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 State-Level Variations in Racial Disparities in Life Expectancy(2011) Bharmal, Nazleen; Tseng, Chi-Hong; Kaplan, Robert; Wong, Mitchell D.Abstract available at publisher's website.Item Eliminating Disparities in Hypertension Care for Hispanics and Blacks Using a Heart Failure Disease Management Program(2011) Hebert, Kathy; Julian, Elyse; Alvarez, Jorge; Dias, Andre; Tamariz, Leonardo; Arcement, Lee; Quevedo, Henry C.Objectives: This study assessed if patients enrolled in a heart failure disease management program (HFDMP) reach the JNC VII target goals for blood pressure (BP) control, eliminate disparities in hypertension control by race/ethnicity and the impact BP control has on survival. Methods: Patients (N = 898) with an ejection fraction <40% were enrolled into two HFDMPs and screened for hypertension, defined as BP > 130/80. Results: Mean baseline systolic BP (SBP) 132 +/- 25.5 mm Hg and diastolic BP (DBP) 79 +/- 16.8 mm Hg. Final mean SBP decreased to 129.6 mm Hg, DBP 77.6 mm Hg. Whites had the highest rate of achieving BP goals. Mortality reduction was associated with minority race, history of hypertension, increase ejection fraction and statin use. Conclusion: HFDMPs are an effective way to reduce BP in hypertensive patients. Disparities by race and ethnicity were not seen after adjustment for disease modifiers. There was no mortality difference in those who reached BP goal.Item Lower Stroke Mortality Among Hispanics: an exploration of potential methodological confounders(2010) Howrey, Bret; Goodwin, James S.; Eschbach, Karl; Freeman, JeanOBJECTIVES: Stroke mortality rates are reported to be lower for Hispanics than non-Hispanic Whites. We investigate the degree to which this lower reported mortality is explained by inaccuracies introduced through omission of nativity, imprecise measurement of cause of death, and under-ascertainment of Hispanic ethnicity on death certificates. We used national vital registration data for the years 1989-1991 and 1999-2002, including foreign- and US-born Hispanics and non-Hispanic Whites. Hispanic deaths were adjusted for misclassification of ethnicity on the death certificate. Denominators for the rates were derived from census estimates. RESULTS: Adjustment for nativity and death certificate misclassification removes the stroke mortality advantage for US-born Hispanic men, but not women. After adjustment, US-born Hispanic men and women have higher rates of mortality from subarachnoid hemorrhage than non-Hispanic Whites (RR: 1.23 and 1.23, respectively), but lower rates of mortality from Ischemic (RR: 0.76 and 0.73, respectively) and chronic effects of stroke (RR: 0.87 and 0.73, respectively). CONCLUSIONS: When adjusted for misclassification the lower stroke mortality remains for Hispanic men and women at older ages. Part of the previously reported advantage is a combination of imprecise measurement and data quality.Item Social determinants of health: the solid facts(World Health Organization, 2003) Wilkinson, Richard G.; Marmot, M. G.Poorer people live shorter lives and are more often ill than the rich. This disparity has drawn attention to the remarkable sensitivity of health to the social environment. This publication examines this social gradient in health, and explains how psychological and social influences affect physical health and longevity. It then looks at what is known about the most important social determinants of health today, and the role that public policy can play in shaping a social environment that is more conducive to better health. This second edition relies on the most up-to-date sources in its selection and description of the main social determinants of health in our society today. Key research sources are given for each: stress, early life, social exclusion, working conditions, unemployment, social support, addiction, healthy food and transport policy. Policy and action for health need to address the social determinants of health, attacking the causes of ill health before they can lead to problems. This is a challenging task for both decision-makers and public health actors and advocates. This publication provides the facts and the policy options that will enable them to act.Item Visiting nurse program aims to prevent Native American infant deaths(2011) Springer, PatrickSISSETON, S.D. - Toshina Oneroad’s infant daughter has sparkling eyes and a sunny disposition, but her tiny cough caught the nurse’s attention. Jodi Lutjens, a visiting nurse with the Indian Health Service clinic near here, 90 miles south of Fargo, took the infant’s temperature. Normal. A good sign. At the tender age of 1 month, the baby is vulnerable to infection – just the sort of pitfall Lutjens is trying to avoid through prevention and education, the front line of defense against infant mortality.Item How white and African Americans view their health and social problems. Different experiences, different expectations.(1995) Blendon, R J; Scheck, A C; Donelan, K; Hill, C A; Smith, M; Beatrice, D; Altman, DDESPITE increases in expenditures and expansions of many US health and social welfare programs and institutions, racial disparities persist in many aspects of American society. Particularly troubling is the reality that the health of our nation's population differs so greatly by race. A number of studies in recent years have documented substantial differences between white and African Americans in health status, morbidity and mortality, access to health services, and perceptions of quality in health care services received.1-9 Consistent with these reports of differences in overall health, national opinion surveys show that African Americans are more likely than whites to rate the health services in their communities as fair or poor (46% and 23%)10; our study also indicates that African Americans are more likely to state that the health system in this country needs to be completely rebuilt (42% vs 31%). This disparity between the assessments of African AmericansItem Barbershops become urban community health centers(2008) Coles, TerriAfrican-American communities in the shadows of the University of Pittsburgh's buildings are getting sick and dying sooner than their white counterparts, of preventable diseases -- and Dr. Stephen Thomas wants to change it. An outreach initiative involving local barbershops and beauty salons is a step in that direction.Item Community Development Model for Public Health Applications: Overview of a Model to Eliminate Population Disparities(2005) Robinson, Robert G.For well over two decades, the public health community has undertaken a broad range of initiatives to identify and eliminate various health-related disparities among popula tions. The Centers for Disease Control and Prevention’s(CDC) Office on Smoking and Health (OSH),for example, has committed resources to help states eliminate population disparities related to tobacco use.These initiatives have enjoyed a degree of success and some measurable decreases in population disparities. However, traditional public health approaches that are overly influenced by reductionist paradigms more content with risk factor assessment of at-risk strata may not be sufficient to produce successful results when applied to more intractable disparities. The elimination of disparities will require a more encompassing and comprehensive approach that addresses both population strata at risk and the communities in which they reside. This article proposes a new, concentrated model to address the elimination of population disparities—a model that focuses on community as the critical unit of analysis and action to achieve success.Item 2005 National Healthcare Disparities Report(Agency for Healthcare Research and Quality, 2005) UNSPECIFIEDKey Themes and Highlights From the National Healthcare Disparities Report Twenty years ago, the Department of Health and Human Services (HHS) released the Report of the Secretary’s Task Force on Black and Minority Health. That report documented many disparities in health and led to interventions to improve the health and health care of minorities. This year, the Agency for Healthcare Research and Quality (AHRQ) is pleased to release the third National Healthcare Disparities Report (NHDR). This annual report provides a comprehensive national overview of disparities in health care among racial, ethnic, and socioeconomic groups in the general U.S. population and within priority populations and tracks the success of activities to reduce disparities. It is a companion report to the National Healthcare Quality Report (NHQR), a comprehensive overview of quality of health care in America. A major advantage of an annual report series is its ability to track changes over time. This year, data are presented that begin tracking trends across a broad array of measures of health care quality and access for many racial, ethnic, and socioeconomic groups. In addition, the 2005 report begins to examine the issue of whether the Nation is making progress toward eliminating health care disparities. The NHDR tracks disparities in both quality of health care and access to health care. Measures of health care quality mirror those in the NHQR and encompass four dimensions of quality—effectiveness, patient safety, timeliness, and patient centeredness. Measures of health care access are unique to this report and encompass two dimensions of access—facilitators and barriers to care and health care utilization.Item A Remedy for the Black-White Test-Score Disparity [Comment](2002) Helms, Janet ESackett, Schmitt, Ellingson, and Kabin (April 2001) analyzed the effectiveness of strategies for reducing the disparities in average scores on high-stakes tests of cognitive abilities (CATs) of (especially) African or Black and Latino and Latina Americans as compared with White Americans. They argued that decision makers in the domains of education, employment, and licensure and certification are becoming increasingly dependent on test scores as the primary criteria for making high-stakes decisions. Consequently, these two socioracial groups, as well as Native and Asian Americans (with respect to tests of verbal skills), who are already underrepresented in many selective educational institutions and professions, may disappear from them entirely if the disparities in test scores cannot be eliminated or rendered meaningless for making high-stakes decisions involving them. Sackett et al.'s proposed solutions to the problem are to either "dumb down" (i.e., remove cognitive content of) the tests or alter the testing process so that it appears to be fair to Black and Hispanic test takers, even, as if the authors' analysis suggested, it is not. In what seems to be an effort to prove that the test performance disparities between groups reflect actual irremediable cognitive deficiencies of the adversely affected test takers, Sackett et al. (2001) cited DeShon, Smith, Chan, and Schmitt's (1998) "unique study" (Sackett et al., 2001, p. 309) as disproving a "social relations and social context" (p. 309) argument, which they misattributed to me (Helms, 1992). I did not recommend that CAT items be modified to include social content. Most CATs already include such content. Instead, I discussed the absence of empirical evidence that CATs are culturally equivalent for African American test takers and proposed a strategy for quantifying the effects of racial and cultural variables on African, Latino and Latina, Asian, and Native American (ALANA) test takers' CAT scores. DeShon et al. allegedly collected the type of cultural data (e.g., racial identity attitudes) that could be used for trying the strategy but did not analyze it appropriately.