienced by members of advantaged and disadvantaged groups. Within each of these pathways, social psychological theory and research identifies mediating mechanisms, moderating factors, and individual differences that can affect health. Conclusions A social psychological perspective illuminates the intergroup, interpersonal, and intrapersonal processes by which structural circumstances which differ between groups for historical, political, and economic reasons can lead to group differences in health. PMID:23646834

  8. A Study of National Physician Organizations’ Efforts to Reduce Racial and Ethnic Health Disparities in the United States

    PubMed Central

    Peek, Monica E.; Wilson, Shannon C.; Bussey-Jones, Jada; Lypson, Monica; Cordasco, Kristina; Jacobs, Elizabeth A.; Bright, Cedric; Brown, Arleen F.

    2012-01-01

    Purpose To characterize national physician organizations’ efforts to reduce health disparities and identify organizational characteristics associated with such efforts. Method This cross-sectional study was conducted between September 2009 and June 2010. The authors used two-sample t tests and chi-square tests to compare the proportion of organizations with disparity-reducing activities between different organizational types (e.g., primary care versus subspecialty organizations, small [<1,000 members] versus large [>5,000 members]). Inclusion criteria required physician organizations to be (1) focused on physicians, (2) national in scope, and (3) membership based. Results The number of activities per organization ranged from 0 to 22. Approximately half (53%) of organizations had 0 or 1 disparity-reducing activities. Organiza-tional characteristics associated with having at least 1 disparity-reducing effort included membership size (88% of large groups versus 58% of small groups had at least 1 activity; P = .004) and the presence of a health disparities committee (95% versus 59%; P < .001). Primary care (versus subspecialty) organizations and racial/ethnic minority physician organizations were more likely to have disparity-reducing efforts, although findings were not statistically significant. Common themes addressed by activities were health care access, health care disparities, workforce diversity, and language barriers. Common strategies included education of physicians/trainees and patients/general public, position statements, and advocacy. Conclusions Despite the national priority to eliminate health disparities, more than half of national physician organizations are doing little to address this problem. Primary care and minority physician organizations, and those with disparities committees, may provide leadership to extend the scope of disparity-reduction efforts. PMID:22534593

  9. Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000-2010.

    PubMed

    O'Keefe, Eileen B; Meltzer, Jeremy P; Bethea, Traci N

    2015-01-01

    Declining cancer incidence and mortality rates in the United States (U.S.) have continued through the first decade of the twenty-first century. Reductions in tobacco use, greater uptake of prevention measures, adoption of early detection methods, and improved treatments have resulted in improved outcomes for both men and women. However, Black Americans continue to have the higher cancer mortality rates and shorter survival times. This review discusses and compares the cancer mortality rates and mortality trends for Blacks and Whites. The complex relationship between socioeconomic status and race and its contribution to racial cancer disparities is discussed. Based on current trends and the potential and limitations of the patient protection and affordable care act with its mandate to reduce health care inequities, future trends, and challenges in cancer mortality disparities in the U.S. are explored. PMID:25932459

  10. Health Disparities and Cancer: Racial Disparities in Cancer Mortality in the United States, 2000–2010

    PubMed Central

    O’Keefe, Eileen B.; Meltzer, Jeremy P.; Bethea, Traci N.

    2015-01-01

    Declining cancer incidence and mortality rates in the United States (U.S.) have continued through the first decade of the twenty-first century. Reductions in tobacco use, greater uptake of prevention measures, adoption of early detection methods, and improved treatments have resulted in improved outcomes for both men and women. However, Black Americans continue to have the higher cancer mortality rates and shorter survival times. This review discusses and compares the cancer mortality rates and mortality trends for Blacks and Whites. The complex relationship between socioeconomic status and race and its contribution to racial cancer disparities is discussed. Based on current trends and the potential and limitations of the patient protection and affordable care act with its mandate to reduce health care inequities, future trends, and challenges in cancer mortality disparities in the U.S. are explored. PMID:25932459

  11. Racial and Ethnic Health Disparities among People with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Magaña, Sandra; Parish, Susan; Morales, Miguel A.; Li, Henan; Fujiura, Glenn

    2016-01-01

    Racial and ethnic health disparities are a pervasive public health problem. Emerging research finds similar health disparities among people with intellectual and developmental disabilities (IDD) compared to nondisabled adults. However, few studies have examined racial and ethnic health disparities among adults with IDD. Using national data, we…

  12. The Black-White perception gap and health disparities research.

    PubMed

    Carlson, Elizabeth D; Chamberlain, Robert M

    2004-01-01

    Reducing and eliminating racial and ethnic health disparities has become a national research priority. This research agenda requires new research frameworks that encompass the social determinants of health and the translation pathways of these social contexts into physiological morbidity. Within these sociobiological research frameworks, identity and emotions are seen as crucial links in the causal pathways from stressors to biological responses. In this country, the lived social reality of African American individuals is experienced through the color of their skin. Their identity is bound with the racial inequities of our society. It has been suggested that the emotions of anger and frustration resulting from this institutionalized racial discrimination are an emotional causative pathway to the pathophysiology contributing to the health disparities experienced by African Americans. However, as much as we espouse the concept of cultural competency in health care, until recently, there has been very little honest dialogue about how race and racism influences health. This article will explore the Black-White cultural perception gap and attempt to provide insight on the relationship to African American health and implications for health disparities research. PMID:15260843

  13. Population Disparities in Mental Health: Insights From Cultural Neuroscience

    PubMed Central

    Blizinsky, Katherine D.

    2013-01-01

    By 2050, nearly 1 in 5 Americans (19%) will be an immigrant, including Hispanics, Blacks, and Asians, compared to the 1 in 8 (12%) in 2005. They will vary in the extent to which they are at risk for mental health disorders. Given this increase in cultural diversity within the United States and costly population health disparities across cultural groups, it is essential to develop a more comprehensive understanding of how culture affects basic psychological and biological mechanisms. We examine these basic mechanisms that underlie population disparities in mental health through cultural neuroscience. We discuss the challenges to and opportunities for cultural neuroscience research to determine sociocultural and biological factors that confer risk for and resilience to mental health disorders across the globe. PMID:23927543

  14. Resident Physicians and Cancer Health Disparities: a Survey of Attitudes, Knowledge, and Practice.

    PubMed

    Mejia de Grubb, Maria C; Kilbourne, Barbara; Zoorob, Roger; Gonzalez, Sandra; Mkanta, William; Levine, Robert

    2016-09-01

    Workforce development initiatives designed to mitigate cancer health disparities focus primarily on oncologists rather than on primary care providers (PCPs) who could be better positioned to address the issue at the preventive and community levels. The purpose of this project was to assess primary care resident physicians' self-perceived attitudes and comfort level in addressing cancer health disparities. Resident physicians in their first- through third-year of training in family, internal, preventive/occupational medicine, and obstetrics and gynecology (OB/GYN) at three academic centers responded to a 13-question survey in the spring of 2013. Descriptive and chi-square statistics were performed to analyze responses to (1) attitudes about cross-cultural communication and understanding, (2) knowledge about sources of cancer health disparities, (3) self-reported preparedness to provide cross-cultural cancer care and skills to manage specific situations, and (4) relevance of cancer-disparity education to clinical practice. A total of 78 (70.9 %) residents responded to the survey. Twenty three (29.5 %) of the respondents felt they did not understand the socio-demographic characteristics of their patients' communities, and 20 (25.6 %) did not feel capable of discussing current cancer-related care guidelines when the patients' personal beliefs conflict with their own. Few of the relationships between residency program and location with outcome measures met the criteria for statistical significance. Family medicine residents were the most likely to report in that it was hard to interact with persons from other cultures. As PCPs will play a key role in addressing cancer health disparities, effective educational opportunities in cancer care by primary care residents are warranted. PMID:25943900

  15. Reduction in health risks and disparities with participation in an employer-sponsored health promotion program.

    PubMed

    Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; Schultz, Alyssa B; Edington, Dee W

    2013-08-01

    There is an increasing awareness among employers and health care providers that health care needs to be tailored to address the diversity of the workforce. Population-based data have shown significant differences in health behaviors and health risks among different racial/ethnic groups in the United States. The purpose of this study was to examine health risks and changes in health risks over time in an employed population at a financial services corporation. This large financial services corporation is naturally concerned about any disparities in health among employees. The study population consists of employees who participated in the organization's medical plan and also the annual health risk appraisal questionnaire in both 2009 and 2010. Significant demographic differences exist among the four ethnic groups studied: whites, African Americans, Hispanics, and Asians. At baseline, African American employees had a significantly higher average number of health risks measured by the health risk appraisal, but they also experienced the greatest improvement in health risks by time 2. There were differences in the health risk profiles of the ethnic groups, with certain risk factors being more prevalent among some ethnicities than among others. The health care costs were not significantly different among the groups studied here. It is likely that other large employers may also find health risk differences among employees belonging to various ethnicities. Future research in this field should seek to understand the reasons behind differences in health among ethnic groups and how best to address them so that all employees can achieve a high level of health and wellness. PMID:23924828

  16. A REFERENCE-INVARIANT HEALTH DISPARITY INDEX BASED ON RÉNYI DIVERGENCE

    PubMed Central

    Talih, Makram

    2015-01-01

    One of four overarching goals of Healthy People 2020 (HP2020) is to achieve health equity, eliminate disparities, and improve the health of all groups. In health disparity indices (HDIs) such as the mean log deviation (MLD) and Theil index (TI), disparities are relative to the population average, whereas in the index of disparity (IDisp) the reference is the group with the least adverse health outcome. Although the latter may be preferable, identification of a reference group can be affected by statistical reliability. To address this issue, we propose a new HDI, the Rényi index (RI), which is reference-invariant. When standardized, the RI extends the Atkinson index, where a disparity aversion parameter can incorporate societal values associated with health equity. In addition, both the MLD and TI are limiting cases of the RI. Also, a symmetrized Rényi index (SRI) can be constructed, resulting in a symmetric measure in the two distributions whose relative entropy is being evaluated. We discuss alternative symmetric and reference-invariant HDIs derived from the generalized entropy (GE) class and the Bregman divergence, and argue that the SRI is more robust than its GE-based counterpart to small changes in the distribution of the adverse health outcome. We evaluate the design-based standard errors and bootstrapped sampling distributions for the SRI, and illustrate the proposed methodology using data from the National Health and Nutrition Examination Survey (NHANES) on the 2001–04 prevalence of moderate or severe periodontitis among adults aged 45–74, which tracks Oral Health objective OH-5 in HP2020. Such data, which uses a binary individual-level outcome variable, are typical of HP2020 data. PMID:26568778

  17. A humanizing gaze for transcultural nursing research will tell the story of health disparities.

    PubMed

    Clark, Lauren

    2014-04-01

    If we limit our gaze to epidemiologic or medicalized discourse about health disparities, we risk losing sight of the person living in a health disparity context. We may erase or make invisible the person from a health disparity group; pathologize difference at the population level and, by extension, stigmatize the individual; eliminate the upstream context or causes of disparities; and obscure the human story. For the continued viability of our ideas about health disparities, it is crucial that we maintain cognitive flexibility. The unconscious bedrock of trusted ideas about "culture" and "disparities" can be enriched through a humanized view of the person in the health disparities story. Transcultural nursing research complements the biomedical gaze, placing the patient at the center of a cultural context where health problems are embodied, place based, and socially constituted. Humanizing our practice depends on dialogues with those who experience health disparity conditions. PMID:24391122

  18. Social Disparities in Children’s Respiratory Health in El Paso, Texas

    PubMed Central

    Grineski, Sara E.; Collins, Timothy W.; Chavez-Payan, Paola; Jimenez, Anthony M.; Clark-Reyna, Stephanie; Gaines, Marie; Kim, Young-an

    2014-01-01

    The objectives of this study were to assess prevalence of children’s respiratory health conditions and to measure and describe social disparities in children’s respiratory problems and access to health resources for asthma/wheezing management. Data were collected through a cross-sectional, observational mail survey of all primary caretakers of 4th and 5th grade children in El Paso Independent School District (El Paso, TX, USA). 6295 primary caretakers received surveys at their home address and 1904 surveys were completed and returned for a 30% response rate. El Paso children have high rates of asthma (17%) and allergies (51%). In terms of social disparities, children that are male, not poor, obese, Hispanic, born in El Paso, have a US-born caretaker, and have a caretaker who has lower levels Spanish proficiency have increased odds of respiratory problems. Among children with asthma and wheezing, disparities exist in access to care; those that are poor, with a Spanish-speaking caretaker, or with a foreign-born caretaker had increased odds of seeking care in urgent care center, emergency rooms and hospitals. Results have scholarly and practical implications for broader trends in terms of increasing prevalence of respiratory health problems across multiple scales (from El Paso to the US context to worldwide) and health disparities experienced within the rapidly growing US Hispanic population. PMID:24619157

  19. Health Disparities and Intellectual Disabilities: Lessons from Individuals with down Syndrome

    ERIC Educational Resources Information Center

    Booth, Karin Vander Ploeg

    2011-01-01

    Individuals with intellectual disabilities experience health disparities and disparities in accessing health care services compared to individuals within the general population. In order to eliminate these disparities the contributors to them must be understood. In this article, we aim to describe a recent reconceptualization of health and…

  20. Health Disparities of Adults with Intellectual Disabilities: What Do We Know? What Do We Do?

    ERIC Educational Resources Information Center

    Krahn, Gloria L.; Fox, Michael H.

    2014-01-01

    Background: Recent attention to health of people with intellectual disabilities has used a health disparities framework. Building on historical context, the paper summarizes what is known about health disparities from reports and research and provides direction on what to do to reduce these disparities among adults with intellectual disabilities.…

  1. Muslim patients and health disparities in the UK and the US

    PubMed Central

    Laird, Lance D; Amer, Mona M; Barnett, Elizabeth D; Barnes, Linda L

    2007-01-01

    This article provides a framework for understanding how Muslim identity, and the current social and political contexts in which it is shaped, affects the health of Muslims in the UK and the US, and the quality of health care they receive. Key medical and public health literature that addresses health concerns related to Muslim communities in the UK and the US is reviewed. Few data exist specific to health disparities for Muslim minorities. However, the article focuses on emerging studies concerning the consequences of “Islamophobia” for the physical and mental health and health care of Muslim families and children. We argue that, despite substantive structural differences in the health care systems of the UK and the US, social structural and political forces play similar roles in the health of Muslim children in both countries. Finally, we call for significant cultural and institutional adjustments in health care settings and further research studies to provide specific data to address health disparities for these growing and diverse populations. PMID:17895342

  2. Muslim patients and health disparities in the UK and the US.

    PubMed

    Laird, Lance D; Amer, Mona M; Barnett, Elizabeth D; Barnes, Linda L

    2007-10-01

    This article provides a framework for understanding how Muslim identity, and the current social and political contexts in which it is shaped, affects the health of Muslims in the UK and the US, and the quality of health care they receive. Key medical and public health literature that addresses health concerns related to Muslim communities in the UK and the US is reviewed. Few data exist specific to health disparities for Muslim minorities. However, the article focuses on emerging studies concerning the consequences of "Islamophobia" for the physical and mental health and health care of Muslim families and children. We argue that, despite substantive structural differences in the health care systems of the UK and the US, social structural and political forces play similar roles in the health of Muslim children in both countries. Finally, we call for significant cultural and institutional adjustments in health care settings and further research studies to provide specific data to address health disparities for these growing and diverse populations. PMID:17895342

  3. An Approach to Studying Social Disparities in Health and Health Care

    PubMed Central

    Braveman, Paula A.; Egerter, Susan A.; Cubbin, Catherine; Marchi, Kristen S.

    2004-01-01

    Objective. We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care. Methods. Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relative group size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and “at-risk” groups to identify particular factors warranting attention. Results. We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities. Conclusions. This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care. PMID:15569966

  4. 78 FR 9402 - National Institute on Minority Health and Health; Disparities Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Minority Health and Health... Health and Health Disparities. The meeting will be open to the public as indicated below, with...

  5. The Impact of Disasters on Populations With Health and Health Care Disparities

    PubMed Central

    Davis, Jennifer R.; Wilson, Sacoby; Brock-Martin, Amy; Glover, Saundra; Svendsen, Erik R.

    2010-01-01

    Context A disaster is indiscriminate in whom it affects. Limited research has shown that the poor and medically underserved, especially in rural areas, bear an inequitable amount of the burden. Objective To review the literature on the combined effects of a disaster and living in an area with existing health or health care disparities on a community’s health, access to health resources, and quality of life. Methods We performed a systematic literature review using the following search terms: disaster, health disparities, health care disparities, medically underserved, and rural. Our inclusion criteria were peer-reviewed, US studies that discussed the delayed or persistent health effects of disasters in medically underserved areas. Results There has been extensive research published on disasters, health disparities, health care disparities, and medically underserved populations individually, but not collectively. Conclusions The current literature does not capture the strain of health and health care disparities before and after a disaster in medically underserved communities. Future disaster studies and policies should account for differences in health profiles and access to care before and after a disaster. PMID:20389193

  6. Discrimination and racial disparities in health: evidence and needed research

    PubMed Central

    Mohammed, Selina A.

    2010-01-01

    This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health. PMID:19030981

  7. Discrimination and racial disparities in health: evidence and needed research.

    PubMed

    Williams, David R; Mohammed, Selina A

    2009-02-01

    This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health. PMID:19030981

  8. Exploring the Sociodemographic, Organizational and Other Correlates Affecting the Promotion of Cultural and Linguistic Competence: Implications for Mental Health Disparities

    ERIC Educational Resources Information Center

    Francis, Karen Belinda

    2012-01-01

    Background: Cultural and linguistic competence is widely viewed as a strategy for addressing disparities in health and mental health care. Organizational activities towards the integration and implementation of cultural and linguistic competence span the gamut to include training, workforce development, policy development and standards that inform…

  9. Health and Mental Health Policies' Role in Better Understanding and Closing African American-White American Disparities in Treatment Access and Quality of Care

    ERIC Educational Resources Information Center

    Snowden, Lonnie R.

    2012-01-01

    Since publication of the U.S. Surgeon General's report "Mental Health: Culture, Race and Ethnicity--A Supplement to Mental Health: A Report of the Surgeon General" (U.S. Department of Health and Human Services, 2001), several federal initiatives signal a sustained focus on addressing African American-White American disparities in mental health…

  10. The Double Disparity Facing Rural Local Health Departments.

    PubMed

    Harris, Jenine K; Beatty, Kate; Leider, J P; Knudson, Alana; Anderson, Britta L; Meit, Michael

    2016-01-01

    Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities. PMID:26735428

  11. Assessing needs and assets for building a regional network infrastructure to reduce cancer related health disparities.

    PubMed

    Wells, Kristen J; Lima, Diana S; Meade, Cathy D; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K; Pledger, W Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E; Fouad, Mona; Moreno, Carlos S; Lacey, Michelle; Christie, Debra W; Price-Haywood, Eboni G; Quinn, Gwendolyn P; Coppola, Domenico; Sodeke, Stephen O; Green, B Lee; Lichtveld, Maureen Y

    2014-06-01

    Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nation-wide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. PMID:24486917

  12. Assessing Needs and Assets for Building a Regional Network Infrastructure to Reduce Cancer Related Health Disparities

    PubMed Central

    Wells, Kristen J.; Lima, Diana S.; Meade, Cathy D.; Muñoz-Antonia, Teresita; Scarinci, Isabel; McGuire, Allison; Gwede, Clement K.; Pledger, W. Jack; Partridge, Edward; Lipscomb, Joseph; Matthews, Roland; Matta, Jaime; Flores, Idhaliz; Weiner, Roy; Turner, Timothy; Miele, Lucio; Wiese, Thomas E.; Fouad, Mona; Moreno, Carlos S.; Lacey, Michelle; Christie, Debra W.; Price-Haywood, Eboni G.; Quinn, Gwendolyn P.; Coppola, Domenico; Sodeke, Stephen O.; Green, B. Lee; Lichtveld, Maureen Y.

    2015-01-01

    Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nationwide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals. PMID:24486917

  13. Women and Lung Disease. Sex Differences and Global Health Disparities

    PubMed Central

    Harbaugh, Mary; Han, MeiLan K.; Jourdan Le Saux, Claude; Van Winkle, Laura S.; Martin, William J.; Kosgei, Rose J.; Carter, E. Jane; Sitkin, Nicole; Smiley-Jewell, Suzette M.; George, Maureen

    2015-01-01

    There is growing evidence that a number of pulmonary diseases affect women differently and with a greater degree of severity than men. The causes for such sex disparity is the focus of this Blue Conference Perspective review, which explores basic cellular and molecular mechanisms, life stages, and clinical outcomes based on environmental, sociocultural, occupational, and infectious scenarios, as well as medical health beliefs. Owing to the breadth of issues related to women and lung disease, we present examples of both basic and clinical concepts that may be the cause for pulmonary disease disparity in women. These examples include those diseases that predominantly affect women, as well as the rising incidence among women for diseases traditionally occurring in men, such as chronic obstructive pulmonary disease. Sociocultural implications of pulmonary disease attributable to biomass burning and infectious diseases among women in low- to middle-income countries are reviewed, as are disparities in respiratory health among sexual minority women in high-income countries. The implications of the use of complementary and alternative medicine by women to influence respiratory disease are examined, and future directions for research on women and respiratory health are provided. PMID:25945507

  14. Women and Lung Disease. Sex Differences and Global Health Disparities.

    PubMed

    Pinkerton, Kent E; Harbaugh, Mary; Han, MeiLan K; Jourdan Le Saux, Claude; Van Winkle, Laura S; Martin, William J; Kosgei, Rose J; Carter, E Jane; Sitkin, Nicole; Smiley-Jewell, Suzette M; George, Maureen

    2015-07-01

    There is growing evidence that a number of pulmonary diseases affect women differently and with a greater degree of severity than men. The causes for such sex disparity is the focus of this Blue Conference Perspective review, which explores basic cellular and molecular mechanisms, life stages, and clinical outcomes based on environmental, sociocultural, occupational, and infectious scenarios, as well as medical health beliefs. Owing to the breadth of issues related to women and lung disease, we present examples of both basic and clinical concepts that may be the cause for pulmonary disease disparity in women. These examples include those diseases that predominantly affect women, as well as the rising incidence among women for diseases traditionally occurring in men, such as chronic obstructive pulmonary disease. Sociocultural implications of pulmonary disease attributable to biomass burning and infectious diseases among women in low- to middle-income countries are reviewed, as are disparities in respiratory health among sexual minority women in high-income countries. The implications of the use of complementary and alternative medicine by women to influence respiratory disease are examined, and future directions for research on women and respiratory health are provided. PMID:25945507

  15. Implications of sleep and energy drink use for health disparities

    PubMed Central

    Grandner, Michael A; Knutson, Kristen L; Troxel, Wendy; Hale, Lauren; Jean-Louis, Girardin; Miller, Kathleen E

    2014-01-01

    The popularity of energy drinks has increased rapidly in the past decade. One of the main reasons people use energy drinks is to counteract effects of insufficient sleep or sleepiness. Risks associated with energy drink use, including those related to sleep loss, may be disproportionately borne by racial minorities and those of lower socioeconomic status. In this review, a brief introduction to the issue of health disparities is provided, population-level disparities and inequalities in sleep are described, and the social-ecological model of sleep and health is presented. Social and demographic patterns of energy drink use are then presented, followed by discussion of the potential ways in which energy drink use may contribute to health disparities, including the following: 1) effects of excessive caffeine in energy drinks, 2) effects of energy drinks as sugar-sweetened beverages, 3) association between energy drinks and risk-taking behaviors when mixed with alcohol, 4) association between energy drink use and short sleep duration, and 5) role of energy drinks in cardiometabolic disease. The review concludes with a research agenda of critical unanswered questions. PMID:25293540

  16. Aberrant DNA Methylation: Implications in Racial Health Disparity

    PubMed Central

    Wang, Xuefeng; Ji, Ping; Zhang, Yuanhao; LaComb, Joseph F.; Tian, Xinyu; Li, Ellen; Williams, Jennie L.

    2016-01-01

    Background Incidence and mortality rates of colorectal carcinoma (CRC) are higher in African Americans (AAs) than in Caucasian Americans (CAs). Deficient micronutrient intake due to dietary restrictions in racial/ethnic populations can alter genetic and molecular profiles leading to dysregulated methylation patterns and the inheritance of somatic to germline mutations. Materials and Methods Total DNA and RNA samples of paired tumor and adjacent normal colon tissues were prepared from AA and CA CRC specimens. Reduced Representation Bisulfite Sequencing (RRBS) and RNA sequencing were employed to evaluate total genome methylation of 5’-regulatory regions and dysregulation of gene expression, respectively. Robust analysis was conducted using a trimming-and-retrieving scheme for RRBS library mapping in conjunction with the BStool toolkit. Results DNA from the tumor of AA CRC patients, compared to adjacent normal tissues, contained 1,588 hypermethylated and 100 hypomethylated differentially methylated regions (DMRs). Whereas, 109 hypermethylated and 4 hypomethylated DMRs were observed in DNA from the tumor of CA CRC patients; representing a 14.6-fold and 25-fold change, respectively. Specifically; CHL1, 4 anti-inflammatory genes (i.e., NELL1, GDF1, ARHGEF4, and ITGA4), and 7 miRNAs (of which miR-9-3p and miR-124-3p have been implicated in CRC) were hypermethylated in DNA samples from AA patients with CRC. From the same sample set, RNAseq analysis revealed 108 downregulated genes (including 14 ribosomal proteins) and 34 upregulated genes (including POLR2B and CYP1B1 [targets of miR-124-3p]) in AA patients with CRC versus CA patients. Conclusion DNA methylation profile and/or products of its downstream targets could serve as biomarker(s) addressing racial health disparity. PMID:27111221

  17. 76 FR 31618 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities.... App.), notice is hereby given of a meeting of the National Advisory Council on Minority Health...

  18. 75 FR 53975 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities.... App.), notice is hereby given of a meeting of the National Advisory Council on Minority Health...

  19. 75 FR 28262 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center on Minority Health and Health Disparities.... App.), notice is hereby given of a meeting of the National Advisory Council on Minority Health...

  20. Removing Obstacles To Eliminating Racial And Ethnic Disparities In Behavioral Health Care.

    PubMed

    Alegría, Margarita; Alvarez, Kiara; Ishikawa, Rachel Zack; DiMarzio, Karissa; McPeck, Samantha

    2016-06-01

    Despite decades of research, racial and ethnic disparities in behavioral health care persist. The Affordable Care Act expanded access to behavioral health care, but many reform initiatives fail to consider research about racial/ethnic minorities. Mistaken assumptions that underlie the expansion of behavioral health care run the risk of replicating existing service disparities. Based on a review of relevant literature and numerous observational and field studies with minority populations, we identified the following three mistaken assumptions: Improvement in health care access alone will reduce disparities, current service planning addresses minority patients' preferences, and evidence-based interventions are readily available for diverse populations. We propose tailoring the provision of care to remove obstacles that minority patients face in accessing treatment, promoting innovative services that respond to patients' needs and preferences, and allowing flexibility in evidence-based practice and the expansion of the behavioral health workforce. These proposals should help meet the health care needs of a growing racial/ethnic minority population. PMID:27269014

  1. Measuring health disparities and health inequities: do you have REGAL data?

    PubMed

    Ramos, Roberto; Davis, Jenna L; Ross, Thomas; Grant, Cathy G; Green, B Lee

    2012-01-01

    Measuring health disparities is a challenging and at times a difficult proposition. It is generally accepted that at minimum, collecting, analyzing, reporting, and applying data through tailored and targeted interventions responsive to issues regarding race, ethnicity, and preferred language are essential for identifying, monitoring, and, ultimately, eliminating health disparities. Key to eliminating these disparities is determining whether the care and services being provided are resulting in vastly different experiences for some patients. Health care institutions and providers often convince themselves that collecting these data is a time-consuming, costly, and arduous endeavor. However, if patient information on Race, Ethnicity, Gender, Age, and preferred Language (REGAL) is currently being collected, one has the basic elements to effectively measure disparities across a host of clinical and nonclinical indicators. In formulating comparisons among targeted populations in areas such as access to health care, health care quality, health outcomes, prevention, early detection, treatment, and morbidity and mortality rates, it is critical to frame part of the discussion around collecting, analyzing, reporting, and applying REGAL data, including future expansion of measures and indicators. The Health Disparities REGAL Data Dashboard is a useful tool for health care institutions and providers and can provide an innovative approach to measuring health disparities. PMID:22722524

  2. Health disparities across the lifespan: meaning, methods, and mechanisms.

    PubMed

    Adler, Nancy E; Stewart, Judith

    2010-02-01

    Over the past two decades, exponential growth of empirical research has fueled markedly increased concern about health disparities. In this paper, we show the progression of research on socioeconomic status (SES) and health through several eras. The first era reflected an implicit threshold model of the association of poverty and health. The second era produced evidence for a graded association between SES and health where each improvement in education, income, occupation, or wealth is associated with better health outcomes. Moving from description of the association to exploration of pathways, the third era focused on mechanisms linking SES and health, whereas the fourth era expanded on mechanisms to consider multilevel influences, and a fifth era added a focus on interactions among factors, not just their main effects or contributions as mediators. Questions from earlier eras remain active areas of research, while later eras add depth and complexity. PMID:20201865

  3. Federal Investments to Eliminate Racial/Ethnic Health-Care Disparities

    PubMed Central

    Freeman, William

    2014-01-01

    Health care is an important lever for moderating the effects of social determinants on health. We present a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. Improving access to health care and enhancing patient-provider interaction are critical pathways for reducing disparities. Increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication. Federal policy makers should continue interest in workforce diversity to optimize the health of all Americans. PMID:24385667

  4. Oral Cancer in African Americans: Addressing Health Disparities

    ERIC Educational Resources Information Center

    Dodd, Virginia J.; Watson, Jennifer M.; Choi, Youjin; Tomar, Scott L.; Logan, Henrietta L.

    2008-01-01

    Objectives: To explore factors underlying African Americans' perceptions of oral cancer and the oral cancer exam. Study findings were used to guide development of oral cancer messages designed to increase oral cancer exams among African Americans. Methods: Focus groups were conducted to understand African Americans' attitudes and expectations…

  5. Addressing health literacy in patient decision aids

    PubMed Central

    2013-01-01

    Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies

  6. Under the radar: how unexamined biases in decision-making processes in clinical interactions can contribute to health care disparities.

    PubMed

    Dovidio, John F; Fiske, Susan T

    2012-05-01

    Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love-hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health. PMID:22420809

  7. Under the Radar: How Unexamined Biases in Decision-Making Processes in Clinical Interactions Can Contribute to Health Care Disparities

    PubMed Central

    Fiske, Susan T.

    2012-01-01

    Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love–hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health. PMID:22420809

  8. Review: Increasing Awareness and Education on Health Disparities for Health Care Providers.

    PubMed

    Nesbitt, Shawna; Palomarez, Rigo Estevan

    2016-01-01

    The focus of this review is to highlight health care disparities and trends in several common diseases in selected populations while offering evidence-based approaches to mitigating health care disparities. Health care disparities cross many barriers and affect multiple populations and diseases. Ethnic minorities, the elderly, and those of lower socioeconomic status (SES) are more at-risk than others. However, many low SES Whites and higher SES racial minorities have poorer health than their racial or SES peers. Also, recent immigrant groups and Hispanics, in particular, maintain high health ratings. The so-called Hispanic Paradox provides an example of how culture and social background can be used to improve health outcomes. These groups have unique determinants of disparity that are based on a wide range of cultural and societal factors. Providing improved access to care and reducing the social determinants of disparity is crucial to improving public health. At the same time, for providers, increasing an understanding of the social determinants promotes better models of individualized care to encourage more equitable care. These approaches include increasing provider education on disparities encountered by different populations, practicing active listening skills, and utilizing a patient's cultural background to promote healthy behaviors. PMID:27103768

  9. 75 FR 42100 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center on Minority and Health Disparities; Notice... personal privacy. Name of Committee: National Center on Minority Health and Health Disparities...

  10. The community need index. A new tool pinpoints health care disparities in communities throughout the nation.

    PubMed

    Roth, Richard; Barsi, Eileen

    2005-01-01

    Catholic Healthcare West, San Francisco (CHW), has developed a national Community Need Index (CNI) in partnership with Solucient, an information products company, to help health care organizations, not-for-profits, and policymakers identify and address barriers to health care access in their communities. The CNI aggregates five socioeconomic indicators long known to contribute to health disparity--income, culture/language, education, housing status, and insurance coverage--and applies them to every zip code in the United States. Each zip code is then given a score ranging from 1.0 (low need) to 5.0 (high need). Residents of communities with the highest CNI scores were shown to be twice as likely to experience preventable hospitalization for manageable conditions--such as ear infections, pneumonia or congestive heart failure--as communities with the lowest CNI scores. The CNI provides compelling evidence for addressing socioeconomic barriers when considering health policy and local health planning. The tool highlights health care disparities between geographic regions and illustrates the acute needs of several notable geographies, including inner city and rural areas.Further, it should enable health care providers, policymakers, and others to allocate resources where they are most needed, using a standardized, quantitative tool. The CNI provides CHW with an important means to strategically allocate resources where it will be most effective in maintaining a healthy community. PMID:16092512