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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Item The health of Latino children: urgent priorities, unanswered questions, and a research agenda.(2002) Flores, Glenn; Fuentes-Afflick, Elena; Barbot, Oxiris; Carter-Pokras, Olivia; Claudio, Luz; Lara, Marielena; McLaurin, Jennie A; Pachter, Lee; Ramos-Gomez, Francisco J; Mendoza, Fernando; Valdez, R Burciaga; Villarruel, Antonia M; Zambrana, Ruth E; Greenberg, Robert; Weitzman, Michael; Gomez, Francisco J RamosLatinos recently became the largest racial/ethnic minority group of US children. The Latino Consortium of the American Academy of Pediatrics Center for Child Health Research, consisting of 13 expert panelists, identified the most important urgent priorities and unanswered questions in Latino child health. Conclusions were drawn when consensus was reached among members, with refinement through multiple iterations. A consensus statement with supporting references was drafted and revised. This article summarizes the key issues, including lack of validated research instruments, frequent unjustified exclusion from studies, and failure to analyze data by pertinent subgroups. Latino children are at high risk for behavioral and developmental disorders, and there are many unanswered questions about their mental health needs and use of services. The prevalence of dental caries is disproportionately higher for Latino children, but the reasons for this disparity are unclear. Culture and language can profoundly affect Latino children's health, but not enough cultural competency training of health care professionals and provision of linguistically appropriate care occur. Latinos are underrepresented at every level of the health care professions. Latino children are at high risk for school dropout, environmental hazards, obesity, diabetes mellitus, asthma, lack of health insurance, nonfinancial barriers to health care access, and impaired quality of care, but many key questions in these areas remain unanswered. This article suggests areas in which more research is needed and ways to improve research and care of Latino children.Item Meaningful Disparities Reduction Through Research and Translation Programs(2011) Chin, M. H.; Goldmann, D.Health care disparities are unacceptable, but progress toward reducing them has been painfully slow. Each year the Agency for Healthcare Research and Quality's (AHRQ’s) National Healthcare Disparities Report documents persistent differences in care by factors such as race, ethnicity, and insurance status. 1 Public awareness of these disparities is growing, and the Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act of 2010 will hasten transparency by encouraging collection of race, ethnicity, and language data. However, recognizing the existence of disparities is not sufficient to catalyze meaningful action. Even the most motivated clinicians and health care organizations may not know how to proceed because information on which interventions work in specific contexts or at scale is limited. 2 There is broad agreement that meaningful efforts to reduce disparities are linked inextricably to quality improvement. In its 2001 report Crossing the Quality Chasm, the Institute of …Item THE BOSTON PARADOX Lots of Health Care, Not Enough Health(New England Healthcare Institute, 2007) Hubbard, Thomas; King, Nick; Fleishman, Valerie; Johnston, DouglasThe objective of this report is to focus on broad trends in Greater Boston’s health, its health care, and its overall economic competitiveness in a way that will suggest new strategies Greater Boston can use to meet three often conflicting goals: ■ The best health for all Greater Boston residents ■ Effective and sustainable health care ■ Sustained economic growth that benefits all Greater Boston residents As a result the full version of this report examines trends in many different fields, organized into two sections: The Health of Greater Boston ■ Population and Demography: The report looks at broad, ongoing trends at work in Greater Boston’s changing population that will affect health and health care demand. ■ Determinants of Health: Scientific research in epidemiology has identified several factors that have a decisive influence on the health and life expectancy of an entire population such as Greater Boston’s. The most critical “determinants” include socio-economic factors such as educational attainment level and the distribution of income among residents. Socioeconomic factors decisively influence the interaction of four other types of determining factors: genetics; environmental factors; health-related personal behaviors; and the degree of access to health care (such as the level of insurance coverage in the population). Greater Boston’s Economy and Its Health Care ■ Health Status: In the interest of brevity this report examines six conditions prevalent throughout the population: heart disease and cancer (the two leading causes of mortality); hypertension; low birth weight (LBW) births; and diabetes and asthma (both chronic diseases of increasing prevalence in Greater Boston). Equally important conditions (such as mental health) may be incorporated in future revisions or as pertinent data is developed. * Sources of Health care funding: the report examines trends in three sectors that provide the majority of health care financing: employer-sponsered health insurance, state government and the federal government. * Uses of Health care funding: The report examines the five largest categories of health care as enumerated in the National Health Expenditure Accounts, the federal government's annual measure of all health care-related expenditures in the US and the 50 states. Trends in public health and the health insurance industry are also examined. * Related Industries: The report examines three fields tightly linked to health care in Greater Boston: Medical and Nursing education; Biomedical research and technology transfer; and the life science sector.Item Changes in Reporting of Race/Ethnicity, Socioeconomic Status, Gender, and Age Over 10 Years(2005) Brahan, Denise; Bauchner, HowardBackground. The recognition of health disparities as an important aspect of US health care has led to renewed interest in the reporting of race/ethnicity and socioeconomic status (SES) in original research reports. Purpose. To describe reporting of race/ethnicity and SES, in comparison with age and gender, and to report changes with time. Methods. All original research articles that focused on children and asthma that were published in The Journal of the American Medical Association, The New England Journal of Medicine, Pediatrics, The Journal of Pediatrics, and Archives of Pediatrics and Adolescent Medicine were reviewed for 2 time periods, 1991–1993 and 2000–2002. Each report was assessed for coding of age, gender, race/ethnicity (number of groups and which groups), and SES. Results. In 1991–1993, 27 reports met the inclusion criteria; in 2000–2002, 74 were reviewed. Overall, significantly more reports described age (90.1%) and gender (78.2%) than SES (41.6%) and race/ethnicity (54.5%). During the 2 study periods, there were significant increases in studies reporting race/ethnicity (from 29.6% to 63.5%) but not in studies reporting SES or gender. Coding of race/ethnicity, even in the later time period, was largely confined to white (78.7%) and black (89.4%). Fewer reports coded Latino (55.3%) or Asian (14.9%). Only 2 of the 31 articles that coded Latino subjects contained information on ethnic subgroups, whereas none of the 8 articles included Asian subgroups. Conclusions. Original research reports in a specific area (asthma) for which health disparities have been well documented still contain few data on race/ethnicity and SES, particularly in comparison with age and gender. There has been some improvement in the past decade in the reporting of race/ethnicity, but the reporting of Latino and Asian subgroups remains poor. If we are to understand health disparities, then more appropriate reporting of SES and race/ethnicity is necessary.