Think Cultural Health
HHS.gov HHS.gov HHS.gov
minorityhealth.hhs.gov
Advancing Health Equity at
Every Point of Contact

Join the CLCCHC

CLAS Clearinghouse: Results for "Policy"



Patient Protection And Affordable Care Act Of 2010: Advancing Health Equity for Racially and Ethnically Diverse Populations External Web Site Policy

Andrulis, D. P., Siddiqui, N. J., Purtle, J. P., & Duchon, L. (2010). Patient protection and affordable care act of 2010: advancing health equity for racially and ethnically diverse populations. Retrieved from Joint Center for Political and Economic Studies website: http://www.jointcenter.org/sites/default/files/upload/research/files/Patient%20Protection%20and%20Affordable%20Care%20Act.pdf

The Joint Center for Political and Economic Studies has published a report detailing the implications of 2010's healthcare reform on health equity. It states that recent healthcare reform legislation offers an unprecedented opportunity to improve health equity in the United States.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Irvine's Hoag Hospital works to bridge cultural barriers External Web Site Policy

Reicher, M. (2010, September 8). Irvine's Hoag Hospital works to bridge cultural barriers. Los Angeles Times. Retrieved from http://articles.latimes.com/2010/sep/08/local/la-me-hoag-hospital-20100908

This article details a California hospital's efforts to incorporate culturally competent practices into its services and system. Hoag Hospital in Irvine, CA, took many steps to adapt to its patients' cultural beliefs, traditions, and languages. These preparations include creating patient rooms arranged according to the principles of feng shui, serving steamed rice for breakfast, and using gestures such as presenting documents respectfully with two hands and speaking to patients with more formality.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Communication | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

At Hospitals, New Methods With a Focus on Diversity External Web Site Policy

Santos, F. (2010, September 6) At hospitals, new methods with a focus on diversity. The New York Times. Retrieved from http://www.nytimes.com/

This New York Times article discusses the ways that hospitals nationwide are adopting practices intended to improve care for an increasingly diverse patient population beyond language access services. Making immigrant and minority individuals feel more at ease can translate into improved health outcomes according to health providers.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Ending health disparities takes interdisciplinary approach External Web Site Policy

Lewis, C., & Stout, J. (2010). Toothache in US children. Archives of Pediatrics & Adolescent Medicine, 164, 1056-1063. doi:10.1001/archpediatrics.2010.206

In this message from the American Medical Association (AMA) president to all physicians, Dr. Rohack notes that an interdisciplinary approach to patient-centered care may help reduce health disparities by addressing challenges in communication such as low health literacy and medication mismanagement. He commits to helping guide the changes needed to ensure culturally competent patient care. When patients do not understand their medical conditions or what to do to control them, unnecessary healthcare costs only will increase, a situation he notes the AMA is committed to avoiding.

Keywords:    Policy | Clinical & Mental Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Future Directions for the National Healthcare Quality and Disparities Reports External Web Site Policy

Institute of Medicine. (2010). Future directions for the national healthcare quality and disparities reports. Retrieved from http://iom.edu/

The Institute of Medicine (IOM) released in Spring 2010 a report that discusses future directions for the AHRQ National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR). The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the healthcare system.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Government | Population-Based | Profession-Based | Disease-Based | Quality Improvement | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

HHS Launches Oral Health Initiative

HHS Launches Oral Health Initiative. (2010, April 26). U.S. Department of Health and Human Services. Retrieved from http://minorityhealth.hhs.gov/

In April 2010, Dr. Howard Koh (Assistant Secretary for Health, HHS) announced an initiative to expand oral health services, education, and research in America ("Oral Health Is Integral to Overall Health"). Through the initiative, the department is increasing support for access to oral healthcare and the delivery of services to underserved populations.

Keywords:    Policy | Government | Profession-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

National Healthcare Disparities Report

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. National Healthcare Disparities Report (AHRQ Publication No. 10-0004). Retrieved from http://www.ahrq.gov/qual/nhdr09/nhdr09.pdf

The AHRQ produced the 2009 NHDR. The NHDR tracks the healthcare system through quality measures and summarizes healthcare quality and access among various racial, ethnic, and income groups and other priority populations, such as children and older adults.

Keywords:    Research | Policy | Clinical & Mental Health | Government | Disease-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

American Journal of Public Health External Web Site Policy

American Public Health Association. (2010). American Journal of Public Health, 100(5). Retrieved from http://ajph.aphapublications.org/content/vol100/issue5/

The first issue of any major public health journal devoted to Asian American, Native Hawaiian and Pacific Islander populations, the May issue of the American Journal of Public Health (AJPH) explores an array of new research on both alarming disparities and significant successes in care.

Keywords:    Research | Policy | Public Health | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care External Web Site Policy

The Joint Commission (2010). Topic Library Item: Advancing effective communication, cultural competence, and patient-and family-centered care. Retrieved from http://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf

The Joint Commission proposes accreditation requirements for hospitals. These standards aim to improve communication, cultural competence, and patient-centered care. The standards will be published in the 2011 Comprehensive Accreditation Manual for Hospitals (CAMH): The Official Handbook. Compliance with the patient-centered communication standards will be included in the accreditation decision no earlier than January 2012.

Keywords:    Policy | Clinical & Mental Health | Governance & Leadership | Government | Communication | Quality Improvement | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement External Web Site Policy

Institute of Medicine, Subcommittee on Standardized Collection of Race/Ethnicity Data for Healthcare Quality Improvement. (2009). Race, ethnicity, and language data: standardization for health care quality improvement. Retrieved from http://iom.edu/Reports/2009/RaceEthnicityData.aspx

In its 2009 report titled Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement, the IOM recommends that healthcare providers collect and assess comprehensive patient data on their cultural and linguistic needs. Having more precise quality metrics can assist in eliminating disparities in health and healthcare.

Keywords:    Tools | Research | Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Government | Population-Based | Quality Improvement | Engagement, Continuous Improvement, and Accountability |

Improving Patient-Provider Communication: Joint Commission Standards and Federal Laws External Web Site Policy

The Joint Commission (Producer). (2009). Improving Patient-Provider Communication: Joint Commission Standards and Federal Laws [Video]. Available from http://www.jointcommission.org/

"Improving Patient-Provider Communication" is a video created by the Joint Commission along with HHS and the Office for Civil Rights as part of their efforts to eliminate racial, ethnic, and language disparities in healthcare. The video educates healthcare providers in providing language access in healthcare organizations. Language access is critical in providing safe, quality patient care.

Keywords:    Tools | Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

The New Era of Professional Healthcare Interpreters External Web Site Policy

Birz, S. (2009, October 23). The new era of professional healthcare interpreters. AMN Healthcare. Retrieved from http://www.amnhealthcare.com/Default.aspx

This article discusses the need for language access service criteria, such as having interpreters professionally trained and credentialed to better guarantee effective communication between healthcare providers and patients. It also recommends that within the next year, healthcare organizations should begin using the Certification Commission for Healthcare Interpreters to find credentialed interpreters.

Keywords:    Research | Policy | Profession-Based | Communication | Communication and Language Assistance |

Eliminating Health Disparities: What Works? External Web Site Policy

Anderson, J. (2009, April to present). Eliminating health disparities: what works? Journal of the American Academy of Physician Assistants. Retrieved from http://www.jaapa.com/

"Eliminating Health Disparities: What Works?" is a series of articles in the Journal of the American Academy of Physician Assistants. Each month, the journal examines a pertinent topic within the field of health disparities and discusses tools that can help healthcare providers assess and eliminate health disparities in their practice. The column tackles issues such as bias and the role of race in health.

Keywords:    Tools | Research | Policy | Clinical & Mental Health | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Informacion en espanol External Web Site Policy

Agency for Healthcare Research and Quality. (n.d.). Informacion en espanol. Retrieved from http://www.ahrq.gov/consumer/espanoix.htm

The AHRQ's website called Informacion en Espanol provides a variety of publications and other resources on healthcare issues, including audio and video, in Spanish. Informacion en Espanol includes a monthly online health advice column titled "Consejos de Salud Para Ti" ("Health Advice for You"), which provides evidence-based tips on preventive health, safe and appropriate use of medications, ways to get better healthcare, and more.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Government | Communication | Communication and Language Assistance |

Study: Many Say Disparities Genetic External Web Site Policy

Study: many say disparities genetic. (2009, October 20). United Press International. Retrieved from http://www.upi.com/Health_News/2009/10/20/Study-Many-say-racial-disparities-genetic/UPI-80281256018232/

A study published in the Social Science Quarterly indicates that a majority of Americans support strategies to reduce healthcare disparities that are caused by social and economic status but believe that racial and ethnic health disparities are genetic. The authors note that the general public's belief that racial disparities have a genetic foundation is troubling because people will resist strategies aimed at eliminating health disparities.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Disease-Based | Communication | Disparities | Governance, Leadership, and Workforce | Engagement, Continuous Improvement, and Accountability |

Multicultural Health Care: A Quality Improvement Guide

National Committee for Quality Assurance, & Lilly USA, LLC. (2011). Multicultural health care: a quality improvement guide. Retrieved from http://www.clashealth.org/

The National Committee for Quality Assurance and Lilly USA, LLC, have developed Multicultural Health Care: A Quality Improvement Guide, a free, online resource for healthcare professionals. The website helps those seeking to undertake quality improvement initiatives to improve culturally and linguistically appropriate services and to reduce disparities in care.

Keywords:    Tools | Policy | Clinical & Mental Health | Profession-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

CSMS issues results of health disparities survey External Web Site Policy

CSMS issues results of health disparities survey. (2009, October 28). Connecticut State Medical Society. Retrieved from http://www.csms.org/index.php?option=com_content&task=view&id=2415&Itemid=222

This article discusses the results of a survey conducted by the Connecticut State Medical Society (CSMS) about physicians' views on ways to reduce disparities in healthcare, including cultural competency training. The results indicate that Connecticut physicians believe they could provide better care to patients of minority communities if they had better access to training. As a result of these findings, CSMS has committed to providing cultural competency training to physicians to help eliminate healthcare disparities in Connecticut.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Government | Profession-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Studying State Legislation of Cultural and Linguistic Competence External Web Site Policy

Robert Wood Johnson Foundation. (2009). Studying state legislation of cultural and linguistic competence. Retrieved from http://www.rwjf.org/

The Robert Wood Johnson Foundation (RWJF) funded a study by the National Center for Cultural Competence at Georgetown University that assessed State efforts to integrate cultural competence into continuing education and licensure requirements for healthcare professionals. The study reveals characteristics common between those States with legislation and States with barriers to the passage of legislation, and the study offers several strategic planning ideas.

Keywords:    Policy | Education & Training | Clinical & Mental Health | Public Health | Government | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Non-Native English Speakers Face Numerous Linguistic, Cultural Barriers to Medical Care External Web Site Policy

California Healthline. (2009). Non-Native English Speakers Face Numerous Linguistic, Cultural Barriers to Medical Care [Audio report]. Retrieved from http://www.californiahealthline.org/

This is an audio report that discusses a study conducted at the University of California-Berkley. The study finds that many non-native English speakers encounter difficulties in communicating with their healthcare providers, which can lead to lower quality healthcare. The researchers interviewed several key experts, who recommend that policymakers address health access issues by investing in telemedicine-based interpretation services and by recruiting bilingual medical professionals.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Improving Access to Language Services in Health Care: A Look at National and State Efforts

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. (2009). Improving access to language services in health care: a look at national and state efforts. Retrieved from http://www.ahrq.gov/

The issue brief explores national efforts to address language barriers for patients with limited English proficiency. It identifies challenges to delivering language services and highlights successes and implications for future policy as well as activities related to providing language services.

Keywords:    Tools | Policy | Clinical & Mental Health | Patients & Consumers | Government | Population-Based | Communication | Disparities | Communication and Language Assistance |

Speaking the Same Language: Medical Providers Struggle to Communicate With Immigrant Patients External Web Site Policy

Barclay, E. (2009, April 21). Speaking the same language: medical providers struggle to communicate with immigrant patients. The Washington Post. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2009/04/20/AR2009042002466_pf.html

This Washington Post article discusses the effect of the Washington area's high immigration rates on its healthcare providers and the quality of care offered to patients. The author describes the medical errors and discrimination that can result from inadequate language services, and she provides doctors' and patients' points of view.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Government | Population-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Journal of Health Care for the Poor and Underserved External Web Site Policy

Brennan, V. M. (Ed.). (2009). Journal of Health Care for the Poor and Underserved. doi: 10.1353/hpu.0.0146

The May 2009 issue of the Journal of Health Care for the Poor and Underserved offers a variety of articles that address issues of health disparities and access to care. It highlights medical education issues regarding obstacles and supports for different minority groups during the application process for medical school. It includes a section on immigrant health, which contains articles on a variety of racial and ethnic groups, including Chinese and Latinos.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Population-Based | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Health Information Technology: Addressing Health Disparity by Improving Quality, Increasing Access, and Developing Workforce External Web Site Policy

Custodio, R., Gard, A. M., & Graham, G. (2009). Health information technology: addressing health disparity by improving quality, increasing access, and developing workforce. Journal of Healthcare for the Poor and Underserved, 20(2), 301-307. doi: 10.1353/hpu.0.0146

This article discusses the role of health information technology (HIT) as a tool to assist in health reform. Through quality improvement, education and outreach, and workforce and training development, advances in HIT show strong potential to help the healthcare system reduce persistent racial and ethnic health disparities by delivering patient-centered, culturally competent care.

Keywords:    Tools | Research | Policy | Education & Training | Clinical & Mental Health | Governance & Leadership | Quality Improvement | Engagement, Continuous Improvement, and Accountability |

2008 National Healthcare Quality & Disparities Reports

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. (2009). National healthcare quality report, 2008 (AHRQ Publication No. 09-0001). Retrieved from http://www.ahrq.gov/qual/qrdr08.htm

The AHRQ released 2008's NHQR and NHDR, which present findings on quality of and access to healthcare by measuring trends in effectiveness of care, patient safety, patient centeredness, and more.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Government | Quality Improvement | Disparities | Engagement, Continuous Improvement, and Accountability |

One Size Does Not Fit All: Meeting The Health Care Needs of Diverse Populations External Web Site Policy

Wilson-Stronks, A., Lee, K. K., Cordero, C. L., Kopp, A. L., & Galvez, E. (2008). One size does not fit all: meeting the health care needs of diverse populations. Retrieved from The Joint Commission website: http://www.jointcommission.org/assets/1/6/HLCOneSizeFinal.pdf

This report provides insight into the ways in which hospitals meet diverse patient needs and reduce health disparities. It examines the challenge that healthcare organizations face when addressing cultural and language issues, and it provides a general framework for developing organizational cultural competence. The report stresses that each hospital is responsible for tailoring an approach to cultural competence that addresses its needs rather than relying on a "one size fits all" solution.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Governance & Leadership | Profession-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health External Web Site Policy

Commission on the Social Determinants of Health (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Retrieved from the World Health Organization website: http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf

This is the final report by the World Health Organization's Commission on Social Determinants of Health, which set out to examine ways to achieve health equity around the world. The report determines that the problem of health disparities can be tackled by developing strategies to influence policies and organizations that affect entire societies. The Commission has succeeded in its goal to create a global movement to promote health equity by establishing partnerships with governments and global organizations. The Commission concludes that achieving health equity within a generation is achievable.

Keywords:    Research | Policy | Public Health | Governance & Leadership | Government | Population-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

National Consensus Statement on Integrating Racially and Ethnically Diverse Communities into Public Health Emergency Preparedness External Web Site Policy

U.S. Department of Health & Human Services Office of Minority Health and Drexel University, Center for Health Equality National Consensus Panel on Emergency Preparedness and Cultural Diversity. (2008). National consensus statement on integrating racially and ethnically diverse communities into public health emergency preparedness. Retrieved from http://www.diversitypreparedness.org/SiteData/docs/National%20Consensus%20Statement%20%26%20Guiding%20Principles%20%26%20Panel%20List%20508/695132ab58eb36a7c2f67ba98d5a72ec/National%20Consensus%20Statement%20%26%20Guiding%20Principles%20%26%20Panel%20List%20508.pdf

This statement provides a framework for integrating racially and ethnically diverse communities into emergency preparedness. It was developed by the National Consensus Panel on Emergency Preparedness and Cultural Diversity, an initiative of the Drexel University School of Public Health's Center for Health Equality and the HHS Office of Minority Health.

Keywords:    Tools | Policy | Public Health | Governance & Leadership | Government | Profession-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Racial and Ethnic Disparities in U.S. Health Care: A Chartbook External Web Site Policy

Mead, H., Cartwright-Smith, L., Jones, K., Ramos, C., Woods, K., & Siegel, B. (2008). Racial and ethnic disparities in U.S. health care: a chartbook. Retrieved from the Commonwealth Fund website: http://www.commonwealthfund.org/~/media/Files/Publications/Chartbook/2008/Mar/Racial%20and%20Ethnic%20Disparities%20in%20U%20S%20%20Health%20Care%20%20A%20Chartbook/Mead_racialethnicdisparities_chartbook_1111%20pdf.pdf

This chartbook provides a framework through which policymakers, teachers, researchers, and practitioners may understand health disparities and formulate solutions. The chartbook presents data regarding health disparities, including their nature and etiology, and seeks to provoke thought about why disparities exist and how they can be eliminated.

Keywords:    Tools | Research | Policy | Education & Training | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Educating Physicians to Provide Culturally Competent, Patient-Centered Care External Web Site Policy

Like, R. C., Barrett, T. J., & Moon, J. (2008, Summer). Educating physicians to provide culturally competent, patient-centered care. Perspectives: A View of Family Medicine in New Jersey, 7(2), 10-20. Retrieved from http://www.njafp.org/publications/archive

This article in a New Jersey family medicine publication discusses the history of, rationale for, and effects of the legislation in New Jersey enacted in March 2005 that requires all physicians to complete cultural competency training for re-licensure and mandates the inclusion of relevant curricular content in the State's medical schools. It also outlines the development of cultural competency in legislation throughout the country on both State and national levels.

Keywords:    Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Government | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Health Disparities: Barriers to a Culture of Preparedness External Web Site Policy

Honore, R. L. (2008). Health Disparities: Barriers to a Culture of Preparedness. Journal of Public Health Management & Practice, 14(6), S5-S7. doi: 10.1097/01.PHH.0000338381.29071.d6

This article discusses the ways that inequalities in health and healthcare present a barrier to the United States' disaster preparedness and response activities. The article sets out to show that individuals, communities, the private sector, nonprofits, and all levels of government need to work together to reduce health inequalities to improve the Nation's level of preparedness and response to a crisis.

Keywords:    Research | Policy | Public Health | Patients & Consumers | Government | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Integrating Immigrant Families in Emergency Response, Relief and Rebuilding Efforts External Web Site Policy

Wang, T., & Yasui, L. (2008). Integrating immigrant families in emergency response, relief and rebuilding efforts. The Annie E. Casey Foundation and Grantmakers Concerned with Immigrants and Refugees. Retrieved from the Grantmakers Concerned with Immigrants and Refugees website: http://www.gcir.org/system/files/Integrating%20Immigrant%20Families%20in%20Emergency%20Response%2C%20Relief%20and%20Rebuilding%20Efforts.pdf

This report examines the disparities faced by immigrants and limited-English-proficiency communities during times of disaster. It focuses on emergency management at the local level since, oftentimes, the local government is the first on the scene during a disaster event.

Keywords:    Research | Policy | Education & Training | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Roadmap to diversity: Key legal and educational policy foundations for medical schools External Web Site Policy

Coleman, A. L., Palmer, S. R., Winnick, S. Y., & Holland & Knight, L.L.P. (2008). Roadmap to diversity: key legal and educational policy foundations for medical schools. Association of American Medical Colleges. Retrieved from http://www.cossa.org/diversity/reports/Key_Legal_and_Policy_Foundations_for_Medical_Schools.pdf

This report, published by the Association of American Medical Colleges, seeks to provide hands-on guidance to medical schools that seek to improve diversity among their students, their missions, and their policies. The report is designed to guide all medical schools in their quest for increased diversity.

Keywords:    Tools | Policy | Education & Training | Clinical & Mental Health | Governance & Leadership | Government | Profession-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

The influence of physicians' demographic characteristics and their patients' demographic characteristics on physician practice: Implications for education and research External Web Site Policy

Berger, J. T. "The influence of physicians' demographic characteristics and their patients' demographic characteristics on physician practice: Implications for education and research." Academic Medicine, 83.1 (2008): 100-105.

Demographic differences, specifically race, gender, and religion, have been shown to affect the diagnosis, type of treatment, and prevention methods provided to patients. This study from Academic Medicine highlights the necessity of cultural self-awareness and individualized patient care.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Population-Based | Profession-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Demographics and Health Care Access and Utilization of Limited-English-Proficient and English-Proficient Hispanics

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. (2008). Research findings #28: demographics and health care access and utilization of limited-English-proficient and English-proficient Hispanics. Retrieved from http://www.meps.ahrq.gov/mepsweb/data_files/publications/rf28/rf28.pdf

Using data from the 2004 Household Component of the Medical Expenditure Panel Survey, researchers examined the use and access of healthcare among Hispanic adults with limited English proficiency as well as English-proficient Hispanic adults. In comparison to English-proficient Hispanic adults, it was found that limited-English-proficiency Hispanic adults are more likely to be less educated, have a lower income, be unemployed, be without private insurance or uninsured, use health services less often, and have a lower satisfaction rate with the healthcare they receive.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Population-Based | Profession-Based | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Public health preparedness: Mobilizing state by state

U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, Coordinating Office for Terrorism Preparedness and Emergency Response. (2008). Public health preparedness: mobilizing state by state. A CDC report on the public health emergency preparedness cooperating agreement. Retrieved from http://www.cdc.gov/

The report details the progress of States in preparedness and response issues. This report is intended to serve as a first step in detailing collaboration efforts in preparedness between local, State, and Federal governments. National and State-specific data are presented for all 50 States and the District of Columbia.

Keywords:    Tools | Research | Policy | Public Health | Government | Profession-Based | Disparities | Engagement, Continuous Improvement, and Accountability |

National Resource Center External Web Site Policy

Drexel University School of Public Health's Center for Public Health Readiness & Communication, & U.S. Department of Health & Human Services Office of Minority Health. National resource center on advancing emergency preparedness for culturally diverse communities. (2011, June 10). Retrieved from http://www.diversitypreparedness.org/

The National Resource Center is a database of resources on the public health preparedness needs of diverse communities. The National Resource Center aims to serve as a clearinghouse for those stakeholders who are working to eliminate disparities among minority communities before, during, and following disasters.

Keywords:    Tools | Research | Policy | Education & Training | Public Health | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Racial disparities in cancer therapy External Web Site Policy

Gross, C. P., Smith, B. D., Wolf, E., & Andersen, M. (2008). Racial disparities in cancer therapy. Cancer, 112(4), 900-908. doi: 10.1002/cncr.23228

This study, published by the American Cancer Society, analyzes whether racial disparities in cancer therapy received by Medicare beneficiaries had been reduced between the early 1990s and 2002 as a result of the increase of disparities reduction initiatives. The study shows no noticeable decrease in racial disparities between 1992 and 2002.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Government | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Community variation: Disparities in health care quality between Asian and white Medicare beneficiaries External Web Site Policy

Moy, E., Greenberg, L. G., & Borsky, A. E. "Community variation: Disparities in health care quality between Asian and white Medicare beneficiaries." Health Affairs 27.2 (2008): 538-549.

This study focused on disparities in quality of health care received between Asian and white Medicare recipients. The researchers found that, overall, Asian Medicare beneficiaries were less likely than whites to receive any of the services examined.

Keywords:    Research | Policy | Clinical & Mental Health | Government | Population-Based | Profession-Based | Disease-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Summary of state law requirements addressing language needs in health care External Web Site Policy

Perkins, J., & Youdelman, M. (2008). Summary of state law requirements addressing language needs in health care. Retrieved from the National Health Law Program website: http://www.healthlaw.org/images/stories/issues/nhelp.lep.state.law.chart.final.0319.pdf

The National Health Law Program published a report detailing all existing State law requirements relating to language access needs in healthcare settings. Each State's data are presented in a unique chart with citation to the legislation, a brief description, and coding that indicates the subject matter being addressed.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Government | Communication | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Health care in the aftermath of Hurricane Katrina: Health care in New Orleans before and after Hurricane Katrina External Web Site Policy

Shartzer, A. (Author), & kaiserEDU.org (Producer). (2008). Health care in the aftermath of Hurricane Katrina: Health care in New Orleans before and after Hurricane Katrina [Video tutorial]. Retrieved from http://www.kaiseredu.org/tutorials/katrina/player.html

This is a narrated tutorial from the Kaiser Family Foundation that discusses the state of healthcare in New Orleans both before Hurricane Katrina and following it. Much of the information presented discusses the effect that Katrina had on low income individuals, many of whom are minorities.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Government | Population-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Identifying and Evaluating Equity Provisions in State Health Care Reform External Web Site Policy

Smedley, B., Alvarez, B., Panares, R., Fish-Parcham, C., & Adland, S. (2008). Identifying and evaluating equity provisions in state health care reform (Volume 90). Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/

This report examines barriers to healthcare primarily among racial and ethnic minorities, immigrants, and those who are limited English proficient through the lens of insurance and State-level policies and reforms. The report evaluates existing or proposed policies in five States-Massachusetts, Washington, California, Illinois, and Pennsylvania. It also identifies existing State-level policies for equal access to care.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Population-Based | Communication | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Ready or not? Protecting the public's health from diseases, disasters, and bioterrorism, 2010 External Web Site Policy

Trust for America's Health, & The Robert Wood Johnson Foundation. (2010). Ready or not 2010: protecting the public's health from diseases, disasters, and bioterrorism. Retrieved from the Trust for America's Health website: http://www.healthyamericans.org/assets/files/TFAH2010ReadyorNot%20FINAL.pdf

Since 2003, Trust for America's Health has been measuring the Nation's emergency health preparedness efforts to evaluate what is being done at the Federal, State, and local levels. This eighth annual Ready or Not? report regarding the United States' level of preparedness for disasters, bioterrorism threats, and disease epidemics indicates that, while important progress has been made in the Nation's public health preparedness, efforts need to continue, and much remains to be done.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Government | Profession-Based | Disparities | Governance, Leadership, and Workforce | Engagement, Continuous Improvement, and Accountability |

The medical tongue: U.S. laws and policies on language access. External Web Site Policy

Youdelman, M. (2008). The medical tongue: U.S. laws and policies on language access. Health Affairs, 27(2), 424-433. doi: 10.1377/hlthaff.27.2.424

Despite many Federal- and State-level laws regarding language access services, language barriers in healthcare are still prevalent for many individuals with limited English proficiency. The existing laws are not always sufficiently implemented or enforced. This article examines the current legislation and makes suggestions for improving language access for limited-English-proficiency individuals through a variety of lenses, including implementation and enforcement, funding, education, interpreters and translators, and accountability.

Keywords:    Research | Policy | Public Health | Government | Communication | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Creating Equity Reports: A Guide for Hospitals. Boston, MA External Web Site Policy

Weinick, R. M., Flaherty, K., & Bristol, S. J. (2008). Creating Equity Reports: A Guide for Hospitals. Retrieved from The Disparities Solutions Center, Massachusetts General Hospital website: http://www2.massgeneral.org/disparitiessolutions/z_files/Disparities%20Hospital%20guide.qxp.pdf

The findings in this report indicate that although many hospitals collect information about their patients' demographics, race, and ethnicity, they often do not make use of the information. This resource is a guide designed to assist hospitals in using that information to develop an equity report.

Keywords:    Tools | Policy | Education & Training | Clinical & Mental Health | Patients & Consumers | Governance & Leadership | Profession-Based | Communication | Quality Improvement | Health Literacy | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Crossing the Quality Chasm: A New Health System for the 21st Century External Web Site Policy

Committee on the Quality of Health Care in America: Institute of Medicine. (2001). Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press.

This report from the IOM's Committee on the Quality of Health Care in America documents the quality gap and its causes, and it calls for fundamental change to close the quality gap, recommending a redesign of the American healthcare system. The report provides principles to implement change for policymakers, healthcare leaders, clinicians, regulators, purchasers, and others.

Keywords:    Research | Disparities | Policy |

In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce External Web Site Policy

Institute of Medicine, Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Healthcare Workforce. (2004). In the nation's compelling interest: ensuring diversity in the health care workforce. Retrieved from the National Academies Press website: http://www.nap.edu/catalog.php?record_id=10885

The report examines institutional- and policy-level strategies to increase diversity among health professionals. The report assesses the potential benefits of greater diversity among health professionals and an assessment of strategies that may increase diversity in five areas.

Keywords:    Policy | Governance & Leadership | Engagement, Continuous Improvement, and Accountability |

Measuring the Gaps: Collecting Data to Drive Improvements in Health Care Disparities External Web Site Policy

Russell, L. (2010). Measuring the Gaps: Collecting Data to Drive Improvements in Health Care Disparities. Retrieved from the Center for American Progress website: http://www.americanprogress.org/issues/2010/12/pdf/measuringgaps.pdf

This article discusses the Affordable Care Act requirements for the collection and analysis of healthcare disparities data, which will lay the foundation for developing targeted interventions to improve quality of care for racial and ethnic minorities.

Keywords:    Policy | Disparities | Government | Governance & Leadership | Quality Improvement |

Medical Interpreters Are a Patient's Right External Web Site Policy

Krtiz, F. L. (2010, December 27). Medical interpreters are a patient's right. The Los Angeles Times. Retrieved from http://www.latimes.com/

This article documents language access requirements and advancements that help the healthcare system facilitate communication between providers and those who are limited English proficient. It discusses technological improvements, nationwide certification bodies, and Federal and State laws.

Keywords:    Policy | Communication and Language Assistance | Governance & Leadership | Research | Profession-Based |

Obama Official: Affordable Care Act Closes Racial Disparities External Web Site Policy

Chideya, F. (Host). (2011, March 23) Obama official: affordable care act closes racial disparities. In Martin, M. (Host), Tell Me More (Audio podcast), National Public Radio. Retrieved from http://www.npr.org/

In this interview, Assistant Secretary for Minority Health Dr. Garth Graham discusses the impact of the Affordable Care Act on minority communities. He discusses several aspects of the law that will reduce health disparities among racial and ethnic minorities.

Keywords:    Policy | Disparities | Government | Quality Improvement |

State Works to Improve Indian Health External Web Site Policy

Uken, C. (2011, January 8). State works to improve Indian health. The Billings Gazette. Retrieved from http://billingsgazette.com/news/state-and-regional/montana/article_efcf15bc-85d1-5af5-b396-eac182a2d146.html

This article details Montana's comprehensive efforts to address health disparities suffered by the State's American Indian population. Montana is implementing culturally competent services and partnering with tribal governments to improve the health of this population.

Keywords:    Population-Based | Policy | Profession-Based | Clinical & Mental Health | Public Health | Quality Improvement | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Multicultural HIV/AIDS and Hepatitis Service External Web Site Policy

A public site where people can access multilingual information on HIV and Hepatitis C.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Clinical & Mental Health | Communication | Governance, Leadership, and Workforce | Disease-Based | Disparities | Education & Training | Government | Health Literacy | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Patients & Consumers | Policy | Population-Based | Profession-Based | Public Health | Quality Improvement | Research | Tools |

NCQA Multicultural Healthcare Distinction fact sheet External Web Site Policy

A fact sheet describing how NCQA's Multicultural Healthcare Distinction program can help health care organizations meet Office of Minority Health CLAS standards.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance, Leadership, and Workforce | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Policy | Quality Improvement | Tools |

Native American Spirituality External Web Site Policy

An information Guide for Health Care providers, hospital staff and administrators, chaplains, school administrators, funeral directors and others regarding ceremonies, rights and obligations.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Governance, Leadership, and Workforce | Education & Training | Government | Health Literacy | Engagement, Continuous Improvement, and Accountability | Patients & Consumers | Policy | Quality Improvement |

Advancing Effective Communication, Cultural Competency, and Patient/Family-Centered Care for LGBT Community External Web Site Policy

This new field guide from The Joint Commission urges U.S. hospitals to create a more welcoming, safe and inclusive environment that contributes to improved health care quality for lesbian, gay, bisexual, and transgender (LGBT) patients and their families. The guide, Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care for the Lesbian, Gay, Bisexual and Transgender (LGBT) Community: A Field Guide, was developed with support from The California Endowment.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Communication | Governance, Leadership, and Workforce | Disparities | Education & Training | Engagement, Continuous Improvement, and Accountability | Patients & Consumers | Policy | Population-Based | Public Health | Quality Improvement | Research | Tools |

Health care delivery and deaf people: Practice, problems, and recommendations for change External Web Site Policy

Harmer, L. (1999). Health care delivery and deaf people: Practice, problems, and recommendations for change. Journal of Deaf Studies and Deaf Education, 4(2), 73-110. doi:10.1093/deafed/4.2.73

The author reviews socio-economic and legal issues, patients' "knowledge base, personal experiences, and understanding of health care relationships, ... the Deaf community's perspectives, providers' views about disability, communication between providers and deaf patients, ... barriers encountered in health care delivery," and the ethical implications of these factors. She concludes that deaf and hard-of-hearing individuals often receive "inadequate, inappropriate, and unethical health care."

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Population-Based | Policy | Patients & Consumers | Research |

Unequal treatment: Confronting racial and ethnic disparities in health care External Web Site Policy

Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy. (2003). B. D. Smedley, A. Y. Stith, & A. R. Nelson (Eds.). Unequal treatment: Confronting racial and ethnic disparities in health care. Retrieved from http://www.nap.edu/openbook.php?record_id=10260&page=R1

This book explores how racial and ethnic minorities experience the health care environment, how treatment disparities can arise in health care systems, and how aspects of the clinical interaction could contribute to disparity. Attitudes, expectations, and behavior - of patients and providers alike - are examined. Based on their findings, the committee makes a number of recommendations for legal, regulatory, and policy changes; health systems interventions; patient and cross-cultural education efforts; data collection and monitoring; and research.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Disparities | Policy | Public Health | Research |

National Council on Interpreting in Health Care External Web Site Policy

National Council on Interpreting in Health Care. (2011). Retrieved from http://www.ncihc.org

This website provides links to NCIHC publications and training programs. Links are available to other relevant sites, such as state interpreter associations, educational programs, and sites discussing cultural competency or legal and regulatory issues. Member benefits include quarterly webinars, interpreter trainer mentorship programs, annual meetings, and access to a members' Listserv. The site offers a discussion of the history of the NCIHC's efforts toward the creation of a nationally recognized certification for health care interpreters. Interpreting in the mental health care environment is also specifically discussed.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Policy |

National Health Law Program External Web Site Policy

National Health Law Program. (2010). Retrieved from http://www.healthlaw.org/

The National Health Law Program is a public interest law firm working to advance access to high-quality health care and to protect the legal rights of underserved and low-income individuals. The issues addressed include (broadly) Medicare and Medicaid, children's health, reproductive health, language access, health disparities, court access, government accountability, and health reform. The website offers links to publications, access to an advocacy Listserv, and news of NHeLP's activities.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Policy | Public Health |

Ensuring that patient centered medical homes effectively serve patients with complex needs

U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (2011). Ensuring that patient centered medical homes effectively serve patients with complex needs (AHRQ Publication No. 11-0109). Retrieved from http://pcmh.ahrq.gov/portal/server.pt/community/pcmh__home/1483/pcmh_tools___resources_patient-centered_v2

This brief paper outlines programmatic and policy changes that may enable practices implementing a patient-centered medical home model to ensure a high quality of care even to those patients with the most complex needs. The information provided may be of particular use in small practices.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Government | Policy |

Guidance to federal financial assistance recipients regarding Title VI and the prohibition against national origin discrimination affecting limited English proficient persons: Summary

U.S. Department of Health and Human Services, Office for Civil Rights. (n.d.). Guidance to federal financial assistance recipients regarding Title VI and the prohibition against national origin discrimination affecting limited English proficient persons: Summary. Retrieved from http://www.hhs.gov/ocr/civilrights/resources/laws/summaryguidance.html

This summary of the full 2003 guidance briefly discusses the use of patients' family members and friends as interpreters, the translation of vital documents, interpreter and translator competence, the elements of an effective language assistance plan, and the factors used to determine the obligation under Title VI of recipients of federal funding to ensure meaningful access to programs for persons with limited English proficiency. It is noted that what constitute reasonable steps to be required of large providers "may not be reasonable where small providers are concerned."

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Government | Policy |

Taking cultural competency from theory to action External Web Site Policy

Wu, E., & Martinez, M. (2006). Taking cultural competency from theory to action. (Commonwealth Fund Publication No. 964) Retrieved from http://www.commonwealthfund.org/usr_doc/Wu_takingcultcomptheoryaction_964.pdf

The authors interviewed leaders in the field of cultural competency. They offer recommendations for the implementation of cultural competency and find that six principles are fundamental to a successful effort: (1) community representation and feedback at all stages of implementation; (2) cultural competency integrated into all levels of the organization; (3) changes that are manageable, measurable, and sustainable; (4) a business case for policy implementation; (5) commitment from leadership; and (6) ongoing staff training.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Engagement, Continuous Improvement, and Accountability | Policy | Governance & Leadership |

Common program requirements External Web Site Policy

Accreditation Council for Graduate Medical Education. (2011). Common program requirements. Retrieved from http://www.acgme.org/acwebsite/home/common_program_requirements_07012011.pdf

These requirements for residency program accreditation include "Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds" [Requirement IV.A.5.e).(1)]; "Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation" [IV.A.5.f).(5)]; and "Provision of patient- and family-centered care" [VI.A.5.b)].

Keywords:    Governance, Leadership, and Workforce | Education & Training | Policy |

A planner's guide: Infusing principles, content and themes related to cultural and linguistic competence into meetings and conferences External Web Site Policy

Georgetown University Child Development Center, Center for Child Health and Mental Health Policy, National Center for Cultural Competence. (2000). A planner's guide: Infusing principles, content and themes related to cultural and linguistic competence into meetings and conferences. Retrieved from http://gucchd.georgetown.edu/products/PlannersGuide.pdf

A short guide designed to help meeting planners incorporate material related to cultural and linguistic competence. Includes discussion of meeting content planning, logistics, and evaluation questions.

Keywords:    Governance, Leadership, and Workforce | Policy | Governance & Leadership |

Resources in cultural competence education for health care professionals External Web Site Policy

Gilbert, M. J. (Ed.). (2003). Resources in cultural competence education for health care professionals. Retrieved from http://www.diversityrx.org/resources/resources-cultural-competence-education-health-care-professionals

This is a book of resources in such areas of cultural competence education as policy statements and standards; guidelines and curricula designed for health care professionals; guidebooks and manuals; personnel and organizational assessment tools; articles, books, and reports; videos; journals; and websites. It was designed for use with Principles and Recommended Standards for Cultural Competence of Health Care Professionals and A Manager's Guide to Cultural Competence Education for Health Care Professionals, both also edited by M. J. Gilbert.

Keywords:    Governance, Leadership, and Workforce | Policy | Education & Training |

Legislation as intervention: A survey of cultural competence policy in health care

Graves, D. L., Like, R. C., Kelly, N., & Hohensee, A. (2007). Legislation as intervention: A survey of cultural competence policy in health care. Journal of Health Care Law and Policy, 10(2), 339-361. Retrieved from http://thecqc.org/uploads/Graves_et_al.pdf

The authors outline the development of cultural competence policy initiatives at the state, organizational, and federal levels. They conclude by noting that the success of policy efforts "will depend on the clarity of the specified criteria for success, the detail of the proposed plans, and the availability of financial support to develop and implement" the programs.

Keywords:    Governance, Leadership, and Workforce | Policy | Engagement, Continuous Improvement, and Accountability |

Functions and structure of a medical school: standards for accreditation of medical education programs leading to the M.D. degree External Web Site Policy

Liaison Committee on Medical Education. (2011). Functions and structure of a medical school: standards for accreditation of medical education programs leading to the M.D. degree. IS-16, ED-21, ED-22. Retrieved from http://www.lcme.org/functions2011may.pdf

Institutional Setting Standard 16 says, "An institution that offers a medical education program must have policies and practices to achieve appropriate diversity among its students, faculty, staff, and other members of its academic community, and must engage in ongoing, systematic, and focused efforts to attract and retain students, faculty, staff, and others from demographically diverse backgrounds." Educational Program Standard 21 says, "The faculty and medical students of a medical education program must demonstrate an understanding of the manner in which people of diverse cultures and belief systems perceive health and illness and respond to various symptoms, diseases, and treatments." Educational Program Standard 22 says, "Medical students in a medical education program must learn to recognize and appropriately address gender and cultural biases in themselves, in others, and in the process of health care delivery."

Keywords:    Governance, Leadership, and Workforce | Policy | Education & Training |

Educating clinicians about cultural competence and disparities in health and health care External Web Site Policy

Like, R. C. (2011). Educating clinicians about cultural competence and disparities in health and health care. Journal of Continuing Education in the Health Professions, 31(3), 196-206. doi:10.1002/chp.20127

The author provides an overview of legislative, accreditation, professional, and policy initiatives related to health care disparities and cultural competence and reviews the status of continuing medical education offerings in these areas. He examines whether the CME profession itself needs to become more culturally competent in the development, implementation, and evaluation of programs.

Keywords:    Governance, Leadership, and Workforce | Disparities | Policy | Public Health |

A national code of ethics for interpreters in health care External Web Site Policy

National Council on Interpreting in Health Care. (2004). A national code of ethics for interpreters in health care. Retrieved from http://data.memberclicks.com/site/ncihc/NCIHC%20National%20Code%20of%20Ethics.pdf

The council's Standards, Training and Certification Committee developed this code to guide the practice of health care interpreters and to serve as the basis for any subsequent standards of practice for the field. The nine-item code is stated in brief at the beginning of the document. Each point is elaborated more fully in the course of the following discussion.

Keywords:    Governance, Leadership, and Workforce | Policy | Education & Training |

Hospital governing board assessment: a self-help guide

Powell, L., & Taylor, C. (2004). Hospital governing board assessment: a self-help guide. Boise, ID: Mountain States Group.

Keywords:    Governance, Leadership, and Workforce | Engagement, Continuous Improvement, and Accountability | Policy |

Leadership in healthcare organizations: A guide to Joint Commission leadership standards External Web Site Policy

Schyve, P. M., & The Governance Institute. (2009). Leadership in healthcare organizations: A guide to Joint Commission leadership standards. Retrieved from http://www.jointcommission.org/assets/1/18/WP_Leadership_Standards.pdf

This white paper is meant to serve as a guide to the Joint Commission accreditation standards on leadership.

Keywords:    Governance, Leadership, and Workforce | Policy | Governance & Leadership |

In the nation's compelling interest: Ensuring diversity in the health-care workforce External Web Site Policy

Smedley, B. D., Stith-Butler, A., & Bristow, L. R. (2004). In the nation's compelling interest: Ensuring diversity in the health-care workforce. Retrieved from http://www.nap.edu/openbook.php?record_id=10885&page=1

This book makes a case for increasing the number of individuals from currently underrepresented minorities in the health care workforce. Examined are school admissions policies and practices, educational costs and financing, accreditation, institutional climate, community benefit, and mechanisms to garner support for institutional diversity policies.

Keywords:    Governance, Leadership, and Workforce | Public Health | Policy |

Missing persons: Minorities in the health professions External Web Site Policy

The Sullivan Commission on Diversity in the Healthcare Workforce. (2004). Missing persons: Minorities in the health professions. Retrieved from http://www.aacn.nche.edu/media-relations/SullivanReport.pdf

The Sullivan Commission was established in 2003 under a grant from the W. K. Kellogg Foundation to Duke University and was composed of health, business, higher education, legal, and legislative experts. The commission held a series of hearings across the country to examine the causes of the ethnic imbalance among the nation's medical, dental, and nursing workforce as compared with the country's population at large. The report integrates findings from testimony heard at these hearings and from the health sciences literature. Thirty-seven recommendations are put forward to address the root causes of minority underrepresentation in the health professions.

Keywords:    Governance, Leadership, and Workforce | Public Health | Policy |

The legal framework for language access in healthcare settings: Title VI and beyond

Chen, A. H., Youdelman, M. K., & Brooks, J. (2007). The legal framework for language access in healthcare settings: Title VI and beyond. Journal of General Internal Medicine, 22(Supplement 2), 362-367. doi:10.1007/s11606-007-0366-2

The authors discuss federal mandates and offer an overview of state laws and recent legal decisions in the field of language rights in health care. The article also includes the authors' analysis of policy initiatives that could improve the health care of patients with limited proficiency in English.

Keywords:    Communication and Language Assistance | Government | Policy |

Effect of awareness of language law on language access in the health care setting

Grubbs, V., Chen, A. H., Bindman, A. B., Vittinghoff, E., & Fernandez, A. (2006). Effect of awareness of language law on language access in the health care setting. Journal of General Internal Medicine, 21(7), 683-688. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924696/?tool=pubmed

A telephone survey was conducted in 11 non-English languages with 1,000 participants who had limited proficiency English to determine whether awareness of federal law regarding access to language services affected their use of interpreters. The authors found that awareness of the law was not associated with interpreter utilization, although it was associated with having a provider who speaks one's own language. The authors conclude that awareness of the law is insufficient to resolve linguistic barriers.

Keywords:    Communication and Language Assistance | Policy | Research |

Hablamos Juntos: Language policy and practice in health care External Web Site Policy

Hablamos Juntos: Language policy and practice in health care. (n.d.). Retrieved from http://www.hablamosjuntos.org

Hablamos Juntos ("We Speak Together") is developing affordable models of language services in health care organizations through the funding of 10 demonstration sites in regions, both rural and urban, with fast-growing Latino populations. Information is available on interpreter services and signage. The website also offers an extensive resource library.

Keywords:    Communication and Language Assistance | Policy | Population-Based |

Language Access and the Law: Caring for the LEP Patient External Web Site Policy

Hunt, D., & Walker, P. F. (2010). Language Access and the Law: Caring for the LEP Patient [E-learning program]. Minneapolis, MN: Critical Measures.

This interactive e-learning course was designed to increase the understanding of medical professionals about the reasons (e.g., business, legal, and medical) for providing language services. The course may help clinicians to avoid common problems, identify cross-cultural medical issues and integrate them into the practice, work with interpreters, and avoid litigation. Continuing education credit is available.

Keywords:    Communication and Language Assistance | Policy | Education & Training |

Medical interpreting standards of practice External Web Site Policy

International Medical Interpreters Association. (2007). Medical interpreting standards of practice. Retrieved from http://www.imiaweb.org/uploads/pages/102.pdf

As the introduction points out, although it is contrary to common belief, the clinical interview relies heavily on language. This document delineates the core performance standards for professional interpreters and may serve as a tool for the evaluation of practice and competence. The 27 standards are divided among three broad areas of focus: interpretation, cultural interface, and ethical behavior.

Keywords:    Communication and Language Assistance | Policy |

National Standards of Practice for Interpreters in Health Care External Web Site Policy

National Council on Interpreting in Health Care. (2005). National standards of practice for interpreters in health care. Retrieved from http://mchb.hrsa.gov/training/documents/pdf_library/National_Standards_of_Practice_for_Interpreters_in_Health_Care%20(12-05).pdf

Thirty-two standards are offered divided among the following areas: (1) accuracy, (2) confidentiality, (3) impartiality, (4) respect, (5) cultural awareness, (6) role boundaries, (7) professionalism, (8) professional development, and (9) advocacy. An objective is given for each of the areas. Each standard is followed by an example.

Keywords:    Communication and Language Assistance | Policy | Tools |

Sight translation and written translation: Guidelines for healthcare interpreters External Web Site Policy

National Council on Interpreting in Health Care. (2010). Sight translation and written translation: Guidelines for healthcare interpreters. Retrieved from http://data.memberclicks.com/site/ncihc/Translation%20Guidelines%20for%20Interpreters%20REVISED%2031710.pdf

Interpreting and translation rely upon different skill sets and are generally conducted in different settings and contexts. This short work addresses the "small but troublesome area of overlap" in which interpreters may be called upon to provide an oral rendition of text or a written summary of a verbal exchange.

Keywords:    Communication and Language Assistance | Policy |

Language Access External Web Site Policy

National Health Law Program. (2010). Language Access. Retrieved from http://www.healthlaw.org/index.php?option=com_content&id=239&Itemid=196

This Web page serves as a gateway to numerous resources on the subject of language access. These resources are organized into the following broad areas: publications, research studies, federal administrative activities, federal and state legislation, health care disparities, and links to other websites.

Keywords:    Communication and Language Assistance | Policy | Tools |

Straight talk: Model hospital policies and procedures on language access External Web Site Policy

Paras, M. (2005). Straight talk: Model hospital policies and procedures on language access. Retrieved from http://www.calendow.org/uploadedFiles/straight_talk_model_hospital_policies.pdf

The introduction notes that the adoption of policies and procedures has, historically, proven to be the primary means of making significant changes in the hospital industry. While the model policies and procedures presented here were based on California public hospitals, they are intended to be "applicable and adaptable" to hospitals throughout the United States.

Keywords:    Communication and Language Assistance | Policy |

The high costs of language barriers in medical malpractice External Web Site Policy

Quan, K., & Lynch, J. (2010). The high costs of language barriers in medical malpractice. Retrieved from National Health Law Program website: http://www.healthlaw.org/images/stories/High_Costs_of_Language_Barriers_in_Malpractice.pdf

The authors note that, in 2008, nearly 20 percent of people living in the United States spoke a language other than English at home. In the Western U.S., the figure rose to 32 percent, and, in California, to 42 percent. Of those populations, more than 40 percent spoke English "less than very well." This study examines the malpractice claims of one insurer, across four states, in which language barriers may have had an effect on patients' health outcomes. Topics covered in the course of the analysis include, broadly, failure to provide competent interpreters, defective informed consent and lack of written translations, inadequate documentation, and allegations of discrimination. The authors conclude with recommendations for insurance carriers and for providers.

Keywords:    Communication and Language Assistance | Policy | Public Health |

Case study: The language of diversity External Web Site Policy

Tang, G., Lanza, O., & Rodriguez, F.M. (2011). Case study: The language of diversity. Diversity Executive, 44-46. Retrieved from http://diversity-executive.com/articles/view/1160

Kaiser Permanente's Qualified Bilingual Staff model makes the most of workforce diversity to provide qualified, cost-effective, and operationally efficient linguistic services. Trained bilingual staff serve Kaiser's members at all points of contact.

Keywords:    Communication and Language Assistance | Governance, Leadership, and Workforce | Policy |

Resident physicians' preparedness to provide cross-cultural care: Implications for clinical care and medical education policy External Web Site Policy

Betancourt, J. R., Weissman, J. S, Kim, M. K., Park, E., & Maina, A. W. (2007). Resident physicians' preparedness to provide cross-cultural care: Implications for clinical care and medical education policy. Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/usr_doc/1026_Betancourt_resident_MDs_preparedness_provide_cross-cultural_care.pdf

Noting that some residents in their final year of training felt unprepared to care for patients whose cultural characteristics (which may include mistrust of the health care system or beliefs at odds with Western medicine) are very far from their own, the authors recommend integration of cross-cultural training into curricula, the training of faculty members, and mandatory formal evaluation of residents' cross-cultural communication skills.

Keywords:    Engagement, Continuous Improvement, and Accountability | Profession-Based | Policy | Public Health |

Culturally-appropriate dispute resolution techniques and the formal judicial system in Hawaii. A report to the State Justice Institute External Web Site Policy

Dator, J. (1991). Culturally-appropriate dispute resolution techniques and the formal judicial system in Hawaii. A report to the State Justice Institute. Retrieved from http://www.futures.hawaii.edu/publications/courts/CultAppropAD1991.pdf

The author reviews a project undertaken by the State Justice Institute and the Hawaii Center for Futures Studies on alternative dispute resolution techniques in the Pacific region and legal precedents for dispute-resolution autonomy for certain groups. The recommendation is made to the chief justice of the Hawaii Supreme Court to appoint a committee to advise him on "appropriate action to be taken in order to incorporate culturally appropriate dispute resolution techniques into the Hawaii Judicial system." The author makes several suggestions as to what the focus of the committee should be.

Keywords:    Engagement, Continuous Improvement, and Accountability | Policy | Government |

Barriers to collecting patient race, ethnicity and primary language data in physician practices: An exploratory study

Hasnain-Wynia, R., Van Dyke, K., Youdelman, M., Krautkramer, C., Ivey, S., Gilchick, R., ... & Wynia M. (2010). Barriers to collecting patient race, ethnicity and primary language data in physician practices: An exploratory study. Journal of the National Medical Association, 102(9), 769-775.

The authors conducted telephone interviews with representatives of 20 small practices (five or fewer physicians) nationwide. Nine practices reported collecting demographic data. One linked demographic data to quality. The single practice feature noted as facilitating the collection of demographic data was the use of an electronic medical records system. Pay-for-performance programs and cultural competency training did not have an effect on data collection. Perceived barriers included privacy concerns, uncertainty regarding the usefulness of the data, the legality of collecting the information, and possible patient and staff resistance.

Keywords:    Engagement, Continuous Improvement, and Accountability | Profession-Based | Policy | Public Health |

Promoting cultural competency in public administration and public service delivery: Utilizing self-assessment tools and performance measures External Web Site Policy

Rice, M. F. (2007). Promoting cultural competency in public administration and public service delivery: Utilizing self-assessment tools and performance measures. Journal of Public Affairs Education, 13(1), 41-57.

The author tenders a definition of cultural competency in public administration and public service delivery and puts forward performance measures and self-assessment tools to assist public agencies in becoming culturally competent.

Keywords:    Engagement, Continuous Improvement, and Accountability | Governance & Leadership | Policy |

Cultural and linguistic competency policy External Web Site Policy

San Francisco Department of Public Health. (2002). Cultural and linguistic competency policy. Retrieved from http://www.sfdph.org/dph/comupg/aboutdph/insideDept/CLAS/CLASPolicies.asp

The National CLAS Standards were used as guidelines for the seven policies and associated procedures detailed in this document from the San Francisco Department of Public Health. The policies concern nondiscrimination in the provision of services, grievance procedures, cultural and linguistic competency reports, contracts for direct services to the public, program monitoring, and training.

Keywords:    Engagement, Continuous Improvement, and Accountability | Policy | Public Health |

Defining and measuring community benefit External Web Site Policy

Sandrick, K. (2006, October). Defining and measuring community benefit. Trustee, 59(9), 6-10. Retrieved from http://www.trusteemag.com/trusteemag_app/jsp/articledisplay.jsp?dcrpath=TRUSTEEMAG/PubsNewsArticleGen/data/2006October/0610TRU_CoverStory&domain=TRUSTEEMAG

In the face of threats to their tax-exempt status, not-for-profit hospitals must find consistent ways of identifying and tracking their benefits to the community. The author discusses legal requirements for community benefit, giving many examples. Documentation is discussed with reference to the Catholic Health Association's Guide for Planning and Reporting Community Benefit.

Keywords:    Engagement, Continuous Improvement, and Accountability | Policy | Public Health |

An introduction to effectiveness, dissemination and implementation research: A resource manual for community-engaged research External Web Site Policy

Schillinger, D. (2010). An introduction to effectiveness, dissemination and implementation research: A resource manual for community-engaged research. Retrieved from http://accelerate.ucsf.edu/files/CE/edi_introguide.pdf

This guide offers an introduction to the principles of effectiveness research, diffusion research, dissemination research, and implementation sciences. One of the author's purposes is to promote interest among members of the scientific community, medical practitioners, policymakers at the local, regional, and state levels, and community members in research that will help to close the gap between scientific discovery and integration of that new knowledge into institutional practice and policy. The author provides an extensive bibliography and a list of relevant Web resources.

Keywords:    Engagement, Continuous Improvement, and Accountability | Policy | Public Health |

Building coalitions among communities of color: A multicultural approach

Summit Health Institute for Research and Education. (2004). Building coalitions among communities of color: A multicultural approach. Retrieved from http://www.shireinc.org/wp-content/files/Building_Coalitions_among_Communities_of_Color.pdf

The introduction notes that "[t]his guide is intended as a resource primarily for people of color, who are building coalitions in which representatives from communities of color predominate." It is structured around 10 strategies, and specific, practical steps within those strategies, to maximize their abilities as change agents by fostering skills in the areas of coalition building, strategic planning, intergroup relations, organizational development, and group maintenance and evaluation.

Keywords:    Engagement, Continuous Improvement, and Accountability | Policy | Tools |

LGBT-TRISTAR External Web Site Policy

LGBT-TRISTAR is a government-funded technical assistance (TA) and training services division targeting providers of alcohol and other drug (AOD) prevention, treatment and recovery support services. We provide on-site and online technical assistance and training designed to equip administrators and staff to provide services that are more accessible and culturally responsive to Lesbian, Gay, Bisexual and Transgender (LGBT) individuals and families.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Clinical & Mental Health | Governance, Leadership, and Workforce | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Policy | Quality Improvement | Tools | Provide effective, equitable, understandable, and respectful quality care and services |

LGBT Resources by Gil Gerald & Associates, Inc. External Web Site Policy

Every year, research is advancing knowledge about best practices in serving LGBT/SGL individuals and families. Additionally and fortunately there are a growing number of organizations, programs and services that target and serve LGBT/SGL communities throughout the U.S. This site will maintain and update information of particular interest to health and human services providers.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Governance, Leadership, and Workforce | Disparities | Education & Training | Policy | Provide effective, equitable, understandable, and respectful quality care and services |

Implementing Cultural and Linguistic Requirements in Health Insurance Exchanges External Web Site Policy

This timely report offers an update on implementation progress, guidance, best practices, and tools for states, health plans, and organizations hastening to implement ACA’s cultural and linguistic requirements by October 1, 2013, when open enrollment begins. Also featured are seven in-depth case studies on State-Based Exchanges in California, Colorado, Connecticut, Maryland, New York, Oregon, and Washington, with information on best practices on integrating race, culture, and language in planning and operation.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Disparities | Health Literacy | Communication and Language Assistance | Policy | Research | Tools |

Supporting and Transitioning the Health Care Safety Net External Web Site Policy

The Texas Health Institute recently released its second report, “Supporting and Transitioning the Health Care Safety Net,” in its five-part series known as The ACA & Racial and Ethnic Health Equity Series. This new report provides a snapshot on status and progress of nine key provisions in the ACA critical for advancing racial and ethnic health equity within the health care safety net. Through a close review of latest data, research, and federal guidance on safety net provisions, this report describes how the safety net stands at a crossroads in an era of reform. Complemented by perspectives from the field—including hospitals and health centers—the report discusses important priorities, challenges, and next steps for addressing and advancing racial and ethnic health equity through the safety net.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance, Leadership, and Workforce | Disparities | Health Literacy | Communication and Language Assistance | Patients & Consumers | Policy | Research | Tools | Provide effective, equitable, understandable, and respectful quality care and services |