Reducing Racial and Ethnic Health Disparities: Exploring an Outcome-Oriented Agenda for Research and Policy

Abstract

Eliminating racial and ethnic disparities in health status and health care, a major focus of Healthy People 2010, remains on the national agenda and among the priorities for the administration of President George W. Bush. Even though the elimination of racial and ethnic health disparities challenges the whole nation, individual states are on the front line of many initiatives and are often the focus of important policy efforts. In addition, it is important to focus on states because they are already responsible for much of the health and public health infrastructure, and several states have developed initiatives dating back to the release of Margaret Heckler's report on the gaps in health outcomes by race in 1985. This article makes the case for an outcome-oriented approach and provides a summary of lessons learned based upon preliminary investigations into constructing and applying two indices, the disparity reduction profile to measure effort and the disparity index to measure outcomes.

Strategies for Targeting Health Care Disparities Among Hispanics

“…65 Health care facilities providing services to Medicaid beneficiaries in an MUA could contribute by recruiting bilingual minority health care professionals. Health care facilities may be supported by the private 53 or government funding for recruiting and retaining bilingual health care professionals.…”

Community-Based Dialogue: Engaging Communities of Color in the United States' Genetics Policy Conversation

“…Scholars have described racial and ethnic health disparities as an issue of distributive justice (Gamble 2006). A call has been made for the federal government, together with researchers, to set an outcome-oriented national agenda to reduce racial and ethnic health disparities (Gibbs et al 2006). However, racial and ethnic health disparities may be exacerbated if researchers assume that the basis of these disparities is solely genetic and thus conduct studies in a manner that appears to affirm a genetic basis for racial differences in disease prevalence (Sankar et al 2004).…”

Healthcare Systems in Comparative Perspective: Classification, Convergence, Institutions, Inequalities, and Five Missed Turns

“…Governmental and non-governmental organizations are making efforts toward reducing healthcare disparities, and advocates and researchers are interested in incorporating health inequalities research into policy (Exworthy et al 2006; Gibbs et al 2006; Pittman 2006). This is despite the “rule of the thumb” that the healthcare system contributes no more than 10% to overall healthcare disparities; this truism is in line with longstanding work demonstrating that public-health improvements such as basic sanitation have far outweighed medical technology in the lowering of mortality rates across the advanced industrial countries, although critics argue that technology matters more in mortality reduction after 1945.…”

“…For instance, Schuster and coauthors (2005) identify significant gaps between need and healthcare delivery, and they suggest detailed methods for monitoring the quality of health care. We note that monitoring quality and inequality is a forefront area for data collection since current data collection often fails to match the political organization of healthcare delivery (Blewett et al 2004; Gibbs et al 2006). …”