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.
Browse
10 results
Search Results
Item Racial and Ethnic Differences in Access to and Use of Health Care Services, 1977 to 1996(2000) Weinick, Robin M.; Zuvekas, Samuel H.; Cohen, Joel W.Abstract available at publisher's web site.Item A Plan for Action: Key Perspectives from the Racial/Ethnic Disparities Strategy Forum(2008) KING, RODERICK K.; GREEN, ALEXANDER R.; TAN-McGRORY, ASWITA; DONAHUE, ELIZABETH J.; KIMBROUGH-SUGICK, JESSIE; BETANCOURT, JOSEPH R.Abstract available at publisher's web site.Item Race, Ethnicity, and the Health Care System: Public Perceptions and Experiences(2000) Lillie-Blanton, Marsha; Brodie, Mollyann; Rowland, Diane; Altman, Drew; McIntosh, MaryAbstract available on publisher's web site.Item HIV Screening and Access to Care: Exploring the Impact of Policies on Access to and Provision of HIV Care(National Academies Press, 2011) Committee on HIV Screening , and Access to Care; Institute , of MedicineWith the widespread use of highly active anti-retroviral treatment (HAART), HIV has become a chronic, rather than a fatal, disease. But for their treatment to succeed, patients require uninterrupted care from a health care provider and uninterrupted access to anti-HIV medications. The IOM identifies federal, state, and private health insurance policies that inhibit HIV-positive individuals from initiating or continuing their care.Item Inequality in quality: addressing socioeconomic, racial, and ethnic disparities in health care.(2000) Fiscella, K; Franks, P; Gold, M R; Clancy, C MSocioeconomic and racial/ethnic disparities in health care quality have been extensively documented. Recently, the elimination of disparities in health care has become the focus of a national initiative. Yet, there is little effort to monitor and address disparities in health care through organizational quality improvement. After reviewing literature on disparities in health care, we discuss the limitations in existing quality assessment for identifying and addressing these disparities. We propose 5 principles to address these disparities through modifications in quality performance measures: disparities represent a significant quality problem; current data collection efforts are inadequate to identify and address disparities; clinical performance measures should be stratified by race/ethnicity and socioeconomic position for public reporting; population-wide monitoring should incorporate adjustment for race/ethnicity and socioeconomic position; and strategies to adjust payment for race/ethnicity and socioeconomic position should be considered to reflect the known effects of both on morbidity. JAMA. 2000;283:2579-2584Item Auditing Access to Specialty Care for Children with Public Insurance(2011) Bisgaier, Joanna; Rhodes, Karin V.Background Health care reform has expanded eligibility to public insurance without fully addressing concerns about access. We measured children’s access to outpatient specialty care to identify disparities in providers’ acceptance of Medicaid and the Children’s Health Insurance Program (CHIP) versus private insurance. Methods Between January and May 2010, research assistants called a stratified, random sample of clinics representing eight specialties in Cook County, Illinois, which has a high proportion of specialists. Callers posed as mothers of pediatric patients with common health conditions requiring outpatient specialty care. Two calls, separated by 1 month, were placed to each clinic by the same person with the use of a standardized clinical script that differed by insurance status. Results We completed 546 paired calls to 273 specialty clinics and found significant disparities in provider acceptance of Medicaid–CHIP versus private insurance across all tested specialties. Overall, 66% of Medicaid–CHIP callers (179 of 273) were denied an appointment as compared with 11% of privately insured callers (29 of 273) (relative risk, 6.2; 95% confidence interval [CI], 4.3 to 8.8; P<0.001). Among 89 clinics that accepted both insurance types, the average wait time for Medicaid–CHIP enrollees was 22 days longer than that for privately insured children (95% CI, 6.8 to 37.5; P = 0.005). Conclusions We found a disparity in access to outpatient specialty care between children with public insurance and those with private insurance. Policy interventions that encourage providers to accept patients with public insurance are needed to improve access to care.Item Racial and Ethnic Differences in Access to Medical Care(2000) Mayberry, Robert M; Mili, Fatima; Ofili, ElizabethThe authors’ review of the health services literature since the release of the landmark Report of the Secretary’s Task Force Report of Black and Minority Health in 1985 revealed significant differences in access to medical care by race and ethnicity within certain disease categories and types of health services. The differences are not explained by such factors as socioeconomic status (SES), insurance coverage, stage or severity of disease, comorbidities, type and availability of health care services, and patient preferences. Under certain circumstances when important variables are controlled, racial and ethnic disparities in access are reduced and may disappear. Nonetheless, the literature shows that racial and ethnic disparities persist in significant measure for several disease categories and service types. The complex challenge facing current and future researchers is to understand the basis for such disparities and to determine why disparities are apparent in some but not other disease categories and service types.Item Disaggregating Data on Asian and Pacific Islander Women to Assess Cancer Screening(2004) Chen, Judy Y; Diamant, Allison L; Kagawa-Singer, Marjorie; Pourat, Nadereh; Wold, CherylBackground: Although incidence of cancer is increasing among Asian-American and Pacific-Islander (AAPI) women, their low cancer screening rates are inadequately addressed. Furthermore, the traditional approach of studying the diverse AAPI nationalities as one group hides important intra- and inter-group ethnic differences in cancer screening, as well as lack of representativeness because the surveys are not administered in any AAPI language. To address these problems, this study compared cancer screening rates among particular AAPI groups and non-AAPIs living in an ethnically diverse region. Methods: This study was conducted in 2001–2002 using data from the 1999–2000 Los Angeles County Health Survey, a population-based telephone survey that relied on random-digitdialing techniques. Cervical and breast cancer–screening rates were measured, and key determinants of screening using bivariate analyses and multivariate logistic regression were assessed. Results: AAPIs had lower screening rates than whites, with significant variation among AAPI subgroups. Moreover, AAPI women were less likely to have undergone cervical cancer screening compared to white women, independent of major demographic, socioeconomic, and health status factors. Determinants for receipt of cancer screening differed for AAPIs and whites. Immigration factors were significant barriers to cancer screening for AAPIs. Conclusions: These findings support the evidence of disparities in receipt of cancer screening services among subgroups of AAPI women. Additionally, these findings highlight the importance of disaggregating the heterogeneous AAPI population to identify higher-risk subgroups and facilitate development of effective targeted interventions.Item The Uninsured in America(2005) Blue Cross, Blue Shield AssociationThe rising number of Americans without health insurance concerns us all. The ability to live a healthy and productive life is important to everyone. Quality healthcare coverageis essential to that goal, and the lack of coverage can be devastating to families. Reducing the number of uninsured Americans and keeping quality healthcare affordable are the top priorities of the Blue Cross and Blue Shield System. As healthcare companies that have been members of the American community for more than 75 years, Blue Cross and Blue Shield Plans want to be part of the solution. There is no single magic answer to this problem. Research shows that the uninsured are diverse and that there are many reasons why some individuals and their families are uninsured. This report highlights how Blue Cross and Blue Shield has taken a leadership role at the national and local levels to keep costs in line and increase opportunities for affordable coverage. The broad range of initiatives outlined here addresses the specific needs of the many millions of people who make up the uninsured in America. At the same time, we know that the continuing vitality of America's healthcare system depends on thoughtful, coordinated contributions from all sides. That is why we also set out a series of legislative proposals in this document calling for the private sector and government to work hand-in-hand to reduce the number of the uninsured. Taken together, these proposals could reduce the ranks of the 44.7 million uninsured Americans identified in the 2004 Census report by as much as two-thirds.Item Progress Review- Access to Quality Health Services(2002) Carmona, Richard HIn the first in a series of Progress Reviews on the 28 focus areas of Healthy People 2010, Assistant Secretary for Health Dr. Eve Slater chaired a session on Access to Quality Health Services (see the focus area text at www.healthypeople.gov/document/html/volume1/01access.htm). Also participating in the meeting was Deputy Secretary Claude Allen, who stressed the close and mutually reinforcing connection between Healthy People 2010 and the Secretary’s Prevention Initiative. The Progress Review highlighted the need to increase health care coverage and to enhance the quality of that care. Discussions were led by the heads of the focus area co-lead agencies, Health Resources and Services Administration (HRSA) Administrator Elizabeth Duke and Agency for Healthcare Research and Quality (AHRQ) Acting Director Carolyn Clancy, and by National Center for Health Statistics (NCHS) Director Edward Sondik. (For the meeting agenda and a graphic representation of data on selected objectives within the focus area, refer to the following site maintained by NCHS: www.cdc.gov/nchs/about/otheract/hpdata2010/fa1/atqhs.htm.)