Can America’s Urban Safety Net Systems be a Solution to Unequal Treatment?

Abstract

Eliminating disparities in care for racial and ethnic minorities remains a challenge in achieving overall quality health care. One approach to resolving issues of inequity involves utilizing an urban safety-net system to address preventive and chronic care disparities. An analysis was undertaken at Denver Health (DH), an urban safety net which serves 150,000 patients annually, of which 78% are minorities and 50% uninsured. Medical charts for 4,795 randomly selected adult patients at ten DHassociated community health centers were reviewed between July 1999 and December 2001. Logistic regression was used to identify differences between racial/ethnic groups in cancer screening, blood pressure control, and diabetes management. No disparities in care were found, and in most instances, the quality of care met or exceeded available benchmarks, leading us to conclude that treatment in urban integrated safety net systems committed to caring for minority populations may represent one approach to reducing disparity.

Predictors of timely follow‐up after abnormal cancer screening among women seeking care at urban community health centers

“…Even within CHCs, we found differences in socio-demographic characteristics for the two cancer screening populations, reflecting generational shifts in the community populations given the changing composition of modern cities and immigration patterns. These findings are particularly important given the emerging role of the community health center model in caring for the country's most vulnerable populations 22-24, 31. Our findings highlight the potential diversity both across and within CHCs, underscoring the need to understand the specific socio-demographics of the populations served.…”

Advance Directive Discussions: Lost in Translation or Lost Opportunities?

“…DHMC was another of our study hospitals and is a safety-net health care system and nationally recognized for providing high-quality care without disparities. 26 It may have been that the quality and equality of care at these two hospitals resulted in similar rates of documented ADs between ethnic groups. However, if the inclusion of these two model health care systems explains why rates of documented ADs did not differ, it leaves the more troubling question of why were rates of reported AD discussions so much lower among Latinos unanswered.…”

Pharmacological Treatment of Alzheimer's Disease: Effect of Race and Demographic Variables

“…The Robert Wood Johnson Foundation commissioned the Dartmouth Atlas Project report and has pledged significant allocation of resources toward community-focused programs, under “Aligning Forces for Quality”, based on their similar findings [13,26]. Community-based approaches such as the Urban Safety Net System and the Comprehensive Community Mental Health Services for Children and their Families Program have shown success in reducing racial, ethnic, and socioeconomic disparity in such measures as cancer screening, blood pressure control, diabetes management, and mental health [27,28]. Therefore, research and programs to reduce health disparities in AD should be considered as well.…”