Racial and Ethnic Disparities
in Health
Knowledge Path
Knowledge Path Table of Contents
Special Topic: Cultural and Linguistic Competence
Please provide feedback on this knowledge path.
This knowledge path has been compiled by the MCH Library at Georgetown University. It offers a selection of current, high-quality resources about preventing, identifying, and eliminating racial and ethnic disparities in health. Separate sections present resources for professionals (health professionals, program administrators, policymakers, researchers) and families. A special topics area lists resources about cultural and linguistic competence to remove barriers to care and narrow health disparities. The knowledge path will be updated periodically.
See the Commonwealth Fund publication, Racial and ethnic disparities in U.S. health care: A chartbook (2008). This chartbook, which is intended for policymakers, teachers, researchers, and health professionals, aims to help users understand disparities in their communities and formulate solutions. Topics include demographics, disparities in health status and mortality, disparities in access to health care, disparities in coverage, disparities in quality, and strategies for closing the gap. A webinar accompanied the chartbook's release.
- Advocates
For Youth: Youth of Color. Presents information
about the disproportionate rates of HIV, sexually transmitted
infections, and pregnancy among adolescents from racial and ethnic
minority groups and resources to plan and implement culturally
appropriate interventions to meet their needs. Advocates for Youth aims to help adolescents and young adults
make informed and responsible decisions about their reproductive
and sexual health.
- Agency
for Healthcare Research and Quality (AHRQ): Minority Health.
Describes AHRQ's efforts to identify and understand how inequities
in health care contribute to racial and ethnic disparities in
health and how disparities can be eliminated. Includes links
to AHRQ-funded centers, research programs, and support networks
that focus on racial and ethnic disparities in health. Also links
to conference and meeting information, workshop summaries, evidence
reports, speeches and testimony, and research findings. Presents
data from the Healthcare Cost and Utilization
Project (HCUP), Medical Expenditure Panel
Survey (MEPS), and National Quality Measures
Clearinghouse™
(NQMC). Resources include
National healthcare disparities report. This annual report provides an overview of disparities in quality of and access to health care among racial, ethnic, and socioeconomic groups in the United States and tracks the nation's progress toward reducing disparities. A chapter focuses on health care disparities within specific priority populations that include women, children and adolescents, and individuals with special health care needs. The NHQRDRnet is an interactive tool for exploring data from the reports. State snapshots provide state-specific information from the 2009 report.
Also see AHRQ's resource, Health Literacy and Cultural Competency.
- American
Medical Association (AMA): Eliminating Health Disparities.
Offers program information, online courses, and other resources
for health professionals aimed at the elimination of racial and
ethnic disparities in health.
- American
Public Health Association (APHA): Eliminating Health Disparities. An issue brief, fact sheet, and policy statements about disparities in health status and health care access.
- Census
Bureau: Minority Links. Links to reports and news releases
containing data on racial and ethnic populations in the United
States. Includes social and economic characteristics for Black
or African American, Hispanic or Latino, Asian, Native Hawaiian
and other Pacific Islander, and American Indian and Alaska Native
populations. Health topics include disability, fertility, and
health insurance. Also see the Bureau's resource about the U.S.
foreign-born population, which presents profiles containing
detailed demographic, social, economic, and housing information
about the total, native, and foreign-born populations of the
United States.
- Centers for Disease Control and
Prevention (CDC). Offers programs and initiatives about
racial and ethnic disparities in health that include
CDC health disparities and inequalities report—United States. (2011). [Report, Fact sheets].
Morbidity and Mortality Weekly Report (MMWR). This series of publications contains articles and data about infectious and chronic diseases, environmental hazards, natural or human-generated disasters, occupational diseases and injuries, intentional and unintentional injuries, and other topics of interest to the public health community. Search for articles about racial and ethnic disparities in health or about specific population groups.
National Center for Health Statistics (NCHS). Contains vital and health statistics about racial and ethnic groups. Resources include
- Faststats
A to Z. Browse the alphabetical list of topics to find
statistical fact sheets about the health of racial and ethnic
groups.
- Health, United States.
This annual report on trends in health statistics includes information
about racial, ethnic, and socioeconomic disparities in health.
- National Vital
Statistics System (NVSS). Tracks births, deaths, marriages,
divorces, and fetal deaths by race and ethnic group. NVSS produces
the linked birth/infant death data set.
National Center for HIV, STD, and TB Prevention (NCHSTP): Office of Health Disparities (OHD). Provides information about initiatives to address disparities in HIV and AIDS, sexually transmitted diseases, and tuberculosis cases for racial and ethnic minority groups.
Racial and Ethnic Approaches to Community Health (REACH). Includes program information about and resources to support community-based programs and culturally appropriate interventions to eliminate racial and ethnic health disparities.
- Faststats
A to Z. Browse the alphabetical list of topics to find
statistical fact sheets about the health of racial and ethnic
groups.
- Community Voices:
Health Care for the Underserved. Contains program descriptions,
articles, and policy briefs about community efforts to improve
access to and the quality of health care for underserved populations
in the United States. Community Voices is an initiative of the
W. K. Kellogg Foundation.
- Factline:
Tracking Health in Underserved Communities. Presents
information and bibliographic references about health disparities faced by women, members
of minority groups, the elderly, and others. Factline is a project of the Journal of HealthCare
for the Poor and Underserved, and it is sponsored by the National
Library of Medicine (NLM) and Meharry
Medical College. Factline is also available in Spanish.
- Families
USA: Health Equity. Presents resources including an electronic
newsletter about minority health and racial and ethnic health
disparities with a focus on disparities in health insurance and
access to care. Families USA advocates at the national, state,
and local levels for high-quality, affordable health care for
all Americans.
- Healthy
People 2020. Information about this national health-promotion
and disease-prevention initiative of the Department
of Health and Human Services. One of the overarching goals
of the initiative is to achieve health equity, eliminate disparities,
and improve the health of all groups. A tool on the home page
of the website allows users to compare the top 10 causes of
death by race/ethnicity and age range.
- Kaiser
Family Foundation (KFF): Minority Health. Contains policy
research and analysis, program information, state-level
data, webcasts,
and other resources about minority health and efforts to reduce
racial and ethnic disparities in health care access and quality.
KFF is an independent philanthropy focusing on national health
care issues.
- Medical
Education Futures Study (MEFS). Presents
policy briefs, research, reports, legislation, news summaries,
and a newsletter about the need to create
a more ethnically and racially diverse physician work force,
to train physicians for primary care, and to ensure a more equitable
geographic distribution of physicians during the current period
of medical school expansion. MEFS is an initiative of the George
Washington University School of Public Health and Health Services.
- Minority Health Project
to Eliminate Health Disparities (MHP). Contains webcasts,
conference materials, reports, news, and other resources concerning
minority health and disparities in health. MHP is part of the
University of North Carolina at Chapel Hill Program
for Ethnicity, Culture, and Health Outcomes (ECHO).
- National
Alliance for Hispanic Health. Provides legislative and
program information and publications about health issues important
to the Hispanic community. Offers toll-free
health helplines to help individuals and families find culturally
and linguistically proficient health information and referrals
to local services. The alliance is a network of health and human
service providers for over 15 million Hispanic consumers throughout
the United States.
- National Center on Minority
Health and Health Disparities (NCMHD). Includes grant
and program information, press releases, conference information,
congressional testimony, and the National Institutes of Health
strategic plan and budget to address disparities in health. NCMHD
is part of the National Institutes
of Health (NIH).
- National
Council of La Raza (NCLR): Institute for Hispanic Health.
Offers legislative news, reports, and background materials about
eliminating or reducing barriers that prevent Latino families
from accessing health care and receiving high-quality care. NCLR
is the largest Latino civil rights and advocacy organization
in the United States.
- National
Health Law Program (NHeLP): Health Disparities. Presents
a collection of resources about health disparities and health
care as a human right. Also see NHeLP's resource collection about language
access in health care. NHeLP is a national public-interest
law firm that aims to improve health care for families with low
incomes, minorities, the elderly, and people with disabilities.
- National Medical Association:
W. Montague Cobb/NMA Health Institute. Describes
its work to develop, evaluate, and implement strategies to promote
wellness and eliminate health disparities for African Americans
and other underserved populations. Resources address HIV/AIDS,
asthma, diabetes, cancer, hypertension and heart disease, and
obesity.
- National
Network to Eliminate Disparities in Behavioral Health (NNED).
Describes efforts to address disparities in behavioral health
care and presents information about meetings, funding opportunities,
and resources. NNED is supported by the Substance Abuse and Mental
Health Services Administration in partnership with the National
Alliance of Multi-ethnic Behavioral Health Associations.
- Office
of Minority Health (OMH). Links to program and conference
information, data, profiles of minority population groups, and
publications about public health issues affecting African Americans,
American Indians and Alaska Natives, Asian Americans, Hispanic
Americans, and Native Hawaiians and other Pacific Islanders.
Issues include racial and ethnic disparities in health and cultural
competence. Some resources are available in Spanish. OMH
is part of the Department of Health
and Human Services (DHHS). Recent resources and initiatives
include
A Healthy Baby Begins with You. Presents information about this national print and radio campaign to raise awareness about infant mortality with an emphasis on the African-American community. Includes campaign materials and infant mortality disparities fact sheets. Also presents information about another phase of the campaign, the Preconception Peer Educators (PPE) Program, which is designed to educate the college-age population about preconception health and care and to train them to serve as ambassadors for their peers who are not attending college.
National Partnership for Action to End Health Disparities for Ethnic and Racial Minority Populations (NPA). Presents program and meeting information about this partnership among organizations from all sectors that focuses on improving health status and health outcomes among racial and ethnic minority populations. Includes background information about health disparities, links to state health disparities plans, and information about promising practices to eliminate health disparities.
HHS action plan to reduce racial and ethnic disparities: A nation free of disparities in health and health care. (2011).
National stakeholder strategy for achieving health equity. (2011).
- Pew
Hispanic Center. Presents reports, fact sheets, surveys,
and data sets that aim to illuminate Latino views on social matters
and public policy issues, improve understanding of the U.S. Hispanic
population, and chronicle Latinos' growing impact on the entire
nation. Topics include demography, economics, education, health, identity,
immigration, labor, politics, and remittances. The center is
supported by the Pew Charitable Trusts, a private philanthropy
serving the public interest.
- Robert
Wood Johnson Foundation (RWJF): Quality/Equality. Offers
research and program information, reports, toolkits, and news
summaries from RWJF and its grantees about reducing racial and
ethnic health care disparities. RWJF seeks to improve the health
and health care of all Americans via its grantmaking efforts.
- THRIVE:
The Tool For Health and Resilience in Vulnerable Environments.
Offers a tool to help communities identify and foster factors
in the community environment that will improve health outcomes
and reduce disparities experienced by racial and ethnic minorities.
THRIVE is presented by the Prevention
Institute.
Additional Electronic Publications
- American Lung Association.
2007. State
of lung disease in diverse communities. New York, NY: American
Lung Association. [Report].
- Children's Defense Fund.
2006. Improving
children's health: Understanding children's health disparities and
promising approaches to address them. [Report].
- Cohen JA. 2008. Challenges
and successes in reducing health disparities: Workshop summary.
Washington, DC : National Academies
Press. [Report].
- Commission on the Social Determinants of Health. 2008. Closing
the gap in a generation: Health equity through action on the social
determinants of health. Geneva, Switzerland: World
Health Organization (WHO). [Report].
- Fox HB, McManus MA, Zarit M, Fairbrother G, Cassedy AE, Bethell
CD, Read D. 2007. Racial
and ethnic disparities in adolescent health and access to care.
Washington, DC: National
Alliance to Advance Adolescent Health. [Fact sheet].
- Hasnain-Wynia R, Pierce D, Haque A, Hedges Greising
C, Prince V, Reiter J. 2007. HRET
disparities toolkit. Chicago, IL: Health
Research and Educational Trust (HRET), American
Hospital Association (AHA). [Ttoolkit].
- Healthy States Initiative.
2007. Addressing
adolescent health disparities through school. Lexington, KY: Council
of State Governments. [Policy brief].
- Hughes D, Kreger M, Kushner K, Pirani H, Surie D. 2007. Reducing health disparities among children: Strategies and programs for
health plans. Washington, DC: National
Institute for Health Care Management Research and Educational Foundation.
[Report].
- Johnson K, Theberge S. 2007. Reducing
disparities beginning in early childhood. New York, NY: National
Center for Children in Poverty (NCCP). [Issue brief].
- Leigh WA, Huff D. 2006. Women
of color health data book: Adolescents to seniors, 3rd ed.
Bethesda, MD: Office of Research
on Women's Health (ORWH). [Chartbook].
- Meng YY, Babey SH, Hastert TA, Brown ER. 2007. California's
racial and ethnic minorities more adversely affected by asthma.
Los Angeles, CA: UCLA
Center for Health Policy Research. [Policy brief].
- Moiduddin E, Massey DS. 2006. Segregation,
the concentration of poverty, and birth weight. Princeton,
NJ: Center for Research on
Child Wellbeing. [Paper].
- National Institutes of Health (NIH).
2008. NIH launches center
to study genomics and health disparities. Bethesda, MD: National
Institutes of Health (NIH). [Press release].
- Perot RT, Davis RJ. 2007. From
awareness to action: Stakeholders’ strategies to eliminate
racial and ethnic health disparities. Washington, DC: Summit
Health Institute for Research and Educations, Inc. [Report].
- Saha S, Shipman SA. 2006. Rationale
for diversity in the health professions: A review of the evidence.
Rockville, MD: Health Resources and
Services Administration (HRSA). [Report].
- Smedley BD, Stith AY, Nelson AR, eds. 2003. Unequal
treatment: Confronting racial and ethnic disparities in health
care. Washington, DC: National
Academies Press. [Report].
- Urban Indian Health
Commission. 2007. Invisible
tribes: Urban Indians and their health in a changing world.
Washington, DC: Urban Indian Health Commission. [Report].
See the following set of MCH Library resource briefs to identify additional data and statistics, literature and research, and programs about racial and ethnic disparities in health.
- Maternal and Child Health Data and Statistics
- Maternal and Child Health Literature and Research Databases
- Maternal and Child Health Programs Databases
- Health Equity Connection. This monthly newsletter
announces new resources in minority health, addresses how major
health policy issues affect communities of color, and presents
comments from leaders in the field of racial and ethnic health
disparities.
- Medical
Education Futures Study (MEFS) Newsletter. This
periodic electronic newsletter covers news and articles about
creating a more ethnically and racially diverse physician work
force, issues about the social mission of medical education,
and new MEFS products.
Special Topic: Cultural and Linguistic Competence
- Agency
for Healthcare Research and Quality (AHRQ): Health Literacy and
Cultural Competency. Presents research and program information
and a collection of resources about health literacy and cultural
and linguistic competence.
- Cross Cultural Health
Care Program (CCHCP). Presents information about
research and training programs, a bibliography, and a collection
of resource
guides on topics surrounding culturally and linguistically
appropriate health care services for medical interpreters, health
professionals, social service providers, and others working with
limited English proficiency (LEP) populations. CCHCP aims to
serve as a bridge between communities and health care institutions
to ensure full access to quality health care that is culturally
and linguistically appropriate, thereby reducing health disparities.
- Culture
and Health Literacy. Presents an online training
module for health professionals and policymakers about how inequalities
in health information contribute to unequal treatment and health
outcomes for some populations and what communities can do to
eliminate health disparities and improve health literacy. The
module is presented by the University
of Minnesota School of Public
Health. Also view a companion training module, Culture and Health Literacy: Case Studies.
- Culture
Clues™. Presents tip sheets for medical professionals
to consider when working with patients from African American,
American Indian/Alaska Native, Chinese, Deaf, Hard-of-Hearing,
Korean, Latino, Russian, Somali, and Vietnamese cultures. Culture
Clues™ are a resource of the University of Washington Medical
Center.
- DiversityRx.
Presents information about materials, conferences, organizations,
and other resources for health professionals, policymakers, researchers,
and advocates about culturally and linguistically appropriate services
in health care settings. Includes webinars, blogs, a listserv, and
networking opportunities about cross cultural health.
- EthnoMed.
Contains information about cultural beliefs, medical issues, and
other related issues pertinent to the health care of recent immigrants
to the Seattle area. Much of the information is applicable to other
geographic areas in the United States. EthnoMed is a joint project
of the University of Washington Health Sciences Library and the Harborview
Medical Center.
- Hablamos
Juntos (HJ). Contains program information and a bibliography
of materials about developing affordable models for health professionals
to overcome language barriers and to develop the business case
for language services. Topics include signage, translation and
production of Spanish-language materials, and interpreter services.
HJ is funded by the Robert Wood Johnson Foundation
(RWJF).
- Health
Literacy Studies (HLS). Includes research and program
materials for health-literacy initiatives, including those designed
for particular racial and ethnic groups. HLS is a program of
the Harvard School of
Public Health (HSPH).
- LEP.gov. Offers links to
information, tools, and technical assistance about LEP and language
services for federal agencies, recipients of federal funds, users
of federal programs and federally assisted programs, and the general
public. LEP.gov was created by the Federal Interagency Working Group
on Limited English Proficiency to promote a positive and cooperative
understanding of the importance of language access to federal programs
and federally assisted programs.
- National Center for Cultural
Competence (NCCC). Presents resources to increase the
capacity of health and mental health programs to design, implement,
and evaluate culturally and linguistically competent service-delivery
systems. Provides tools and processes for individual and organizational
self-assessment, a consultants list, training modules, a section
about working
with linguistically diverse populations, highlights of promising
practices in cultural and linguistic competence, and publications
that include Spanish-language materials. NCCC is part of the Georgetown
University Center for Child and Human Development. Resources include
And the journey continues: Achieving cultural and linguistic competence in systems serving children and youth with special health care needs and their families. (2007). [Report].
Body/Mind/Spirit: Toward a Biopsychosocial-Spiritual Model of Health. Presents a framework for health professionals on spirituality and religion in health. Addresses the potential role of spirituality and religion in how an individual copes with illness, health care decision-making, and health outcomes. Includes literature reviews, international and domestic publications, references, and other resources.
- National
Health Law Program (NHeLP): Language Access in Health Care.
Presents a collection of resources about improving policies and
funding for access to health care for individuals with LEP.
- National
Library of Medicine (NLM). Offers online collections
of resources for and about specific populations: American
Indian Health, Arctic
Health, Asian
American Health. Includes links to background on cultural
traditions and heritage and to information on health topics especially
relevant to the population group. NLM also presents a collection
of multicultural
resources for health information. Also see NLM's PubMed and
MedlinePlus resources on health disparities, health
information in multiple languages, and population
group topics.
- New
Jersey State Board of Medical Examiners: NJ Cultural Competency.
Describes requirements for physician training in cultural competency
in New Jersey. Links to the state statute and set of regulations
governing the requirements.
- Office
of Minority Health (OMH): Cultural Competency. Defines
cultural competence and provides a glossary of terms about cultural
and linguistic competence in health. Presents guides; standards;
training tools; information about policies, initiatives, and
laws; and additional resources to help health professionals and
health care organizations remove cultural and linguistic barriers
to health.
- America's Health Insurance Plans.
2006. Tools
to address disparities in health: Communications resources to close
the gap. A compendium of resources for health insurance plans, physicians,
and health care organizations. Washington, DC: America's Health
Insurance Plans. [Compendium].
- National Quality Forum (NQF).
2009. Comprehensive framework and preferred practices for measuring and reporting cultural competency. Washington,
DC: National Quality Forum (NQF). [Report].
- Office of Disease Prevention and Health Promotion (ODPHP). 2010. National action plan to improve health literacy. Washington, DC: Department of Health and Human Services (DHHS).
- Weiss L, Bauer T, Hill C, Fuld J, Bergman J. 2006. Language
as a barrier to health care for New York City children in immigrant
families: Haitian, Russian and Latino perspectives. New York,
NY: New York Academy of Medicine.
[Paper].
- Also see the MCH Library bibliographies Racial and ethnic disparities in health and Culturally competent services. The library presents a non-English materials and resources list, the resource brief Culturally competent services, and the knowledge path Spanish-language health resources.
- See the MCH Library family resource brief Racial
and Ethnic Disparities in Health.
Racial and Ethnic Disparities in Health: Knowledge Path, 5th ed. (December
2008). (Updated: February 2012).
Author: Susan Brune Lorenzo, M.L.S., MCH Library.
Reviewers: Lauren Agoratus, M.A., Family Voices and Family-To-Family
Health Information Resource Center at the Statewide Parent Advocacy
Network of N.J.; M. Clare Dunne, M.S.W., National Sudden and Unexpected
Infant/Child Death and Pregnancy Loss Resource Center; S. Jean Emans,
M.D., Children's Hospital Boston and Harvard Medical School; Rachel
Y. Moon, M.D., Children's National Medical Center and George Washington
University School of Medicine and Health Sciences; Olivia K. Pickett,
M.A., M.L.S., MCH Library.
Editor: Ruth Barzel, M.A., MCH Library.
