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 What Do Schools of Public Health Have to Say About Diversity and Inclusion?(Pedagogy in Health Promotion, 2019-12-01) Merino, YesinaObjective. The purpose of this study was to understand how schools of public health (SPHs) define and operationalize diversity and inclusion. Methods. Data were collected in February 2017 from publicly available websites for each of the 59 Council on Education in Public Health–accredited SPHs, including mission/vision, goals/strategic plans, and diversity statements. Mentions of diversity were quantified to generate the proportion of SPHs that explicitly address diversity or inclusion. As a related secondary point, mentions of equity were also considered. Results. One third of SPHs do not mention diversity, inclusion, or equity as central tenets of the school. Twenty percent do not mention strategic plans or goals related to diversity, inclusion, or equity. Only 12 of the 59 schools define what they mean by diversity. Conclusions. Recently released Council on Education in Public Health accreditation competencies point to a need for increased attention by SPHs to inclusion and equity. Currently, however, most SPHs do not have a clear definition of how they define diversity. Implications. Additional research is needed into how SPHs will evolve their conceptualizations of diversity, inclusion, and equity to meet the training needs of the next generation of public health professionals.Item Building Castles Together: A sustainable collaboration as a perpetual work-in-progress(2011) Vazquez Jacobus, Michelle; Baskett, Robert; Bechstein, ChristinaAbstract available at publisher's web site.Item Disparities in health and health care: focusing efforts to eliminate unequal burdens.(2003) Baldwin, Dee MDisparities in health and health care have been around for more than two centuries. Evidence suggests that health disparities in ethnic and racial minorities continue to be problematic, with little progress made to eliminate them over time. Ethnic and racial disparities exist for multiple and complex reasons. However, new solutions are needed to resolve some of these old problems. Framing the debate and discussion around the distinctiveness related to disparities in health and health care is a necessary beginning in eliminating unequal burdens in health status. Focusing efforts to eliminate unequal burdens can strengthen existing solutions and policy formation related to this issue. This article defines disparities in health and health care, describes current health disparities impacting ethnic/racial groups, reviews historical factors associated with existing disparities in ethnic/racial groups, and concludes with challenges and solutions to alleviate these disparities.Item Race and healthcare disparities: overcoming vulnerablity.(2002) Stone, JohnThe paper summarizes recently published data and recommendations about healthcare disparities experienced by African Americans who have Medicare or other healthcare coverage. Against this background the paper addresses the ethics of such disparities and how disadvantages of vulnerable populations like African Americans are typically maintained in decision making about how to respond to such disparities. Considering how to respond to disparities reveals much that vulnerable populations would bring to the policy-making table, if they can also be heard when they get there. The paper argues that vulnerable populations like African Americans need fair representation in bodies deciding what to do about such disparities and that fairness requires proportional representation at all levels of decisions that affect healthcare--a radical change. In this decision setting, how to provide adequate protection of minorities needs much further attention. The most attractive decision-making model is deliberative democracy. The paper shows that in deliberation, fair representation requires not only having a voice in decisions, but a fair hearing of those voices. Achieving a fair hearing requires changes in norms of communication and training of all to give importance to greetings and other measures of civility and trust building, and to be open to diverse forms of expression. Decisions about how to respond to healthcare disparities would include what programs to initiate for whom, how to evaluate the programs, and what to do in response to such evaluations. Conclusions are that achieving such goals will take a sea change in how healthcare institutions and providers do their business, and that social activism at every level will be needed to effect these changes. The discussion highlights many ethical issues that need much greater attention.Item Disparities In Human Resources: Addressing The Lack Of Diversity In The Health Professions(2008) Grumbach, K.; Mendoza, R.African Americans, Latinos, and American Indians are severely underrepresented in the health professions. A strong case for diversity may be made on the grounds of civil rights, public health and educational benefit, and business gains. Improving the diversity of the health professions requires multiprong strategies addressing the educational pipeline, admissions policies and the institutional culture at health professions schools, and the broader policy environment.Item 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) Satcher, DavidMental health is fundamental to health, according to Mental Health: A Report of the Surgeon General, the first Surgeon General’s report ever to focus exclusively on mental health. That report of two years ago urged Americans to view mental health as paramount to personal well-being, family relationships, and successful contributions to society. It documented the disabling nature of mental illnesses, showcased the strong science base behind effective treatments, and recommended that people seek help for mental health problems or disorders. The first mental health report also acknowledged that all Americans do not share equally in the hope for recovery from mental illnesses. This is especially true of members of racial and ethnic minority groups. That awareness galvanized me to ask for a supplemental report on the nature and extent of disparities in mental health care for racial and ethnic minorities and on promising directions for the elimination of these disparities. This Supplement documents that the science base on racial and ethnic minority mental health is inadequate; the best available research, however, indicates that these groups have less access to and avail-ability of care, and tend to receive poorer quality mental health services. These disparities leave minority communities with a greater disability burden from unmet mental health needs. A hallmark of this Supplement is its emphasis on the role that cultural factors play in mental health. The cultures from which people hail affect all aspects of mental health and illness, including the types of stresses they confront, whether they seek help, what types of help they seek, what symptoms and concerns they bring to clinical attention, and what types of coping styles and social supports they possess. Likewise, the cultures of clinicians and service systems influence the nature of mental health services.Item Enacting Diverses Learning Environments: Improving the Climate for Racial/Ethnic Diversity in Higher Education(1999) Hurtado, Sylvia; Milem, Jeffery; Clayton-Pedersen, Alma; Allen, Walter; Kezar, Adrianna J.; Scott, Lynne J.; Fishel, Barbara M.This document is intended to provide the higher education community with information from recent and classic research studies that can serve as a guide to improving the climate for diversity on campus. The first section of the report examines the literature on campus climate for diversity, the experiences of various racial/ethnic groups, and the effect of campus climate educational outcomes. Following sections (1) set out the research framework; (2) examine the historical legacy of inclussion and exclussion; (3) examine the impact of structural diversity resulting from the increased complexity of diverse student enrollments and problems associated with diversifying faculty; (4) review the psycological climate and the impact of discrimination and perceptions of climate on students. (5) examine the behavioral dimensions of institutional climate, including student involvemnet and intergroup relations, classroom environment, curricular change, campus race relations and social interaction, and participation in racial/ethnic student organizations and minority support programs; (6) link institutional climate for diversity with general learning environment; (7) provide some principles for improving campus climate for diversity; (8) give some examples of current effortss at various institutions, and (9) conclude with a plan for action in which everyone has a role in improving campus climate.Item Should research samples reflect the diversity of the population?(2004) Allmark, PRecent research governance documents say that the body of research evidence must reflect population diversity. The response to this needs to be more sophisticated than simply ensuring minorities are present in samples. For quantitative research looking primarily at treatment effects of drugs and devices four suggestions are made. First, identify where the representation of minorities in samples matters—for example, where ethnicity may cause different treatment effects. Second, where the representation of a particular group matters then subgroup analysis of the results will usually be necessary. Third, ensuring representation and subgroup analysis will have costs; deciding on whether such representation is worthwhile will involve cost benefit analysis. Fourth, the representation of minorities should not be seen as mainly a locality issue. For qualitative research it is argued that the representation of diversity is often important. Given the small samples of many qualitative projects, however, the best way to ensure representation occurs is to allow a proliferation of such research, not to stipulate such representation in samples.Item Promising Practices For Patient-Centered Communication With Vulnerable Populations: Examples From Eight Hospitals(The Commonwealth Fund -- Institute for Ethics, American Medical Association, 2006) Wynia, Matthew; Matiasek, JenniferABSTRACT: As patient populations become increasingly diverse, health care organizations are looking for innovative ways to communicate effectively across cultures, languages, and health literacy levels. This study identified eight hospitals from across the country that have demonstrated a commitment to providing patient-centered communication with vulnerable patient populations. Through site visits and focus group discussions, the authors draw out “promising practices” from the hospital’s efforts to lower language barriers and ensure safe, clear, and effective health care interactions. The promising practices include: having passionate champions to advocate for communication programs; collecting information on patient needs; engaging communities; developing a diverse and skilled workforce; involving patients; spreading awareness of cultural diversity; providing effective language assistance services; addressing low health literacy; and tracking performance over time. Hospital and health system leaders can use these practices as starting points to encourage patient-centered communication in their own organizations.Item Diversity: Creating an Environment of Inclusiveness(2004) Swanson, Jane WDiversity is a concept that most organizations espouse but find challenging to put into practice. It is especially critical for healthcare organizations to be responsive in addressing issues of diversity related to not only employees but also clients. This article identifies the following 3 areas that must be addressed if an organization is to succeed in creating an environment where diversity and inclusiveness are honored: (1) organizations and their leaders need to be aware of their reactions “those who are different”in their organization. This awareness is critical in identifying the underlying obstacles that prevent a truly inclusive workplace; (2) organizations and their leaders need to be able to expand their perspectives allowing them to not only understand but appreciate others. These expanded perspectives can provide a potentially powerful tool for both problem solving and conflict resolution; (3) if organizations and their leaders are actively engaged in exploring options and are open to alternatives, they will find that they not only succeed in creating an environment of inclusiveness but also are in a better position to meet the needs of employees, patients, and a multicultural society.