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Racial and Ethnic Disparities in Health
Knowledge Path

Introduction

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.

Resources for Professionals

Overview

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.

Websites

  • 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. (2003-). 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.

  • Center for Health Care Strategies (CHCS): Racial and Ethnic Health Disparities. Describes promising approaches and presents tools that states and health plans can use to address disparities as well as improve quality of care. Includes strategies to more effectively collect and use primary race and ethnicity data to close gaps in health care quality. CHCS provides training and technical assistance to improve the quality of publicly financed health care in the United States.

  • Centers for Disease Control and Prevention (CDC). Offers programs and initiatives about racial and ethnic disparities in health that include

    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

    Office of Minority Health and Health Disparities (OMHD). Contains program and conference information, reports, and other resources about efforts to eliminate health disparities for vulnerable populations as defined by race/ethnicity, socioeconomic status, geography, gender, age, disability status, and risk status related to sex and gender, as well as for other populations identified as being at risk for health disparities.

    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 2010). Includes program information about community-based programs and culturally appropriate interventions to eliminate racial and ethnic health disparities in six priority areas: asthma, breast and cervical cancer, cardiovascular disease, diabetes mellitus, hepatitis B, and infant mortality.

  • Commonwealth Fund: Health Care Disparities. Publications, innovations, surveys and data, and fellowships about improving the overall quality of health care delivered to low-income and minority Americans and eliminating racial and ethnic health disparities. The Commonwealth Fund is a private foundation supporting independent research on health care issues to promote a high-performing health care system for all Americans.

  • 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 about health disparities faced by women, members of minority groups, the elderly, and others. Includes bibliographic references to the literature in which each finding is established. The framework for the research is Healthy People 2010. 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, an electronic newsletter, 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.

    Strategic framework for improving racial and ethnic minority health and eliminating racial and ethnic health disparities. (2008).

  • 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

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs addressing racial and ethnic disparities in health. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data
  • ChildStats.gov. Presents statistics and reports about children and families, including population and family characteristics, economic security, health, behavior and social environment, and education. Statistics are available by racial and ethnic group. ChildStats.gov is a service of the Federal Interagency Forum on Child and Family Statistics.

  • Child Trends DataBank. Reports on national trends and research on over 100 key indicators of child and adolescent well-being, including the racial and ethnic composition of the child population. Health indicators include a section presenting differences by race and ethnicity. Child Trends is a nonprofit, nonpartisan research organization providing research and data to inform decision-making that affects children and adolescents.

  • Data Resource Center for Child and Adolescent Health (DRC). Provides access to and use of data from the National Survey of Children's Health, 2003, and the National Survey of Children with Special Health Care Needs, 2001 & 2005/2006. Users can search and compare results on over 100 indicators of child health and well-being; view state and regional profiles on key measures; explore survey content relevant to Healthy People 2010 objectives; and compare findings at all levels for children by age, race and ethnicity, income, or health status. DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI).

  • diversitydata.org. Identifies metropolitan area indicators of diversity, opportunity, quality of life, and health for various racial and ethnic population groups. Data are presented in profiles by metropolitan area or by indicator in ranked lists or maps. diversitydata.org is an initiative of the Harvard School of Public Health in conjunction with the Center for the Advancement of Health.

  • Healthcare Cost and Utilization Project (HCUP): HCUPnet. Provides access to health statistics and information on hospital inpatient and emergency department utilization at the national and state levels that researchers and policymakers can use to identify, track, and analyze trends in health care utilization, access, charges, quality, and outcomes. The data are used to describe patterns of care for uncommon as well as common diseases, to analyze hospital procedures, including those that are performed infrequently, and to study the care of population groups such as racial and ethnic groups, children, women, and the uninsured. HCUP is an initiative of the Agency for Healthcare Research and Quality (AHRQ).

  • Health Data for All Ages. Presents interactive online data tables that provide health statistics for infants, children, adolescents, adults, and older adults. Customize tables with any or all of the following characteristics: age, gender, race and ethnicity, and geographic location.This data warehouse is a service of the National Center for Health Statistics (NCHS).

  • KIDS COUNT Data Center. Contains state- and city-level data for over 100 measures of child well-being, including several indicators that are broken down by race and ethnicity. Generate custom reports for a geographic area or to compare areas on a topic. KIDS COUNT is a project of the Annie E. Casey Foundation (AECF).

  • Linked Birth/Infant Death Data Set. Contains data about infant births/deaths for infants under age 1 occurring within the United States to U.S. residents. Counts can be obtained by state, county, infant's age, weight, cause of death, maternal race, maternal age, maternal education, gestation period, prenatal care, live birth order, and marital status. This data set is provided by the National Center for Health Statistics (NCHS) via CDC Wonder.

  • Medical Expenditure Panel Survey (MEPS). Contains data on the cost and use of health care and health insurance coverage in the United States. The race and ethnicity of individuals in the MEPS are reported to support analyses of minority groups. MEPS is sponsored by the Agency for Healthcare Research and Quality (AHRQ).

  • National Quality Measures Clearinghouse™ (NQMC™). Contains evidence-based health care quality measures and measure sets for physicians, hospitals, and health plans to evaluate and improve the quality of health care for patients. Type race OR racial OR "ethnic*" in the search box to identify measures on the topic. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).

  • PeriStats. Provides access to maternal- and infant-health-related data at the national, state, county, and city levels. Several indicators are broken down by race and ethnicity. Over 60,000 graphs, maps, and tables are available, and data are referenced to the relevant source and Healthy People 2010 objective. PeriStats is a service of the March of Dimes Perinatal Data Center.

  • Quick Health Data Online. Offers comparative, county-level data on the health status of women for all 50 states, the District of Columbia, and U.S. territories and possessions. Data are available by gender, race, and ethnicity in categories that include mortality, natality, reproductive health, violence, prevention, disease, and mental health. NWHID is a service of the Office on Women's Health (OWH). Statistical reports include

    Health disparities profiles. (2008).

  • statehealthfacts.org: Minority Health. Includes information about minority health professionals and medical school enrollees and graduates, in addition to data by race and ethnicity for population demographics, insurance coverage, health status, and other topics. Information is displayed as tables, graphs, or color-coded maps. This database is a service of the Kaiser Family Foundation.

  • Title V Information System (Title V IS). Contains data from annual Title V block grant applications and reports submitted by all 59 U.S. states and jurisdictions. To learn about states' efforts to address racial and ethnic disparities in maternal and child health (MCH), conduct several searches. Under Program Data, find the number of deliveries and infants served by Title V and deliveries and infants eligible for Title XIX, by race and Hispanic ethnicity. Also view Measurement and Indicator Data. Scroll to the State Data section and conduct searches for particular racial and ethnic groups under the State Priority Needs Keyword Search, State Performance Measures, and State Outcome Measures sections. Title V IS is a service of the Maternal and Child Health Bureau (MCHB). Also see MCHB's Discretionary Grant Information System (DGIS).

  • Also see AHRQ's NHDRnet Online Query System, the Census Bureau, Morbidity & Mortality Weekly Reports (MMWR), the National Center for Health Statistics (NCHS), the Office of Minority Health, the Pew Hispanic Center, the Women of color health data book (2006), Child health USA (1989-), and Women's health USA (200-).
Literature and Research Databases
  • ClinicalTrials.gov. Provides access to information about clinical research studies for a wide range of conditions. Included are a summary of the purpose of the study, recruiting status, criteria for patient participation, location of the trial, and contact information. To identify studies that address racial and ethnic health disparities, click on Search for Clinical Trials. Enter the search phrase (ethnic groups OR minority groups) AND "health disparities" and click on Search to get your results. ClinicalTrials.gov is a service of the National Institutes of Health (NIH) and is developed by the National Library of Medicine (NLM).

  • MCH Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Maintains several databases to collect, manage, and disseminate knowledge about MCH, with special emphasis on knowledge gained from initiatives and programs supported by the Maternal and Child Health Bureau (MCHB). The library's bibliographic database is

    MCHLine®. Comprises an online catalog of materials in the MCH Library. See the bibliographies Racial and ethnic disparities in health and Culturally competent services for a selection of recent library items on these topics.

    The MCH Library also offers a non-English materials and resources list that identifies items written in many non-English languages, from Albanian to Yoruba. Also see the resource brief, Culturally competent services; the knowledge path, Spanish-language health resources; and the library's organizations and programs databases.

  • Minority Health Archive. Comprises an online archive of print and electronic media related to the health of minority racial and ethnic groups in the United States. Materials include journal articles, web-based materials, government documents, books, book chapters, conference proceedings, conference papers, course outlines, events/presentations, images, pre-prints, and theses/dissertations. Search by subject or publication year. The archive was created by the Center for Minority Health and the University Library System at the University of Pittsburgh.

  • PubMed. Contains over 20 million citations for biomedical articles from MEDLINE and life science journals. Citations may include links to full-text articles from PubMed Central or publisher websites. To identify citations on the topic, enter the phrase (ethnic groups OR minority groups OR minority health) AND (healthcare disparities OR health status disparities) in the search box. Click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; and select Search Field Tags: MeSH Major Topic. Click on Search to get your results. To narrow your search further or for additional searches, use the MeSH (Medical Subject Headings) database to identify terms (e.g., (ethnic groups OR minority groups OR minority health) AND (healthcare disparities OR health status disparities) AND asthma or (ethnic groups OR minority groups OR minority health) AND (healthcare disparities OR health status disparities) AND prejudice). PubMed is a service of the National Library of Medicine (NLM).
Programs Databases
  • Discretionary Grant Information System (DGIS). Contains financial, national performance measure, and abstract information collected annually from more than 900 grants issued by the Maternal and Child Health Bureau (MCHB). To find information on grants about racial and ethnic disparities in health, select Abstracts. Enter racial disparities in the search box and click on All the words. Select Search to get your results. Conduct another search on the words, ethnic disparities; click on All the words; and click on Search to get your results. There will be some overlap between the search results. Also browse Performance Measures and select those measures that address racial and ethnic health disparities.

  • Health Services Research Projects in Progress (HSRProj). Provides information about ongoing health services research and public health projects. To identify projects on the topic, enter the search phrase (ethnic groups OR minority groups OR minority health) AND (healthcare disparities OR health status disparities). Click on Search to get your results. HSRProj is funded by the National Library of Medicine (NLM).

  • MCH Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Maintains two databases to identify organizations and programs that focus on racial and ethnic disparities in health:

    MCH Organizations Database. Lists over 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. See the list, Culturally competent services, for organizations that provide information on cultural competence, culturally competent services, and minority health. A list is also available for sources of foreign-language materials. For organizations that provide health information for specific minority groups, search the database by typing the name of the group (e.g., Asian Americans, Blacks, Hispanic Americans, Native Americans, Pacific Islanders) in the keyword field of the database search form.

    MCH Projects Database. Comprises an online catalog of projects funded by the Maternal and Child Health Bureau (MCHB) through October 1, 2004. MCHB funded several projects that address racial and ethnic disparities in health. To identify them, enter the term "minority groups" in the abstract field of the database search form and select Status: Active. Click on Search to get your results. Several final reports from these projects are available online. See MCHB's Discretionary Grant Information System (DGIS) for information on projects funded after October 1, 2004.

  • National Association of County and City Health Officials: Model Practice Database. Contains information about model and promising state and local public health program practices. Search by state or health topic. For effective programs to address racial and ethnic disparities in health, select Model Practice Database and choose Find a model or promising practice by category. Conduct two separate searches by choosing the categories, Cultural Competence and Health Equity.

  • TRAIN (TrainingFinder Real-time Affiliate Integrated Network). Presents a system to find and register for public health training programs; track learning with personal online transcripts; and access materials, course reviews, and discussions. To identify training courses about racial and ethnic disparities in health, select Course Search. Scroll the list of subjects to highlight Minority Health/Health Disparities. Click on Search to get your results. TRAIN is a free service of the Public Health Foundation (PHF).

Electronic Newsletters

  • 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 Health Disparities Report: A Weekly Look at Race, Ethnicity and Health. This weekly electronic newsletter synthesizes news coverage from hundreds of print and broadcast news sources related to health and health care issues that affect racial and ethnic communities. The report also highlights new studies and journal articles, initiatives, developments in the field, and upcoming events.

  • 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

Resources for Families

Racial and Ethnic Disparities in Health: Knowledge Path, 5th ed. (December 2008). (Updated: September 2011).
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.

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