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 "Research"



Insurance and Socioeconomic Status Do Not Explain Racial Disparities in Breast Cancer Care External Web Site Policy

Freedman, R. A., Virgo, K. S., He, Y., Pavluck, A. L., Winer, E. P., Ward, E. M., & Keating, N. L. (2010). The association of race/ethnicity, insurance status, and socioeconomic status with breast cancer care. CANCER, 117(1), 180-189. doi: 10.1002/cncr.25542

This study discusses the prevalence of inequities in breast cancer care even when insurance status and socioeconomic status are controlled for. The findings suggest that greater efforts are needed to understand disparities in breast cancer care and to ensure that all receive equal and effective treatments.

Keywords:    Research | Clinical & Mental Health | Population-Based | Disease-Based | Disparities |

Surveillance of Screening-Detected Cancers (Colon and Rectum, Breast, and Cervix)

U.S. Department of Health & Human Services, Centers for Disease Control and Prevention. (2010). Morbidity and Mortality Weekly Report: Surveillance of screening-detected cancers (colon and rectum, breast, and cervix) (CDC Publication No. 59[SS09], 1-25). Retrieved from http://www.cdc.gov/

This study by the U.S. Department of Health and Human Services (HHS) Centers for Disease Control and Prevention (CDC) reveals that almost half of colorectal and cervical cancers and a third of breast cancers are diagnosed at late stages, when treatment is more difficult, despite the availability of effective screenings. The late diagnoses are disproportionately suffered by racial and ethnic minorities. The study identifies education as a key to improving these outcomes, recommending that providers explain the benefits of screenings to patients in a manner that the patient will understand.

Keywords:    Research | Population-Based | Disease-Based | Communication | Disparities | Governance, Leadership, and Workforce |

Toothache in US Children 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

Data from the National Survey of Children's Health offers evidence of racial, ethnic, and socioeconomic disparities in pediatric oral health. Even when socioeconomic status was controlled for, there were inequities by race.

Keywords:    Research | Clinical & Mental Health | Population-Based | Profession-Based | Disease-Based | Disparities |

Racial Disparities in the Outcomes of Communication on Medical Care Received Near Death External Web Site Policy

Mack, J. W., Paulk, M. E., Viswanath, K., & Prigerson, H. G. (2010). Racial disparities in the outcomes of communication on medical care received near death. Archives of Internal Medicine, 170(17), 1533-1540. doi:10.1001/archinternmed.2010.322

Research published in the Archives of Internal Medicine found that Black patients with advanced and terminal cancer are less likely than White patients to have their wishes for end-of-life care honored, even with a similar likelihood of having discussed their preferences with their doctors. These findings reveal the possibility that Black patients receive inferior end-of-life care and the need for standards of care to be equal for all.

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

Muslim patients and cross-gender interactions in medicine: an Islamic bioethical perspective External Web Site Policy

Padela, A. I., & Rodriguez del Pozo, P. (2010). Muslim patients and cross-gender interactions in medicine: an Islamic bioethical perspective. Journal of Medical Ethics, 37(1), 40-44. doi:10.1136/jme.2010.037614

In this article, an emergency room physician provides recommendations for accommodating Muslim sensitivities within the healthcare system. The physician identifies cultural competence as a critical way to reduce healthcare disparities arising from value and cultural differences between patients and providers, noting that adapting one's practice style to meet patient needs and values is an important way to improve quality of care.

Keywords:    Research | Education & Training | Clinical & Mental Health | Population-Based | Profession-Based | Communication | Governance, Leadership, and Workforce |

Racial and Ethnic Disparities in Healthcare in California External Web Site Policy

California Office of Statewide Health Planning and Development. (2010). Racial and ethnic disparities in healthcare in California: California fact book. Retrieved from http://www.oshpd.ca.gov/HID/Products/PatDischargeData/ResearchReports/EthnicRacialDisp/RacialEthnic
FactBook_2010.pdf

The State of California conducted a study on racial and ethnic health disparities in 2010. Although the study found improvement in many areas, it also found that significant inequities persist. The authors note that the report provides strong evidence for policymakers, healthcare providers, public health professionals, researchers, and other interested stakeholders to focus efforts on addressing access to and quality of care.

Keywords:    Research | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Quality Improvement | Disparities |

Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients With Limited English Proficiency External Web Site Policy

Bagchi, A. D., Dale, S., Verbitsky-Savitz, N., Andrecheck, S., Zavotsky, K., & Eisenstein, R. (2010). Examining effectiveness of medical interpreters in emergency departments for Spanish-speaking patients with limited English proficiency: results of a randomized controlled trial. Annals of Emergency Medicine, 57(3), 248-256.e4. doi:10.1016/j.annemergmed.2010.05.032

This study, published in the Annals of Emergency Medicine, examines the impact on patient and provider satisfaction of emergency department use of medical interpreters for limited-English-proficient Spanish speakers. The researchers conclude that the use of in-person, professionally trained medical interpreters significantly increases satisfaction with communication during emergency department visits for both Spanish-speaking, limited-English-proficient patients and their health providers.

Keywords:    Research | Clinical & Mental Health | Patients & Consumers | Population-Based | Profession-Based | Communication | Communication and Language Assistance |

Racial And Ethnic Disparities In Dental Care For Publicly Insured Children External Web Site Policy

Pourat, N., & Finocchio, L. (2010). Racial and ethnic disparities in dental care for publicly insured children. Health Affairs, 29(7), 1356-1363. doi: 10.1377/hlthaff.2009.0089

A study published in Health Affairs examines oral health disparities among children in California. It determines that nearly 25 percent of children in California have never been to the dentist and that disparities exist across race, ethnicity, and type of insurance when it comes to the length of time between dental care visits.

Keywords:    Research | Population-Based | Profession-Based | Disparities |

Race, culture may play role in Alzheimer's disease External Web Site Policy

Brophy Marcus, M. (2010, July 14). Race, culture may play role in Alzheimer's disease. USA Today. Retrieved from http://www.usatoday.com/

This article discusses research presented at the Alzheimer's Association International Conference. It examines the effect of racial and cultural differences on Alzheimer's patients' outcomes and the attitudes of their family members. The study finds that more culturally tailored resources could benefit African Americans, Latinos, and other minority groups.

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

Racial and Ethnic Disparities in Health Care External Web Site Policy

American College of Physicians. (2010).Racial and ethnic disparities in health care, updated 2010. Retrieved from http://www.acponline.org/advocacy/where_we_stand/access/racial_disparities.pdf

The American College of Physicians released a 2010 update to its policy paper, "Racial and Ethnic Disparities in Health Care." It calls for the healthcare system to adapt to meet the needs of an increasingly multicultural patient base. Recommendations include that healthcare professionals need to acknowledge the cultural, informational, and linguistic needs of their patients as our society increasingly becomes more racially and ethnically diverse.

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

How Well Do Doctors Know their Patients? Factors Affecting Physician Understanding of Patients External Web Site Policy

Street, R. L., & Haidet, P. (2010). How well do doctors know their patients? Factors affecting physician understanding of patients' health beliefs. Journal of General Internal Medicine, 26(1), 21-27. doi: 10.1007/s11606-010-1453-3

This study examines the features of patient-centered care; specifically, a physician's understanding of his or her patients' health beliefs and values. The results indicate that physicians' perceptions of their patients' health beliefs differ significantly from patients' actual beliefs. This study indicates that strategies for increasing physicians' awareness of patients' health beliefs include implementing culturally appropriate patient activation programs.

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

Cancer study sees cultural factors in racial disparities External Web Site Policy

Avery, S. (2010, June 16). Cancer study sees cultural factors in racial disparities. The News & Observer. Retrieved from http://www.newsobserver.com/

The Journal of the American Medical Association has published a study from the University of North Carolina-Chapel Hill about the cultural factors present in the racial disparities of lung cancer. The scientists concluded that, despite a high likelihood of death, Black patients are much less inclined to have surgery for early stage lung cancer than White patients, often because of a communication gulf between them and their doctors.

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

Health Disparities Calculator External Web Site Policy

Surveillance Epidemiology and End Results, National Cancer Institute. (2010). Health Disparities Calculator (HD*Calc) [Computer software]. Retrieved from http://seer.cancer.gov/

Surveillance Epidemiology and End Results at the National Cancer Institute has developed a Health Disparities Calculator (HD*Calc), which is a statistical software designed to generate multiple summary measures to evaluate and monitor health disparities.

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

Health Disparities Education External Web Site Policy

Lypson, M. L., Bussey-Jones, J., Glick, S., Brown, A. F., & Jacobs, E. A. (2010). Health disparities education. Journal of General Internal Medicine, 25(2), 79-81. doi: 10.1007/s11606-010-1312-2

The Journal of General Internal Medicine dedicated its May 2010 supplement to health disparities education. This supplement focuses on approaches to teaching health disparities and health disparities curriculums for students. It contains 27 articles, including "Medical Students' Perceptions of Their Teachers' and Their Own Cultural Competency: Implications for Education" and "Beyond Knowledge, Toward Linguistic Competency: An Experiential Curriculum."

Keywords:    Research | Education & Training | Clinical & Mental Health | Governance & Leadership | Profession-Based | Communication | 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 |

Organ Transplant Program 'mistrust' studied External Web Site Policy

Conte, A. (2010, May 2). Organ transplant program 'mistrust' studied. Pittsburgh Tribune-Review. Retrieved from http://www.pittsburghlive.com/x/pittsburghtrib/

Researchers at the University of Pittsburgh School of Medicine have shown that patients who think healthcare providers discriminate against them take more time to get approved for kidney transplant surgery. Blacks are four times more likely than Whites to have kidney failure, but they are less than half as likely to receive transplants from living donors. The lead researcher notes that doctors should identify patients who perceive discrimination in order to help them navigate the process.

Keywords:    Research | Clinical & Mental Health | Patients & Consumers | Population-Based | Disease-Based | 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 |

Commentary: Linking Cultural Competence Training to Improved Health Outcomes: Perspectives From the Field. External Web Site Policy

Betancourt, J. R., & Green, A. R. (2010). Commentary: linking cultural competence training to improved health outcomes: perspectives from the field. Academic Medicine, 85(4), 583-585. doi: 10.1097/ACM.0b013e3181d2b2f3

This article explores the impact cultural competency may have on health outcomes. Cultural competence training should be evaluated in a stepwise fashion by using the tools of health services research and the principles of quality improvement, and it should be held to the same standards as other educational interventions and activities.

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

Cultural competence in oncology: Where do we stand? External Web Site Policy

Surbone, A. (2010). Cultural competence in oncology: where do we stand? Annals of Oncology, 21(1), 3-5. doi: 10.1093/annonc/mdp546

This article in Annals of Oncology discusses the importance and relevance of culturally competent services in oncology. The author emphasizes that cultural differences are a major determinant of unequal access to cancer care. She concludes that provider practice of cultural competence can improve the quality of care offered to all cancer patients and can also foster reciprocal understanding and tolerance in the patient-doctor-institution relationship.

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

Racial/Ethnic Difference in Early-Life Risk Factors for Childhood Obesity External Web Site Policy

Taveras, E. M., Gillman, M. W., Kleinman, K., Rich-Edwards, J. W., & Rifas-Shiman, S. L. (2010). Racial/ethnic difference in early-life risk factors for childhood obesity. Pediatrics, 125(4), 686-695. doi: 10.1542/peds.2009-2100

A team of researchers in Boston set out to examine racial/ethnic differences in early-life risk factors for childhood obesity. The study finds that racial/ethnic differences in risk factors for obesity exist prenatally and in early childhood. Racial/ethnic disparities in childhood obesity may be determined by factors that operate at the earliest stages of life.

Keywords:    Research | Clinical & Mental Health | Public Health | Patients & Consumers | Government | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | 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 |

Talking With Patients: How Hospitals Use Bilingual Clinicians and Staff to Care for Patients with Language Needs External Web Site Policy

Huang, J., Jones, R. C., & Regenstein, M. (2009). Talking with patients: how hospitals use bilingual clinicians and staff to care for patients with language needs. Abstract retrieved from The George Washington University website: http://www.gwumc.edu/sphhs/departments/healthpolicy/dhp_publications/?mdl=pubSearch&evt=view&PublicationID=2AD9B782-5056-9D20-3D85DD1E4BD4272B

This report from The George Washington University presents findings from a survey about bilingual clinicians who interact with limited-English-proficient patients. The survey reveals that many hospitals have bilingual clinicians but often do not adequately assess their language proficiency, meaning that the language access services provided are of unknown quality. The report concludes that proper assessment and use of bilingual staff will allow health systems to meet the needs of linguistically diverse communities.

Keywords:    Research | Clinical & Mental Health | Governance & Leadership | Profession-Based | Communication | Communication and Language Assistance |

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 |

Protection of Racial/Ethnic Minority Populations During an Influenza Pandemic External Web Site Policy

Hutchins, S. S., Fiscella, K., Levine, R. S., Ompad, D. C., & McDonald, M. (2009). Protection of racial/ethnic minority populations during an influenza pandemic. American Journal of Public Health, 99(S2), S261-S270. doi: 10.2105/AJPH.2009.161505

This study examines the disproportionate impact of an influenza pandemic on racial and ethnic minority populations. The research recommends that pandemic interventions implement culturally competent preparedness and response that address the specific needs of racial/ethnic minority populations as well as relevant, practical, and culturally and linguistically tailored communications.

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

Reducing Health Disparities Through a Culturally Centered Mentorship Program for Minority Faculty: The Southwest Addictions Research Group (SARG) Experience External Web Site Policy

Viets, V. L., Baca, C., Verney, S. P., Venner, K., Parker T., & Wallerstein, N. (2009). Reducing health disparities through a culturally centered mentorship program for minority faculty: the southwest addictions research group (SARG) experience. Academic Medicine, 84(8), 1118-1126. doi: 10.1097/ACM.0b013e3181ad1cb1

This study examines the prospect of reducing health disparities through recruitment of minority faculty using a formal mentorship program. A Culturally Centered Mentorship Model was created that emphasizes culture, community service, and community-based participatory research to support the recruitment and advancement of ethnic minority faculty members in academia.

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

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 |

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 |

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 |

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 |

California's Emergency Preparedness Efforts for Culturally Diverse Communities: Status, Challenges and Directions for the Future External Web Site Policy

Andrulis, D., Siddiqui, N., & Purtle, J. (2009). California's emergency preparedness efforts for culturally diverse communities: status, challenges and directions for the future. Retrieved from Drexel University Center for Health Equality and HHS Office of Minority Health website: http://www.diversitypreparedness.org/

This report conducts a systematic assessment of emergency preparedness programs and initiatives for racially and ethnically diverse communities in California, examining barriers to care as well as opportunities for improvement. While this report focuses on the State of California, it provides a methodological framework that allows for similar assessments to be conducted at national, State, and local levels.

Keywords:    Tools | Research | Public Health | Patients & Consumers | Government | Population-Based | Profession-Based | 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 |

National Pharmacy Benefit Manager to Strengthen How it Provides Language Assistance Services External Web Site Policy

National pharmacy benefit manager to strengthen how it provides language assistance services. (2009, June 15). U.S. Department of Health and Human Services. Retrieved from http://www.hhs.gov/

The HHS announced that Medco, a national pharmacy benefit management company, will significantly improve its language access services for limited-English-proficient individuals. The acting director of the HHS Office for Civil Rights noted that this development will combat health disparities, promote healthcare reform, and improve access to care.

Keywords:    Research | Education & Training | Clinical & Mental Health | Patients & Consumers | Government | Population-Based | Profession-Based | Quality Improvement | Disparities | Communication and Language Assistance |

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 |

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 |

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 |

Physician Implicit Attitudes and Stereotypes About Race and Quality of Medical Care External Web Site Policy

Sabin, J. A., Rivara, F. P., & Greenwald, A. G. (2008). Physician implicit attitudes and stereotypes about race and quality of medical care. Medical Care, 46(7), 678-685. doi: 10.1097/MLR.0b013e3181653d58

This study used a social psychological perspective to examine what effects healthcare providers' implicit attitudes about race have on healthcare and racial and ethnic healthcare disparities. The data indicate that most doctors in all racial and ethnic groups show an implicit preference of Whites over Blacks except for Black doctors, who show no preference for either race.

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

Journal of Public Health Management & Practice External Web Site Policy

Graham, G. N., Honore, P. A., & Beadle, M. (Eds.). (2008). Supplement 6. In Novick, L. F. (Journal Ed.) Journal of Public Health Management & Practice, 14(6), S1-S87. Retrieved from http://journals.lww.com/jphmp/pages/toc.aspx?year=2008&issue=11001

This supplemental issue of the Journal of Public Health Management & Practice is dedicated to health disparities. It contains articles on a wide variety of topics relating to health disparities and includes an editorial from Dr. Garth Graham, Deputy Assistant Secretary for Minority Health.

Keywords:    Research | Education & Training | Clinical & Mental Health | Public Health | Governance & Leadership | 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 |

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 |

Viewpoint: Physician, know thyself: The professional cultural of medicine as a framework for teaching cultural competence External Web Site Policy

Boutin-Foster, C., Foster, J. C., & Konopasek, L. (2008). Viewpoint: physician, know thyself: the professional cultural of medicine as a framework for teaching cultural competence. Academic Medicine, 83(1), 106-111. doi: 10.1097/ACM.0b013e31815c6753

Medical schools are emphasizing the importance of cultural competency education, but its emphasis is often overshadowed by a number of challenges, which are addressed in this article. The article discusses several curricula changes for teaching cultural competence to physicians that will assist medical professionals in becoming more adequate in providing care to culturally and linguistically diverse populations.

Keywords:    Research | Education & Training | Clinical & Mental Health | 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 |

Race, medical researcher distrust, perceived harm, and willingness to participate in cardiovascular prevention trials External Web Site Policy

Braunstein, J. B., Sherber, N. S., Schulman, S. P., Ding, E. L., & Powe, N. R. (2008). Race, medical researcher distrust, perceived harm, and willingness to participate in cardiovascular prevention trials. Medicine 87(1), 1-9. doi: 10.1097/MD.0b013e3181625d78

Using a tool called the Medical Researcher Distrust Index, researchers examined individuals' perceived risk of engaging in medical research, specifically in cardiovascular clinical trials. This study presents medical professionals and researchers with a number of intervention approaches that may help alleviate racial and ethnic disparities in research methodology.

Keywords:    Research | Education & Training | Clinical & Mental Health | Patients & Consumers | Population-Based | Disparities | Governance, Leadership, and Workforce | 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 |

Health Disparities Report 2008: A County-Level Look at Health Outcomes for Minorities in Georgia

Georgia Department of Community Health Office of Health Improvement and Minority Health Advisory Council. (2008). Health disparities report 2008: a county-level look at health outcomes for minorities in Georgia. Retrieved from http://dch.georgia.gov/vgn/images/portal/cit_1210/5/49/111684019Georgia_Health_Equity_Initiative_
Health_Disparities_Report_2008.pdf

The Georgia Health Disparities Report examines minority health outcomes in each of the counties throughout the State of Georgia. The findings illustrate the need for additional collaborative efforts to truly reduce disparities in health in Georgia. One of the goals of the report is to illustrate what practices are working in certain counties so that others may adapt them to fit in their own counties.

Keywords:    Research | Clinical & Mental Health | Public Health | Government | Population-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 |

In the absence of words: A compilation of personal stories addressing the language barrier in health care External Web Site Policy

PALS for Health, & the California Endowment. (2008). In the absence of words: A compilation of personal stories addressing the language barrier in health care. Retrieved from http://tcenews.calendow.org/pr/tce/document/In_the_Absence_of_Words.pdf

By presenting individual stories and narratives, this document seeks to educate and raise awareness about language barriers that exist in the U.S. healthcare system. The stories presented here come from interpreters and language ambassadors from the PALS for Health Program. Each story provides a real experience of a limited-English-proficiency individual and their struggles in the healthcare system.

Keywords:    Research | Education & Training | Clinical & Mental Health | Patients & Consumers | Population-Based | Disparities | Communication and Language Assistance |

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 |

Evaluating interventions to reduce health care disparities: An RWJF program External Web Site Policy

Schlotthauer, A. E., Badler, A., Cook, S. C., Perez, D. J., & Chin, M. H. (2008). Evaluating interventions to reduce health care disparities: An RWJF program. Health Affairs 27(2), 568-573. Retrieved from http://www.rwjf.org/

The RWJF's Finding Answers Program provides funding for programs seeking to reduce and eliminate healthcare disparities. This article, published in the March/April 2008 issue of Health Affairs, provides an overview of some of the current interventions that have the potential to reduce or eliminate health disparities in real-world applications.

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

Primary-care clinician perceptions of racial disparities in diabetes care External Web Site Policy

Sequist, T. D., Ayanian, J. Z., Marshall, R., Fitzmaurice, G. M., & Safran, D. G. (2008). Primary-care clinician perceptions of racial disparities in diabetes care. Journal of General Internal Medicine 23(5), 678-684. doi: 10.1007/s11606-008-0510-7

This study analyzes racial disparities within the diagnosis and treatment of diabetes. The findings from this study indicate the need to incorporate strategies such as clinical education about healthcare disparities to improve the treatment of minority patients and to help eliminate healthcare disparities among many racial and ethnic minorities.

Keywords:    Research | Clinical & Mental Health | Patients & Consumers | Disease-Based | Disparities | Governance, Leadership, and Workforce | 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 |

An American Health Dilemma: Race, Medicine, and Health Care in the United States 1900-2000, vol 2 External Web Site Policy

Byrd, W. M., & Clayton, L. A. (2001). An American health dilemma: race, medicine, and health care in the United States 1900-2000, vol 2. New York, NY: Routledge.

This landmark study of African-American healthcare explores the effects of racism on the medical profession. It discusses 20th-century advances in healthcare, the development of the insurance industry, declining support for public health, and the myriad social and economic factors that have had disparate impacts on the health of Black Americans.

Keywords:    Research | Population-Based | Disparities |

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 |

DiversityRx: Improving Health Care in a Diverse World External Web Site Policy

TIDES. (2011). Diversity Rx: Improving Health Care in a Diverse World. Retrieved from http://diversityrx.org/

DiversityRx informs, educates, and supports healthcare providers, policymakers, researchers, and advocates who work to improve quality of care for minority, immigrant, and indigenous communities.

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

Cultural Competence in Health Education and Health Promotion External Web Site Policy

Perez, M. A., & Luquis, R. (Eds.). (2008). Cultural competence in health education and health promotion. San Francisco, CA: Jossey-Bass, & the American Association for Health Education.

This book describes essential theories, models, and practices for working with race, ethnicity, gender, and social issues.

Keywords:    Tools | Research | Education & Training | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare External Web Site Policy

Institute of Medicine, Board of Health Sciences Policy, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. (2003). Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Retrieved from the National Academies Press website: http://www.nap.edu/catalog.php?record_id=12875

This report, requested by Congress in 1999 to assess health disparities in the United States, finds that research demonstrates significant variation in the rates of medical procedures by race, even when insurance status, income, age, and severity of condition are comparable. The committee's recommendations for reducing racial and ethnic disparities in healthcare include increasing awareness about disparities among the general public, healthcare providers, insurance companies, and policymakers.

Keywords:    Research | Disparities |

Culture, Illness, and Care: Clinical Lessons from Anthropologic and Cross-Cultural Research External Web Site Policy

Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88(2), 251-258. Abstract retrieved from http://www.annals.org/content/88/2/251.abstract

This landmark publication from 1978 explains that concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution. "The Eight Questions" in this article, an explanatory model of illness that is designed to elicit the patient's perspective of illness, is the foundation for the field of cultural and linguistic competency.

Keywords:    Research | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

2010 National Healthcare Disparities Report

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. (2011). 2010 National healthcare disparity report (AHRQ Publication No. 11-0005). Retrieved from http://www.ahrq.gov/qual/nhdr10/nhdr10.pdf

The HHS AHRQ released 2011's NHDR, which summarizes healthcare quality and access among various racial, ethnic, and income groups and other priority populations, such as residents of rural areas and people with disabilities.

Keywords:    Research | Government | Population-Based | Disparities |

Black babies at twice risk of whites, study indicates External Web Site Policy

Washburn, L. (2011, March 3). Black babies at twice the risk of whites, study indicates. The Seattle Times. Retrieved from http://seattletimes.nwsource.com/html/home/index.html

This article explores health disparities in pregnancy and births for Black women as compared to White women. Even when factors such as socioeconomic status are accounted for, Black women are more likely to go into labor before their pregnancy has reached full term and are more likely to give birth to babies whose smaller size puts them at greater risk.

Keywords:    Research | Disparities | Disease-Based | Population-Based | Clinical & Mental Health |

CDC Health Disparities and Inequities Report

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2011). CDC health disparities and inequities report-United States, 2011. Morbidity and Mortality Weekly Report, 60, 1-113. Retrieved from http://www.cdc.gov/mmwr/pdf/other/su6001.pdf

This report from the HHS CDC is the agency's first in a series of assessments of the Nations' health disparities and inequities. The report states that "Persistent health disparities in our country are unacceptable and correctable."

Keywords:    Research | Government | Disparities |

Culturally Appropriate Storytelling to Improve Blood Pressure External Web Site Policy

Houston, T. K., Allison, J. J., Sussman, M., Horn, W., Holt, C. L., Trobaugh, J., . . . Hullett, S. (2011). Culturally appropriate storytelling to improve blood pressure: a randomized trial. Annals of Internal Medicine, 154(2), 77-84. Retrieved from http://www.annals.org/content/154/2/77.full.pdf+html

This study tested a culturally appropriate intervention to control blood pressure in African Americans using DVDs of real patients' stories of how they deal with the chronic disease. Patients with uncontrolled blood pressure experience blood pressure reductions after viewing the DVD.

Keywords:    Research | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication | Clinical & Mental Health |

Impact of Patient-Doctor Race Concordance on Rates of Weight-Related Counseling in Visits by Black and White Obese Individuals External Web Site Policy

Bleich, S. N., Simon, A. E., Cooper, L. A. (2011). Impact of patient-doctor race concordance on rates of weight-related counseling in visits by Black and White obese individuals [Abstract]. Obesity. doi:10.1038/oby.2010.330

This study from the journal Obesity found that the race of a patient may be a factor in a doctor's treatment and counseling for obesity. The study showed that Blacks may get less counseling on exercise and weight reduction than Whites regardless if the physician they see is Black or White.

Keywords:    Research | Disease-Based | Population-Based | Disparities | Clinical & Mental Health | Communication |

Language and literacy relate to lack of children's dental sealant use External Web Site Policy

Mejia, G. C., Weintraub, J. A., Cheng, N. F., Grossman, W., Han, P. Z., Phipps, K. R., & Gansky, S. A. (2010). Language and literacy relate to lack of children's dental sealant use. Community Dentistry and Oral Epidemiology, 39. doi: 10.1111/j.1600-0528.2010.00599.x

This study from the journal Community Dentistry and Oral Epidemiology tracks the social determinants of children lacking sealants. The study finds that differences exist by level of acculturation and parental health literacy.

Keywords:    Research | Disparities | Profession-Based | Disease-Based |

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 |

White Patients Most Likely to Get Kidney Transplants: Study External Web Site Policy

Holohan, E. (2011, March 3). White patients most likely to get kidney transplants: study. Health Day: News for Healthier Living. Retrieved from http://consumer.healthday.com/

This study from the University of Washington at Seattle finds that minorities have a significantly lower chance of getting a kidney transplant than Whites do. The researchers note that language and cultural barriers as well as socioeconomic status contribute to this disparity.

Keywords:    Research | Population-Based | Disease-Based | Disparities | Clinical & Mental Health |

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 |

Holistic Honu Wellness Center - Bridging the Gap between Traditional Healing and Western Medicine External Web Site Policy

The Holistic Honu Wellness Center is a very small health and wellness center in Berkeley, California where they address the issue of Native Hawaiian health disparities by acting as a conduit between traditional healing practices and the western medical communities everyday. Their current program has been the development and execution of a culturally competent education curriculum designed to address health disparity issues within Native Hawaiian communities that consists of four distinct levels.

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

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

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 |

Cancers External Web Site Policy

Detection

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

Keywords:    Communication | Disease-Based | Education & Training | Health Literacy | Public Health | Research |

CDC Diabetes website

CDC's Division of Diabetes Translation translates diabetes research into daily practice to understand the impact of the disease, influence health outcomes, and improve access to quality health care. Resources are available in Spanish as well.

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

Keywords:    Disease-Based | Education & Training | Government | Health Literacy | Patients & Consumers | Public Health | Research |

Caring for patients from different cultures: Case studies from American hospitals External Web Site Policy

Galanti, G. A. (2008). Caring for patients from different cultures: Case studies from American hospitals (4th ed.). Philadelphia, PA: University of Pennsylvania Press.

This updated text contains more than 200 case studies illustrating cross-cultural misunderstandings and offering insight into the meaning of culturally competent care. Topics covered include birth, end of life, traditional medicine, mental health, pain, religion, and staff issues. The author is a noted medical anthropologist.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Patients & Consumers | Research | Education & Training |

Mental health literacy: An impediment to the optimum treatment of major depression in the community External Web Site Policy

Goldney, R. D., Fisher, L. I., & Wilson, D. H. (2001). Mental health literacy: An impediment to the optimum treatment of major depression in the community. Journal of Affective Disorders, 64(2-3), 277-84.

The authors find that the public's general lack of knowledge and erroneous beliefs about mental disorders impede the recognition and management of major depression. The authors conclude that a need exists for greater effort in community education.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Health Literacy | Disease-Based | Research |

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 |

Health literacy and emergency department outcomes: A systematic review

Herndon, J., Chaney, M., & Carden, D. (2011). Health literacy and emergency department outcomes: A systematic review. Annals of Emergency Medicine, 57(4), 334-345. doi:10.1016/j.annemergmed.2010.08.035

The authors assess, through a systematic review of the literature, the relationship among the health literacy levels of emergency department patients, the readability of patient materials, and emergency department outcomes.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Health Literacy | Profession-Based | 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 |

Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry

Kleinman, A. (1981). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley, CA: University of California Press.

The author, a medical anthropologist, observes and compares the clinical interviews of medical practitioners from various cultures and traditions. The importance is stressed of making one's clinical interpretations within the proper cultural framework.

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

Teaching culturally effective diabetes care: Results of a randomized controlled trial External Web Site Policy

Kutob, R. M., Senf, J. H., & Harris, J. M. (2009). Teaching culturally effective diabetes care: Results of a randomized controlled trial. Family Medicine, 41(3), 167-174. Retrieved from http://www.stfm.org/fmhub/fm2009/March/Randa167.pdf

The authors developed an Internet-based course on cultural competence and tested it on a national sample of 122 family medicine residents. They conclude that "a skills-based course on cultural competence, delivered via the Internet, is an effective educational strategy," with "potential for dissemination of standardized content."

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Disease-Based | Research | Education & Training |

Disparities Dashboard External Web Site Policy

Massachusetts General Hospital, Committee on Racial and Ethnic Disparities. (n.d.) Disparities Dashboard. In Massachusetts General Hospital, Committee on Racial and Ethnic Disparities. Subcommittees. Retrieved from http://www.mghdisparities.org/sub_quality.html

The Racial and Ethnic Disparities Dashboard is an internal Massachusetts General Hospital report on key quality indicators, stratified by race and ethnicity. This portion of the subcommittees (of the Committee on Racial and Ethnic Disparities) page outlines the structure of the dashboard.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Disparities | Quality Improvement | Research |

Impacting health disparities through community outreach: Utilizing the CLEAN look (culture, literacy, education, assessment, and networking)

Meade, C., Menard, J., Martinez, D., & Calvo, A. (2007). Impacting health disparities through community outreach: Utilizing the CLEAN look (culture, literacy, education, assessment, and networking). Cancer Control, 14(1), 70-77. Retrieved from http://www.moffitt.org/CCJRoot/v14n1/pdf/70.pdf

The authors discuss the importance of considering culture and literacy in the development of community outreach programs for medically underserved populations and describe the application of the CLEAN Look checklist in a breast cancer outreach effort aimed at Haitian-American women.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Disparities | Disease-Based | Public Health | Research | Tools |

Improving patient safety through informed consent for patients with limited health literacy External Web Site Policy

National Quality Forum. (2005). Improving patient safety through informed consent for patients with limited health literacy. Retrieved from http://www.qualityforum.org/Publications/2005/09/Improving_Patient_Safety_Through_Informed_Consent_for_Patients_with_Limited_Health_Literacy.aspx

The foreword to this report notes that informed consent is "an essential component" in addressing health care disparities. The report synthesizes lessons learned by providers who adopted the National Quality Forum's Safe Practice 10. Barriers to implementation are discussed and potential solutions offered, key findings noted, and recommendations made. Appendices contain a number of case studies.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Health Literacy | Quality Improvement | Patients & Consumers | Research |

Cultural safety in nursing: The New Zealand experience External Web Site Policy

Papps, E., & Ramsden, I. (1996). Cultural safety in nursing: The New Zealand experience. International Journal for Quality in Health Care, 8(5), 491-497. doi:10.1093/intqh/8.5.491

In 1992, under prompting by Maori nurses, the Nursing Council of New Zealand made "cultural safety" a requirement for the training of persons seeking registration as nurses or midwives. "Safety," in this context, refers to someone who is safe or competent in practice. "Cultural safety" meant that nurses who attend individuals from another culture have "undertaken a process of reflection" on the way in which their own cultural identities may affect practice. This paper outlines the background and rationale of, and controversy surrounding, the introduction of "cultural safety" into nursing education and practice and discusses the relation between cultural safety and the quality of care.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Profession-Based | Research |

Reflections on the CLAS Standards: Best practices, innovations and horizons

Putsch, R., SenGupta, I., Sampson, A., & Tervalon, M. (2003). Reflections on the CLAS Standards: Best practices, innovations and horizons. Retrieved from The Cross Cultural Health Care Program website: http://www.xculture.org/files/CLAS.Standards.Report.pdf.pdf

On the basis of a literature review, interviews, and on-site visits, a number of best practices were identified in the implementation of the CLAS Standards. Among the findings are that best-practicing organizations tailor their programs and services to the needs of the communities and populations they serve; they engage in a combination of health, community, and social services; policies fostering culturally and linguistically appropriate services are woven into the organization at all levels; and meaningful relationships with the community are seen as critical to achieving equity. Five organizations are profiled in detail.

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

Patient centeredness, cultural competence and healthcare quality

Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of the National Medical Association, 100(11), 1275-1285. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824588

This publication explores the historical and cultural evolution of the concepts of cultural competence and patient centeredness. Early models focused on provider-patient interactions at the interpersonal level; later models were expanded to consider patients in relation to the health care system as a whole. The authors compare conceptual models and find that many of the core features of cultural competence and patient centeredness in these models are the same.

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

Recommendations for teaching about racial and ethnic disparities in health and health care

Smith, W., Betancourt, J., Wynia, M., Bussey-Jones J., Stone, V., Phillips, C., ... & Bowles, J. (2007). Recommendations for teaching about racial and ethnic disparities in health and health care. Annals of Internal Medicine, 147(9), 654-665.

The Health Disparities Task Force of the Society of General Internal Medicine recommends that a curriculum include the following three learning objectives: (1) examination of the attitudes (e.g., mistrust, subconscious stereotyping) that both patients and practitioners may bring to a clinical encounter; (2) the existence, magnitude, and causes of health disparities and their possible solutions; and (3) the skills necessary to communicate effectively across cultures, languages, and literacy levels.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Disparities | Research | Education & Training |

Cultural Diversity in Health & Illness External Web Site Policy

Spector, R. E. (2008). Cultural Diversity in Health & Illness (7th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

The author seeks to promote awareness of the complexities involved in caring for people of diverse cultural backgrounds. Examples of traditional health practices and beliefs are provided for selected populations. Cognizance is taken of recent social, political, and demographic trends.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Governance, Leadership, and Workforce | Research |

The medical manual for religio-cultural competence: Caring for religiously diverse populations External Web Site Policy

Tanenbaum Center for Interreligious Understanding. (2009). The medical manual for religio-cultural competence: Caring for religiously diverse populations. New York, NY: Tanenbaum Center for Interreligious Understanding.

This book examines health-related beliefs and practices from 10 religious traditions - Judaism, Christianity, Islam, Buddhism, Hinduism, Sikhism, Shinto, and traditional Chinese, American Indian/Alaska Native, and Afro-Caribbean religions - and notes how these may affect medical decisions. Communication guides, checklists, and other tools are included.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Population-Based | Research | Education & Training |

2010 National Healthcare Disparities Report

U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (2011). 2010 national healthcare disparities report (AHRQ Publication No. 11-0005). Retrieved from http://www.ahrq.gov/qual/nhdr10/nhdr10.pdf

The report includes discussions of the effectiveness of care (organized according to eight clinical areas), patient safety, timeliness of care, patient centeredness, care coordination, efficiency, health system infrastructure, access, and priority populations. A highlights section summarizes many of the findings, such as: health care quality and access are found to be suboptimal for minority and low-income groups - quality is improving, access and disparities are not; cancer screening and diabetes management are in particular need of attention; palliative and end-of-life care and patient and family engagement are improving - patient safety is not.

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

Hospitals, language, and culture: A snapshot of the nation External Web Site Policy

Wilson-Stronks, A., & Galvez, E. (2007). Hospitals, language, and culture: A snapshot of the nation. Retrieved from The Joint Commission website: http://www.jointcommission.org/assets/1/6/hlc_paper.pdf

In this study of 60 hospitals from across the United States, the authors seek to determine the challenges facing hospitals providing services to culturally and linguistically diverse populations, how hospitals are addressing these challenges, and whether promising practices have emerged that could be used by others. Site visits and interviews focused on six research domains: leadership, quality improvement and data use, workforce, patient safety and provision of care, language services, and community engagement. Recommendations and observations are offered for each domain.

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

Promising practices for patient-centered communication with vulnerable populations: Examples from eight hospitals External Web Site Policy

Wynia, M., & Matiasek, J. (2006). Promising practices for patient-centered communication with vulnerable populations: Examples from eight hospitals (Commonwealth Fund Publication No. 947). Retrieved from http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2006/Aug/Promising%20Practices%20for%20Patient%20Centered%20Communication%20with%20Vulnerable%20Populations%20%20Examples%20from%20Ei/Wynia_promisingpracticespatientcentered_947%20pdf.pdf

The study identified eight hospitals that have demonstrated a commitment to patient-centered communication with vulnerable patient populations. The authors discuss several promising practices in use by these hospitals, including advocates for communication programs, data collection on patient needs, community and patient engagement, a diverse workforce, awareness of cultural diversity, effective language assistance services, addressing the problem of health literacy, and assessing performance.

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

Promising practices for small health care providers. In Providing language services in small health care provider settings: Examples from the field External Web Site Policy

Youdelman, M., & Perkins, J. (2005). Promising practices for small health care providers. In Providing language services in small health care provider settings: Examples from the field (pp. 3-11) (Commonwealth Fund Publication No. 810). Retrieved from http://www.commonwealthfund.org/usr_doc/810_Youdelman_providing_language_services.pdf

Small provider settings, especially, may be hampered by limited resources in their efforts to provide effective care to an increasing number of patients who have limited proficiency in English. The National Health Law Program conducted interviews and site visits to learn how small providers are coping with this problem. Certain practices emerged as promising and replicable. These include the recruitment of bilingual staff to serve in dual capacities, ongoing training for interpreters, use of community resources, and capitalizing on underutilized funding sources. The authors offer an eight-step plan for development of a strategy to allow providers to meet the needs of their patients and communities.

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

Cultural competence: A systematic review of health care provider educational interventions

Beach, M. C., Price, E. G., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A., ... Cooper, L. A. (2005). Cultural competence: A systematic review of health care provider educational interventions. Medical Care, 43(4), 356-373.

The authors sought evidence in the literature of the cost and effectiveness of cultural competence training for health professionals. They found good evidence to indicate that such training positively affects patient satisfaction, poor evidence that it affects patient adherence, and no studies at all evaluating health status outcomes. There is poor evidence on which to determine the costs of training in cultural competence. The authors conclude that, while such training "shows promise as a strategy for improving the knowledge, attitudes, and skills of health professionals," evidence is lacking that it improves "equity of services across racial and ethnic groups." They recommend patient adherence, health outcomes, equity, and determination of effective teaching methods and content as areas for much needed study.

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

Cross-cultural medical education: conceptual approaches and frameworks for evaluation

Betancourt, J. R. (2003). Cross-cultural medical education: conceptual approaches and frameworks for evaluation. Academic Medicine, 78(6), 560-569.

The author notes that the foremost challenge in cross-cultural medical education is curricular evaluation. The article offers conceptual approaches to cross-cultural medical education and a framework for student evaluation that focuses, among other things, on "the impact of curricular interventions on health outcomes."

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

Nine constructs of cultural competence for curriculum development External Web Site Policy

Echeverri, M., Brookover, C., & Kennedy, K. (2010). Nine constructs of cultural competence for curriculum development. American Journal of Pharmaceutical Education, 74(10), Article 181. Retrieved from http://www.ajpe.org/doi/pdf/10.5688/aj7410181

The authors undertook an examination of the validity and reliability of the self-administered Clinical Cultural Competency Questionnaire. They administered the CCCQ to students in the College of Pharmacy at Xavier University. The authors conclude that the CCCQ is "a practical, valid, and reliable self-assessment instrument to measure the perceived level of pharmacy students' knowledge, skills, attitudes, and encounters in cross-cultural environments. The questionnaire allowed the identification of students' needs for training in cultural competence and the development of a curriculum tailored to satisfy those needs."

Keywords:    Governance, Leadership, and Workforce | Profession-Based | Research |

Institute Resource Center External Web Site Policy

Institute for Diversity in Health Management. (2008). Institute Resource Center. Retrieved from http://www.diversityconnection.org/diversityconnection/membership/Institute-Resource-Center.jsp?fll=S12

Contains downloadable information, news, studies, and data designed to help hospitals diversify their workforces and serve their diverse patient populations.

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

Cultural competency in health care: Evaluating the outcomes of a cultural competency training among health care professionals

Khanna, S. K., Cheyney, M., & Engle, M. (2009). Cultural competency in health care: Evaluating the outcomes of a cultural competency training among health care professionals. Journal of National Medical Association, 101, 886-892.

The authors conducted a study of 43 health care providers and administrators who attended a four-hour cultural competency workshop. A post-then-pre self-report was used to evaluate the effectiveness of the training. Participants reported an improved ability to work effectively in cross-cultural situations. The authors conclude that a cultural competency training program integrating key topics recommended by the Institute of Medicine and the National CLAS Standards improves the knowledge and skills of health care professionals.

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

Revising the tool for assessing cultural competence training (TACCT) for curriculum evaluation: Findings derived from seven US schools and expert consensus

Lie, D. A., Boker, J., Crandall, S., DeGannes, C. N., Elliott, D., Henderson, P., ... Seng, L. (2008). Revising the tool for assessing cultural competence training (TACCT) for curriculum evaluation: Findings derived from seven US schools and expert consensus. Medical Education Online, 13(1), 1-11. doi:10.3885/meo.2008.Res00272

The authors tested a 42-item, six-domain TACCT (revised from 67 items and five domains). They find that the shorter version is valid and reliable and that it focuses on underaddressed cultural competence content. The authors suggest that the shorter TACCT be used for curricular evaluation.

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

Using the tool for assessing cultural competence training (TACCT) to measure faculty and medical student perceptions of cultural competence instruction in the first three years of the curriculum

Lie, D., Boker, J., & Cleveland, E. (2006). Using the tool for assessing cultural competence training (TACCT) to measure faculty and medical student perceptions of cultural competence instruction in the first three years of the curriculum. Academic Medicine, 81, 557-564. doi:10.1097/01.ACM.0000225219.53325.52

The authors asked 25 faculty members (basic science and clinical medicine) and 92 third-year medical students at the University of California, Irvine, which items on the TACCT had been covered in the first three years of their curriculum. Faculty and students "responded congruently about the relative degree to which cultural competence instruction occurred." This indicates that the TACCT "can be used to identify significant gaps in cultural competence training and inform curricular revision," although further studies should be undertaken at other schools to confirm these findings.

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

Provider and clinic cultural competence in a primary care setting

Paez, K. A., Allen, J. K., Carson, K. A., & Cooper, L. A. (2008). Provider and clinic cultural competence in a primary care setting. Social Science and Medicine, 66(5), 1204-1216. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2426909/?tool=pubmed

Forty-nine providers and 23 clinics were assessed as to cultural competence. The authors find that culturally appropriate provider behavior is associated with higher percentages of nonwhite staff in the clinic and with clinics offering culturally adapted patient education materials. The authors suggest that enhancing the cultural competence of providers and clinics "may be synergistic strategies for reducing healthcare disparities."

Keywords:    Governance, Leadership, and Workforce | Research | Disparities |

A systematic review of the methodologic rigor of studies evaluating cultural competence training of health professionals External Web Site Policy

Price, E. G., Beach, M. C., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A., ... Cooper, L. A. (2005). A systematic review of the methodologic rigor of studies evaluating cultural competence training of health professionals. Academic Medicine, 80, 578-586. Retrieved from http://journals.lww.com/academicmedicine/Fulltext/2005/06000/A_Systematic_Review_of_the_Methodological_Rigor_of.13.aspx

The authors examined the methodological rigor of studies published in English from 1980 to 2003 that evaluate cultural competence training. Studies were appraised for their representativeness, description of the intervention, bias and confounding, outcome assessment, and analytic approach. The authors conclude that a lack of rigor "limits the evidence for the impact of cultural competence training on minority health care quality" and that more attention should be paid "to the proper design, evaluation, and reporting of these training programs."

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

Language proficiency and adverse events in US hospitals: A pilot study External Web Site Policy

Divi, C., Koss, R. G., Schmaltz, S. P., & Loeb, J. M. (2007). Language proficiency and adverse events in US hospitals: A pilot study. International Journal of Quality in Health Care, 19(2), 60-67. doi:10.1093/intqhc/mzl069

Adverse event data were collected on English-speaking patients and on patients with limited proficiency in English from six hospitals in 2005. Patients with limited English had a higher percentage of adverse events than did English-speaking patients, and, of these events, a higher percentage were traceable to communication errors in the case of patients with limited English skills than was the case among those who spoke fluent English.

Keywords:    Communication and Language Assistance | Research |

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 |

Pediatricians' use of language services for families with limited English proficiency External Web Site Policy

Kuo, D. Z., O'Connor, K. G., Flores, G., & Minkovitz, C. S. (2007). Pediatricians' use of language services for families with limited English proficiency. Pediatrics 119(4), e920-e27. doi:10.1542/peds.2006-1508.

The authors' objective was to study pediatricians' use of language services and the characteristics of the practice and the state associated with the use of these services. Bilingual family members and bilingual staff were the most frequently reported language services. Forty percent of respondents use professional interpreters; 35 percent supply translated written materials. Those in small and rural practices or in states having a large proportion of persons with limited English skills tend to use professional interpreters less often. Pediatricians in states with third-party reimbursement for language services report more frequent use of professional interpreters.

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

Asset-Based Community Development Institute External Web Site Policy

Asset-Based Community Development Institute. (2009). Retrieved from http://www.abcdinstitute.org/

The ABCD Institute, located at Northwestern University, is part of a movement that considers local assets to be the "building blocks of sustainable community development." The institute is involved in building community capacity by engaging with community groups, participating in workshops and training, and offering technical support. They conduct community-participatory research and publish their work for scholars in the community development field and as practical resources for community builders.

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

Cultural competence in mental health care: a review of model evaluations

Bhui, K., Warfa, N., Edonya, P., McKenzie, K., Bhugra, D. (2007). Cultural competence in mental health care: a review of model evaluations. BMC Health Services Research, 7, 15. doi:10.1186/1472-6963-7-15

A literature search of articles published in English since 1985 found only nine that met the criteria of (1) showing implementation of a cultural competence model of mental health care and (2) providing some evaluation data for a cultural competency model of service provision or training - or including an evaluation of adherence to a predefined model of cultural competence in mental health services. None of the studies investigated outcomes for or experiences of the service users. The authors of the present review conclude that there "is limited evidence on the effectiveness of cultural competency training and service delivery" and that further work is required.

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

The Dangers of Drinking and Driving External Web Site Policy

A non-promotional guide that discusses the dangers that can happen if you drink and get behind the wheel of a vehicle.

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

Keywords:    Education & Training | Health Literacy | Engagement, Continuous Improvement, and Accountability | Research |

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 |