Minority Health and Health Equity Archive

Permanent URI for this collectionhttp://hdl.handle.net/1903/21769

Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.

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End date: 2009Subject: search.filters.subject.Health

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Now showing 1 - 10 of 362
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    Good provider, good patient: changing behaviors to eliminate disparities in healthcare.
    (2004) Thiel de Bocanegra, Heike; Gany, Francesca
    We examined the relationship between cross-cultural provider-patient interactions and health outcomes through a literature review. Results were presented in the form of guiding principles to an expert panel of health care administrators, medical practitioners, and medical care providers. This expert panel met at the workshop "Changing Patient Behavior" during a conference convened by the office of Minority Health, US Department of Health and Human Services, February 17-18, 2000. The panel reviewed the themes and formulated suggestions for program and policy change. Six principles were identified: (1) Physicians should acknowledge that patients may be actively involved in health maintenance long before they seek medical care. (2) Patients should be empowered to be active participants in their medical care. (3) Providers should critically evaluate their own assumptions and underlying values about what constitutes a "good" patient and consider how these assumptions and values affect their communication strategies. (4) The patient's behavior change in the medical interaction should result from a process of negotiation between provider and patient. (5) The medical system should focus on community empowerment in addition to individual empowerment. (6) Accessible and understandable health outcome data will empower the community to participate in the elimination of health disparities.
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    Distributive justice in American healthcare: institutions, power, and the equitable care of patients.
    (2004) Putsch, Robert W; Pololi, Linda
    The authors argue that the American healthcare system has developed in a fashion that permits and may support ongoing, widespread inequities based on poverty, race, gender, and ethnicity. Institutional structures also contribute to this problem. Analysis is based on (1) discussions of a group of experts convened by the Office of Minority Health, US Department of Health and Human Services at a conference to address healthcare disparities; and (2) review of documentation and scientific literature focused on health, health-related news, language, healthcare financing, and the law. Institutional factors contributing to inequity include the cost and financing of American healthcare, healthcare insurance principles such as mutual aid versus actuarial fairness, and institutional power. Additional causes for inequity are bias in decision making by healthcare practitioners, clinical training environments linked to abuse of patients and coworkers, healthcare provider ethnicity, and politics. Recommendations include establishment of core attributes of trust, relationship and advocacy in health systems; universal healthcare; and insurance systems based on mutual aid. In addition, monitoring of equity in health services and the development of a set of ethical principles to guide systems change and rule setting would provide a foundation for distributive justice in healthcare. Additionally, training centers should model the behaviors they seek to foster and be accountable to the communities they serve.
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    Healthcare disparities and models for change.
    (2004) Baquet, Claudia R; Carter-Pokras, Olivia; Bengen-Seltzer, Barbara
    With Healthy People 2010 making the goal of eliminating health disparities a national priority, policymakers, researchers, medical centers, managed care organizations (MCOs), and advocacy organizations have been called on to move beyond the historic documentation of health disparities and proceed with an agenda to translate policy recommendations into practice. Working models that have successfully reduced health disparities in managed care settings were presented at the National Managed Health Care Congress Inaugural Forum on Reducing Racial and Ethnic Disparities in Health Care on March 10-11, 2003, in Washington, DC. These models are being used by federal, state, and municipal governments, as well as private, commercial, and Medicaid MCOs. Successful models and programs at all levels reduce health disparities by forming partnerships based on common goals to provide care, to educate, and to rebuild healthcare systems. Municipal models work in collaboration with state and federal agencies to integrate patient care with technology. Several basic elements of MCOs help to reduce disparities through emphasis on preventive care, community and member health education, case management and disease management tracking, centralized data collection, and use of sophisticated technology to analyze data and coordinate services. At the community level, there are leveraged funds from the Health Resources and Services Administration's Bureau of Primary Health Care. Well-designed models provide seamless monitoring of patient care and outcomes by integrating human and information system resources.
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    Cultural Competency as It Intersects With Racial/Ethnic, Linguistic, and Class Disparities in Managed Healthcare Organizations
    (2004) Zambrana, Ruth Enid; Molnar, Christine; Munoz, Helen Baras; Lopez, Debbie Salas
    Culture in and of itself is not the most central variable in the patient-provider encounter. The effect of culture is most pronounced when it intersects with low education, low literacy skills, limited proficiency in English, culture-specific values regarding the authority of the physician, and poor assertiveness skills. These dimensions require attention in Medicaid managed care settings. However, the promise of better-coordinated and higher quality care for low-income and working-poor racial/ethnic populations— at a lower cost to government—has yet to be fully realized. This paper identifies strategies to reduce disparities in access to healthcare that call for partnerships across government agencies and between federal and state governments, provider institutions, and community organizations. Lessons learned from successful precedents must drive the development of new programs in Medicaid managed care organizations (MCOs) to reduce disparities. Collection of population-based data and analyses by race, ethnicity, education level, and patient’s primary language are critical steps for MCOs to better understand their patients’ healthcare status and improve their care. Research and experience have shown that by acknowledging the unique healthcare conditions of lowincome racial and ethnic minority populations and by recruiting and hiring primary care providers who have a commitment to treat underserved populations, costs are reduced and patients are more satisfied with the quality of care.
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    Changing healthcare professionals' behaviors to eliminate disparities in healthcare: What do we know? How might we proceed?
    (2004) Horner, Ronnie D; Salazar, William; Geiger, H Jack; Bullock, Kim; Corbie-Smith, Giselle; Cornog, Martha; Flores, Glenn
    The patient-healthcare provider communication process--particularly the provider's cultural competency--is increasingly recognized as a key to reducing racial/ethnic disparities in health and healthcare utilization. A working group was formed by the Office of Minority Health, Department of Health and Human Services to identify strategies for improving healthcare providers' cultural competency. This expert panel, one of several working groups called together to explore methods of reducing healthcare disparities, was comprised of individuals from academic medical centers and health professional organizations who were nationally recognized as having expertise in healthcare communication as it relates to diverse populations. During the 2-day conference, the panel identified, from personal experience and knowledge of the literature, key points of intervention and interventions most likely to improve the cross-cultural competency of healthcare providers. Proposed interventions included introduction of cultural competence education before, during, and after clinical training; implementation of certification and accreditation requirements in cross-cultural competence for practicing healthcare providers; use of culturally diverse governing boards for clinical practices; and active promotion of workforce cross-cultural diversity by healthcare organization administrators. For each intervention, methods for implementation were specified. On-going monitoring and evaluation of processes of care using race/ethnicity data were recommended to ensure the programs were functioning.
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    Cultural competency as it intersects with racial/ethnic, linguistic, and class disparities in managed healthcare organizations.
    (2004) Zambrana, Ruth Enid; Molnar, Christine; Munoz, Helen Baras; Lopez, Debbie Salas
    Culture in and of itself is not the most central variable in the patient-provider encounter. The effect of culture is most pronounced when it intersects with low education, low literacy skills, limited proficiency in English, culture-specific values regarding the authority of the physician, and poor assertiveness skills. These dimensions require attention in Medicaid managed care settings. However, the promise of better-coordinated and higher quality care for low-income and working-poor racial/ethnic populations--at a lower cost to government--has yet to be fully realized. This paper identifies strategies to reduce disparities in access to healthcare that call for partnerships across government agencies and between federal and state governments, provider institutions, and community organizations. Lessons learned from successful precedents must drive the development of new programs in Medicaid managed care organizations (MCOs) to reduce disparities. Collection of population-based data and analyses by race, ethnicity, education level, and patient's primary language are critical steps for MCOs to better understand their patients' healthcare status and improve their care. Research and experience have shown that by acknowledging the unique healthcare conditions of low-income racial and ethnic minority populations and by recruiting and hiring primary care providers who have a commitment to treat underserved populations, costs are reduced and patients are more satisfied with the quality of care.
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    Discrimination, work and health in immigrant populations in Spain
    (2009) Agudelo-Suárez, Andrés; Gil-González, Diana; Ronda-Pérez, Elena; Porthé, Victoria; Paramio-Pérez, Gema; García, Ana M.; Garí, Aitana
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    The inverse hazard law: Blood pressure, sexual harassment, racial discrimination, workplace abuse and occupational exposures in US low-income black, white and Latino workers
    (2008) Krieger, Nancy; Chen, Jarvis T.; Waterman, Pamela D.; Hartman, Cathy; Stoddard, Anne M.; Quinn, Margaret M.; Sorensen, Glorian; Barbeau, Elizabeth M.