Introduction

This knowledge path directs readers to a selection of current, high-quality resources about preventing, identifying, and eliminating racial and ethnic disparities in health. Health professionals, program administrators, policymakers, and researchers can use this knowledge path to learn more about health disparities, health equity, and removing barriers to care; for program development; and to locate training resources and information to answer specific questions. A separate brief lists resources for families. This knowledge path has been developed by the MCH Library at Georgetown University and will be updated periodically.

View Related MCH Library Resources for guides about culturally competent services, health literacy, life course and social determinants, and more.

Definitions

View the Healthy People 2020 definitions for health equity and health disparity.

Overview

For an overview of racial and ethnic health disparities and Department of Health and Human Services initiatives to reduce them, see HHS Action Plan to Reduce Racial and Ethnic Health Disparities: A Nation Free of Disparities in Health and Health Care (2011).

For analysis and reporting of the recent trends and ongoing variations in health disparities and inequalities in selected social and health indicators, see CDC Health Disparities and Inequalities Report—United States (2011). Infant mortality, preterm births, and adolescent pregnancy and childbirth are among the maternal and child health (MCH) topics addressed.

Also view Unnatural Causes: Is Inequality Making Us Sick?, a seven-part documentary series exploring racial and socioeconomic inequalities in health, including disparities in pregnancy outcomes. Discussion guides, video clips, an action toolkit, a resource database, and other materials accompany the series.

Resources for Professionals

Websites

• Advocates for Youth: Youth of Color. 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.
  
  
• Agency for Healthcare Research and Quality (AHRQ): Minority Health. Initiatives to reduce racial and ethnic disparities in health care and research on health care for specific racial and ethnic groups. Presents conference and meeting information, evidence reports, and research findings, including reports on approaches to using race and ethnicity data for reducing disparities in the quality of health and health care. Includes
  
  National Healthcare Disparities Report. This annual report presents 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 racial and ethnic minorities. The NHQRDRnet is an interactive tool for exploring data from the reports. State snapshots provide state-specific information from the annual reports.
  
  Also see the Health Care Innovations Exchange.
  
  
• Asian Pacific Islander American Health Forum (APIAHF): Health Equity. Fact sheets, issue briefs, presentations, and other resources about health care disparities in Asian Americans, Native Hawaiians, and Pacific Islanders. Includes
  
  Asian American, Native Hawaiian, & Pacific Islander Maternal Health Disparities. (2012). [Fact sheet].
  
  
• Census Bureau: Minority Links. Links to 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.
  
  
• Centers for Disease Control and Prevention (CDC): Minority Health. Information about the demographics, leading causes of death, high prevalence health issues, health disparities, and health statistics for American Indian, Alaskan Native, Asian American, black and African American, Hispanic and Latino, and Native Hawaiian and other Pacific Islander populations. Also presents information about programs and internships, an electronic newsletter and blog, and CDC publications on minority health topics. Includes
  
  CDC Health Disparities and Inequalities Report—United States. (2011). [Report, Executive summary, Fact sheets].
  
  Other resources and initiatives about racial and ethnic disparities from CDC:
  
  Adolescent and School Health: Health Disparities. Fact sheets and recommended action steps to address health disparities, including those experienced by adolescents from various racial and ethnic populations.
  
  African-American Media Resources. Health information for African-American media outlets, as well as mainstream media that reach audiences of color. Presents story ideas with African-American readers in mind, biographies of African-American experts at CDC, and free, ready-to-print articles on health issues affecting African Americans.
  
  Black Women Have Higher Death Rates from Breast Cancer Than Other Women. (2012). [Report].
  
  Disparities in HIV/AIDS, Viral Hepatitis, STDs, and TB. Information on racial and ethnic minority groups disproportionately affected by HIV and AIDS, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB).
  
  Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities. (2012).
  
  Hispanic Media Resources. Health information for Spanish-language media, as well as English-language media that reaches Hispanic audiences. Presents Spanish-language press releases, public service announcements and other information; story ideas with Hispanic readers in mind; and biographies of Spanish-speaking experts at CDC.
  
  Racial and Ethnic Approaches to Community Health (REACH). Community-based programs and culturally tailored interventions to eliminate racial and ethnic health disparities across a wide range of health priority areas such as cardiovascular disease, diabetes, breast and cervical cancer, infant mortality, asthma, immunization, and obesity. Includes grantee information and research publications.
  
  Understanding Racial and Ethnic Disparities in U.S. Infant Mortality Rates. (2011). [Data brief].
  
  
• CityMatCH. Tools and resources for implementing initiatives to mobilize urban communities to reduce infant mortality and pregnancy loss and reduce racial inequities in infant mortality in urban communities. Includes
  
  Conversations that Matter: A How-to Guide for Hosting Discussions About Race, Racism, and Public Health. (2012). [Developed through a collaboration with the Lee Institute].
  
  Institute for Equity in Birth Outcomes. National initiative based in local urban health departments that brings a scientific focus to persistent racial disparities in birth outcomes.
  
  Taking the First Steps: Experiences of Six Community/State Teams Addressing Racism's Impacts on Infant Mortality. (2011). [Report]. [Collaborative effort of CityMatCH, the Association of Maternal & Child Health Programs (AMCHP), and the National Healthy Start Association (NHSA)]. Also see the companion document, Exercises for Team-Building and Community Action Planning: A Toolkit for MCH Leaders Addressing Racism's Impacts on Infant Mortality. (2011).
  
  
• Commonwealth Fund: Vulnerable Populations. Publications, grant and fellowship program information, surveys, and charts about ensuring that vulnerable populations, including people with low incomes, the uninsured, and disadvantaged racial and ethnic minority populations, receive high-quality health care. Equity in health care access and quality, identifying promising models of care, meeting the specific needs of vulnerable populations, and training physicians are among the topics addressed. Includes
  
  Ensuring Equity: A Post-Reform Framework to Achieve High Performance Health Care for Vulnerable Populations. (2011). [Report, Chart pack].
  
  
• Community Voices. Publications, presentations, and information about community-based demonstration projects dedicated to improving access to and the quality of health care for underserved and uninsured populations in the United States.
  
  
• Families USA: Health Equity. Publications, training opportunities, resources lists, and an electronic newsletter about minority health and racial and ethnic health disparities with a focus on access to care. Includes tools for community leaders to help them engage in health advocacy and improve the health and well-being of their communities.
  
  
• Healthy People 2020 (HP2020). 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 website's home page allows users to compare the top 10 causes of death by race/ethnicity and age range. Use the MAP-IT (Mobilize, Assess, Plan, Implement, Track) strategy to implement HP2020 locally and view your state's plan for making progress on the HP2020 objectives.
  
  
• Joint Center for Political and Economic Studies: Place Matters. Research information and publications about this initiative to build the capacity of community leaders to address the social, economic, and environmental conditions in communities that shape health and health outcomes. Includes
  
  Place Matters: Ensuring Opportunities for Good Health for All—A Summary of Place Matters' Community Health Equity Reports. (2012). [Report].
  
  Race and Ethnicity Data Collection: Beyond Standardization. (2012). [Issue brief].
  
  Segregated Spaces, Risky Places: The Effects of Racial Segregation on Health Inequalities. (2011). [Report].
  
  
• Kaiser Family Foundation (KFF): Minority Health. Policy research and analysis, state-level data, tutorials, an electronic newsletter, and other resources about minority health and efforts to reduce racial and ethnic disparities in health care access and quality. Includes
  
  Disparities in Health and Health Care: Five Key Questions and Answers. (2012).
  
  
• Maternal and Child Health Bureau (MCHB). Initiatives on behalf of America's women, infants, children, adolescents, and their families, including Healthy Start, a program to reduce the rate of infant mortality and improve perinatal outcomes in populations at high risk, and the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, a federal, state, and community collaboration to improve health and development outcomes for children who are at risk through evidence-based home-visiting programs. Includes
  
  Eliminating Disparities in Perinatal Health: Technical Assistance Workshop. (2012). [Webcast].
  
  Mentoring Racially and Ethnically Diverse Students and Faculty: What the Literature Tells Us. (2012). [Webcast].
  
  
• Medical Education Futures Study (MEFS). Research and news summaries, reports, legislative updates, policy briefs, and a newsletter about creating a more ethnically and racially diverse physician work force.
  
  
• National Alliance for Hispanic Health. 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.
  
  
• National Association of County and City Public Health Officials (NACCHO): Roots of Health Inequity. Web-based course for public health professionals to consider the root causes of inequity in the distribution of illness, disease, and death and the concepts and strategies that could lead to effective action.
  
  
• National Cancer Institute (NCI): Center to Reduce Cancer Health Disparities (CRCHD). Information about research, training, and outreach efforts to reduce cancer health disparities. Includes
  
  Health Disparities Calculator, Version 1.2.3. (2012). [Statistical software, fact sheet].
  
  
• National Center for Cultural Competence (NCCC). Tools to increase the capacity of health and mental health programs to design, implement, and evaluate culturally and linguistically competent service-delivery systems to address growing diversity and persistent disparities and to promote health and mental health equity. Includes resources for MCH training programs on using mentoring as an evidence-based strategy to increase the number of students and faculty from racial and ethnic groups underrepresented in MCH programs.
  
  
• National Conference of State Legislatures (NCSL): Disparities in Health. Summaries of state laws and legislation aimed at eliminating health disparities for racial and ethnic minorities. Contact information for state offices of minority health or health equity along with a detailed description of state actions that created these offices. Links to publications about health disparities.
  
  
• National Council of La Raza (NCLR): Institute for Hispanic Health. Initiatives to promote the health and well-being of Hispanic Americans by reducing the incidence, burden, and impact of health problems in this community. Nutrition and physical activity, heart disease, diabetes, sexual and reproductive health, emergency preparedness, and genetics education are among the health issues addressed.
  
  
• National Hispanic Medical Association (NHMA). Training and advocacy resources to empower Hispanic physicians to be leaders who will help eliminate health disparities and improve the health of Hispanic populations.
  
  
• National Institute on Minority Health and Health Disparities (NIMHD). Grant and program information, press releases, conference information, and the National Institutes of Health strategic plan and budget to address disparities in health.
  
  
• National Medical Association (NMA). Resources and initiatives about parity and justice in medicine and the elimination of disparities in health. Increasing African-American physicians' and patients' participation in biomedical research and clinical trials and health conditions that disproportionally affect African Americans (e.g., asthma, diabetes, HIV/AIDS) are among the topics addressed.
  
  
• National Network to Eliminate Disparities in Behavioral Health (NNED). Resources and initiatives to address disparities and promote equity in behavioral health care. Includes a resource library, webinars and other training forums, and information about meetings and funding opportunities.
  
  
• Office of Minority Health (OMH). Program, funding, and conference information; statistics; profiles of minority population groups; library; electronic newsletter; and publications about public health issues affecting African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, and Native Hawaiians and other Pacific Islanders. Issues include racial and ethnic disparities in health. Some resources are available in Spanish. Includes
  
  A Healthy Baby Begins with You. Initiative 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 college students about preconception health and care and to train them to serve as ambassadors for their peers who are not attending college.
  
  HHS Action Plan to Reduce Racial and Ethnic Health Disparities: A Nation Free of Disparities in Health and Health Care. (2011).
  
  National Stakeholder Strategy for Achieving Health Equity. (2011).
  
  National Partnership for Action to End Health Disparities (NPA) Guide to Health Disparities Resources. (2011).
  
  Reducing Health Disparities with Improved Data Collection: New Refined Data Standards for Race, Ethnicity, Sex, Primary Language, and Disability Status. (2011). [Fact sheet].
  
  Toolkit for Community Action. (2011).
  
  
• Prevention Institute: Improving Environments for Health and Health Equity. Initiatives, tools, publications, and other resources. Includes a web-based training series for public health professionals and advocates interested in policy advocacy, community change, and multi-sector engagement to achieve health equity.
  
  
• Race Matters Institute. Training tools to help decision-makers, advocates, and elected officials achieve racial equity. Presents data, talking points, and strategies to make the case, shape the message, and do the work.
  
  
• Reproductive Health Equity for Youth (RHEY): Assisting Organizations to Effectively Address Disparities and Inequities in Adolescent Health. Resources and tools for engaging with adolescents from diverse backgrounds and with diverse communities to deliver effective, culturally competent adolescent-pregnancy-prevention programs that meet community needs. Social determinants, enhanced needs and assets assessment, expanding partnerships, cultural competence, diversity as it relates to adolescents, and evaluation are among the topics addressed. Includes webinars, training presentation slides, workbooks, and reports.
  
  
• Robert Wood Johnson Foundation (RWJF): Quality/Equality. Initiatives to improve the overall quality of health care in targeted communities, reduce racial and ethnic disparities, and provide models for national reform. Includes research and program results, issue briefs, multimedia tools, news, and other resources.
  
  
• Substance Abuse and Mental Health Services Administration (SAMHSA): Behavioral Health Equity. Resources and initiatives to eliminate disparities in behavioral health. Includes information on behavioral health issues related to American Indians, Alaskan Natives, Asian Americans, Native Hawaiians, Pacific Islanders, blacks and African Americans, Hispanic Americans and Latinos, and lesbian, gay, bisexual, transgender people.
  
  
• UNC Gillings School of Global Public Health: Minority Health Project (MHP). Webcasts, conference materials, reports, news, and other resources about health equity and health disparities research and interventions.
  

Additional Electronic Resources

• American Hospital Association, Association of American Medical Colleges, American College of Healthcare Executives, Catholic Health Association of the United States, National Association of Public Hospitals and Health Systems. 2012. Eliminating Health Care Disparities: Implementing the National Call to Action Using Lessons Learned. Chicago, IL: American Hospital Association (AHA). [Report].
  
  
• Anderson KM, Rapporteur. 2012. How Far Have We Come in Reducing Health Disparities? Progress Since 2000—Workshop Summary. Washington, DC: National Academies Press. [Report].
  
  
• Anderson KM, Rapporteur. 2011. State and Local Policy Initiatives to Reduce Health Disparities: Workshop Summary. Washington, DC: National Academies Press.
  
  
• Aratani Y, Wight VR, Cooper JL. 2011. Racial Gaps in Early Childhood: Socio-emotional Health, Developmental, and Educational Outcomes Among African-American Boys. New York, NY: National Center for Children in Poverty (NCCP). [Report].
  
  
• Association of State and Territorial Health Officials (ASTHO). 2012. Disparities and Inequities in Maternal and Infant Health Outcomes. Arlington, VA: Association of State and Territorial Health Officials (ASTHO). [Issue brief].
  
  
• Association of State and Territorial Health Officials (ASTHO). 2012. Economic Case for Health Equity. Arlington, VA: Association of State and Territorial Health Officials (ASTHO). [Issue brief].
  
  
• Asthma Disparities Working Group. 2012. Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities. Washington, DC: President's Task Force on Environmental Health Risks and Safety Risks to Children. [Action plan].
  
  
• Bell J, Lee MM. 2011. Why Place and Race Matter: Impacting Health Through a Focus on Race and Place. Oakland, CA: PolicyLink; Los Angeles, CA: California Endowment. [Report and executive summary are available in English and Spanish].
  
  
• Center for Nonviolence and Social Justice at Drexel University School of Public Health, Department of Emergency Medicine at Drexel University, RAND Corporation, PolicyLink, and the Charles Hamilton Houston Institute for Race and Justice at Harvard Law School. 2010. Healthy Communities Matter: The Importance of Place to the Health of Boys of Color. Oakland, CA: PolicyLink. [Report].
  
  
• Dan D, Finch R, Harrison D, Kendall D. 2011. An Employer's Guide to Reducing Racial and Ethnic Health Disparities in the Workplace. Washington, DC: National Business Group on Health. Also view the Health Disparities Cost Impact Tool to help estimate the economic impact of health disparities in a company's diverse work force, in terms of direct medical costs and lost workdays for a variety of health conditions.
  
  
• Dawes DE. 2012. Health Care Reform: A Bridge to Health Equity. Tampa, FL: Community Solutions at the University of South Florida. [Webinar].
  
  
• Department of Health and Human Services (HHS). 2012. Health Disparities and the Affordable Care Act, rev. ed. Washington, DC: Department of Health and Human Services. [Fact sheet].
  
  
• FrameWorks Institute. 2009. Talking About Disparities. Washington, DC: FrameWorks Institute. [Toolkit].
  
  
• Hanlon C, Giles B. 2012. State Policymakers' Guide for Advancing Health Equity Through Health Reform Implementation. Portland, ME: National Academy for State Health Policy (NASHP). [Report].
  
  
• Indian Health Service (IHS). 2013. Indian Health Disparities, rev. ed. Rockville, MD: Indian Health Service (IHS). [Fact sheet].
  
  
• Ingram C, McMahon SM, Guerra V, Weiss A. 2012. Implications of Health Reform for American Indian and Alaska Native Populations. Hamilton, NJ; Washington, DC: Center for Health Care Strategies (CHCS); National Academy for State Health Policy (NASHP). [Issue brief].
  
  
• Michaud M. 2011. Immigrant Media Making New Voices for Community Health: Lessons and Recommendations from the Field. Madison, WI: New Routes to Community Health. [Report]. Also available in Spanish.
  
  
• National Institute for Health Care Management Research and Educational Foundation. 2011. Partnering to Promote Health Equity for Adolescents. Washington, DC: National Institute for Health Care Management Research and Educational Foundation. [Webinar].
  
  
• Nguyen QC, Dembner A. 2012. Promoting Racial and Ethnic Health Equity Through Exchanges. Boston, MA: Community Catalyst. [Report].
  
  
• Sanchez K, Chapa T, Ybarra R, Martinez, Jr., ON. 2012. Enhancing the Delivery of Health Care: Eliminating Health Disparities Through a Culturally and Linguistically Centered Integrated Health Care Approach—Consensus Statements and Recommendations. Austin, TX: Hogg Foundation for Mental Health. [Report].
  
  
• Seith D, Kalof C. 2011. Who Are America's Poor Children? Examining Health Disparities by Race and Ethnicity. New York, NY: National Center for Children in Poverty. [Report].
  
  
• Smedley BD. 2012. Striving for Health Equity: Opportunities as Identified by Leaders in the Field. Washington, DC: Grantmakers In Health. [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].
  
  
• Society for Women's Health Research, Food and Drug Administration Office of Women's Health. 2012. Dialogues on Diversifying Clinical Trials: Successful Strategies for Engaging Women and Minorities in Clinical Trials. Washington, DC: Society for Women's Health Research; Silver Spring, MD: Food and Drug Administration (FDA). [Report].
  
  
• Wizeman TM, Anderson KM, Rapporteurs. 2009. Focusing on Children's Health: Community Approaches to Addressing Health Disparities—Workshop Summary. Washington, DC: National Academies Press.
  

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about racial and ethnic disparities in health.

Data

• diversitydata.org. Metropolitan area indicators of diversity, opportunity, and quality of life (including health) for various racial and ethnic population groups. Data are presented in profiles by metropolitan area or by indicator in ranked lists, maps, bar graphs, or histograms. Harvard School of Public Health (HSPH) with the Center for Advancing Health (CFAH).
  
  
• NHQRDRNet: An Interactive Tool to Explore Data from the National Healthcare Quality and Disparities Reports. Online query system to access national and state data on the quality of, and access to, health care. Click on the topics in the left navigation bar or use the NHQRDRnet Search Tool to locate tables based on selected words, chapters, or type of table. Agency for Healthcare Research and Quality (AHRQ).
  
  
• Also see the MCH Library resource brief, Maternal and Child Health Data and Statistics.
  

Literature and Research Databases

• Minority Health and Health Equity Archive. Online catalog of current and retrospective journal articles and other research and policy resources on minority health and health disparities. University of Maryland Center for Health Equity and the University Library System at the University of Pittsburgh.
  
  
• Native Health Database. Online catalog of health-related articles, reports, surveys, and other documents about the health and health care of American Indians, Alaska Natives, and Canadian First Nations. University of New Mexico Health Sciences Library and Informatics Center.
  
  
• Office of Minority Health (OMH): Knowledge Center Catalog Search. Information about books, reports, journals, multimedia resources, articles, and organizations related to the health status of racial and ethnic minority populations.
  
  
• Also see the MCH Library resource brief, Maternal and Child Health Literature and Research Databases.
  

Programs Databases

• Health Care Innovations Exchange. Information about evidence-based innovations and tools for health professionals and researchers to improve the quality of health care and reduce health disparities. To identify innovations and tools, select Browse by Subject and make a selection based on your area of interest. View a December 2012 article in AHRQ's Health Care Innovations Exchange about reducing health disparities among children. Agency for Healthcare Research and Quality (AHRQ).
  
  
• Also see the MCH Library resource brief, Maternal and Child Health Programs Databases.
  

News and Commentary

• Centers for Disease Control and Prevention (CDC) Office of Minority Health and Health Equity (OMHHE).
  
  Health Equity Matters. This quarterly newsletter presents news, perspectives, and progress in the science and practice of health equity.
  
  Conversations in Equity. This blog aims to increase awareness of health inequities and promote national, state, and local efforts to reduce health disparities and achieve health equity.
  
  
• Families USA: 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.
  
  
• Kaiser Disparities Research Roundup. This regularly updated news summary reports on new research and policy papers about health care disparities.
  
  
• Medical Education Futures Study (MEFS) Newsletter. This periodic newsletter reports on recently published research, reports, legislative updates, books, news, and upcoming events about creating a more ethnically and racially diverse physician work force and the social mission of medical education.
  
  
• Office of Minority Health (OMH): Towards Health Equity. This monthly newsletter announces new resources, initiatives, events and conferences, and research about the health of racial and ethnic minority populations to help eliminate health disparities.
  

Resources for Families

• See the MCH Library family resource brief Health and Health Care for All.
  

Related MCH Library Resources

• Culturally Competent Services resource brief
• Health Literacy resource brief
• Infant Mortality and Pregnancy Loss knowledge path
• Life Course and Social Determinants resource brief
• Maternal Distress in the Perinatal Period and Child Outcomes knowledge path
• Minority Health organizations list
• Non-English Materials and Resources index, organizations list
• Racial and Ethnic Disparities in Health bibliography
• Spanish-Language Health Resources knowledge path

Racial and Ethnic Disparities in Health: Knowledge Path, 6th ed. (February 2013).
Author: Susan Brune Lorenzo, M.L.S., MCH Library.
Reviewers: Suzanne Bronheim, Ph. D., National Center for Cultural Competence; Olivia K. Pickett, M.A., M.L.S., MCH Library; Shree Mohanty, M.A., M.S., R.D., L.D., Maternal and Child Health Bureau, Region V.
Editor: Ruth Barzel, M.A., MCH Library.