December 2008

Introduction

This knowledge path has been compiled by the Maternal and Child Health 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 consumers. 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.

Web Sites: A-Z

• 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. Also see MySistahs. 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 NHDRnet Online Query System is an interactive tool for exploring data from the reports. State snapshots provide state-specific information from the 2007 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. Contains policy statements, fact sheets, and journal articles about disparities in health along with information about legislative activities and conferences. APHA also maintains a database about programs and initiatives around the country that are working to address disparities in health.
  
  
• 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. Resources include
  
  From policy to action: Addressing racial and ethnic disparities at the ground level. (2007). [Issue brief].
  
  Reducing racial and ethnic disparities: Quality improvement in Medicaid managed care toolkit. (2007). Supplementary resources accompany the toolkit.
  
  Using data on race and ethnicity to improve health care quality for Medicaid beneficiaries. (2006). [Toolkit].
  
  
• 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
  
  
  • 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.
    
    
  • Also see the two NCHS databases, Data 2010 and Health Data for All Ages.
    
    
  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. Recent publications include
  
  
  • Power to reduce health disparities: Voices from REACH communities. (2007). [Report].
    
    
  • REACHing across the divide: Finding solutions to health disparities. (2007). [Report].
    
    
• Commonwealth Fund: Health Care Disparities. Describes its program that aims to improve the quality of health care delivered to low-income and minority Americans and to eliminate racial and ethnic health disparities by focusing on hospitals and ambulatory care providers serving large numbers of low-income and minority patients. 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. Recent publications include
  
  Identifying and evaluating equity provisions in state health care reform. (2008). [Report].
  
  Also see Racial and ethnic disparities in U.S. health care: A chartbook (2008) and the Commonwealth Fund's reports about cultural competence.
  
  
• 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: Minority Health. Presents definitions, fact sheets, issue briefs, health policy reports, and 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. Resources include
  
  Health coverage in communities of color: Talking about the new census numbers. (2008). [Fact sheet].
  
  Making public programs work for communities of color: An action kit for community leaders. (2006).
  
  SCHIP and children's health coverage: Leveling the playing field for minority children, rev. ed. (2007). [Issue brief].
  
  
• Health Disparities Collaboratives (HDC). Describes the goals, methods and models, partnerships, and accomplishments of collaboratives for health centers across the country to reduce disparities in health outcomes for underserved and vulnerable populations. Includes a library of resources to support the work of the collaboratives and share best practices with the health community. The collaboratives are sponsored by the Health Resources and Services Administration (HRSA).
  
  
• Healthy People 2010. Describes this national health promotion and disease prevention initiative created by a broad coalition of experts from many sectors to improve the health of all Americans. Healthy People is designed to achieve two overarching goals, one of which is to eliminate health disparities among different segments of the population. It contains 467 objectives in 28 focus areas. Healthy People 2010 provides background information on the initiative; the complete text (online and searchable), Healthy People 2010: Understanding and improving health (2nd ed.) (2000) and Healthy People 2010: Midcourse review (2006); data; a list of the Healthy People partners and related sites; and other Healthy People publications. It is coordinated by the Office of Disease Prevention and Health Promotion (ODPHP).
  
  
• 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. Offers the Race, Ethnicity, and Health Care Reference Library, an online health policy resource for faculty and students. KFF is an independent philanthropy focusing on national health care issues. Resources include
  
  Addressing disparities in health and health care: Issues for reform. (2008). [Testimony].
  
  Black Americans and HIV/AIDS, rev. ed. (2008). [Fact sheet].
  
  Health coverage and access to care among Asian Americans, Native Hawaiians and Pacific Islanders. (2008). [Fact sheet].
  
  Key facts: Race, ethnicity and medical care. (2007). [Chartbook].
  
  Key health and health care indicators by race/ethnicity and state. (2007). [Fact sheet].
  
  Latinos and HIV/AIDS, rev. ed. (2008). [Fact sheet]. Also available in Spanish.
  
  Today's Topics in Health Disparities. Presents a series of live, interactive Webcasts devoted to addressing a range of issues relating to health and health care disparities in the United States. Each discussion will feature a panel of experts tackling current issues in health disparities and answering questions from Webcast viewers. Archived Webcasts and background materials are available.
  
  
• Medical Education Futures Study (MEFS): Examining Medical Education's Role in Reducing Disparities, Increasing Access and Improving Health in an Era of Health Care Reform. 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. Recent publications include
  
  Underrepresented minorities in medicine: The need for a diverse physician workforce. (2008). [Issue brief].
  
  
• 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. A recent publication is
  
  Restoring equity in the health care system: Addressing barriers that Latino families face. (2008). [Testimony].
  
  
• 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. Recent publications include
  
  Unequal health outcomes in the United States: The responsibility of the state. (2008). [Report].
  
  
• 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, identity, immigration, labor, politics, and remittances. The center is supported by the Pew Charitable Trusts, a private philanthropy serving the public interest. Recent publications include
  
  Hispanics and health care in the United States: Access, information, and knowledge. (2008). [Report].
  
  
• 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. Recent resources include
  
  Closing the disparities gap in healthcare quality with performance measurement and public reporting. (2008). [Issue brief].
  
  Legality of collecting and disclosing patient race and ethnicity data. (2006). [Policy brief].
  
  National Health Plan Collaborative toolkit. (2008).
  
  Race, ethnicity, and language of patients: Hospital practices regarding collection of information to address disparities in health care. (2006). [Report].
  
  Racial and ethnic disparities in access to and quality of health care. (2007). [Report].
  
  
• 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. This report provides statistics, background material, and useful information about important lung health issues such as asthma, smoking, and air quality as they relate to racially and ethnically diverse communities.
  
  
• Association of Maternal and Child Health Programs (AMCHP). 2008. AMCHP partners with CityMatCH and NHSA to eliminate disparities in infant mortality. Washington DC: Association of Maternal and Child Health Programs (AMCHP). This article announces a project that will focus on addressing racial inequities in infant mortality through coordinated systems building in communities that have a disproportionate burden of infant mortality. The Partnership to Eliminate Disparities in Infant Mortality is a collaborative effort between CityMatCH, the Association of Maternal and Child Health Programs (AMCHP), and the National Healthy Start Association (NHSA), with funding from the W. K. Kellogg Foundation.
  
  
• Children's Defense Fund. 2006. Improving children's health: Understanding children's health disparities and promising approaches to address them. Washington, DC: Children's Defense Fund. This report documents disparities in outcomes across several major conditions affecting children, provides an analysis of indicators related to children's health, and explores community strategies that have been effective in reducing disparities in many health-related conditions. The report also recommends policies and initiatives to eliminate health disparities for children, focusing on the role that prevention and expanded access to health care for all children can play in improving health outcomes.
  
  
• Children's Defense Fund. 2008. Disparities in children's health and health coverage. Washington, DC: Children's Defense Fund. This fact sheet describes disparities in health and health insurance coverage for infants, children, and adolescents in minority groups from before birth into adulthood, compared to their white counterparts.
  
  
• Cohen JA. 2008. Challenges and successes in reducing health disparities: Workshop summary. Washington, DC : National Academies Press. This report summarizes a workshop convened by the Institute of Medicine to increase the visibility of racial and ethnic health disparities as a national problem. Workshop discussions focused on the importance of differences in life expectancy within the United States, the reasons for those differences, and the implications of this information for programs and policymakers.
  
  
• 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). This report describes the results of a 3-year study that examined evidence on the social determinants of health and what can be done to promote health equity globally. The executive summary and background material are available in several languages.
  
  
• 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: Incenter Strategies. This fact sheet describes disparities in health status and access to care among Hispanic, black, and white adolescents ages 12-17. The fact sheet addresses racial and ethnic disparities for a broad set of indicators and also examines the impact of income, insurance, and mother's education on these indicators. A second fact sheet presents information about older adolescents ages 18-21.
  
  
• Fullilove RE. 2006. African Americans, health disparities and HIVAIDS: Recommendations for confronting the epidemic in Black America. Washington, DC: National Minority AIDS Council. This report examines the underlying causes of excess HIV-related morbidity and mortality among African Americans and makes policy recommendations to alleviate the root causes of the health disparities that devastate the African-American community.
  
  
• 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). This toolkit provides hospitals, health systems, clinics, and health plans information and resources for systematically collecting race, ethnicity, and primary-language data from patients.
  
  
• Healthy States Initiative. 2007. Addressing adolescent health disparities through school. Lexington, KY: Council of State Governments. This policy brief for state legislators identifies ways to assist local schools and school districts in addressing racial and ethnic health disparities among adolescents.
  
  
• Hernandez DJ, Macartney SE. 2008. Racial-ethnic inequality in child well-being from 1985-2004: Gaps narrowing, but persist. New York, NY: Foundation for Child Development (FCD). This report analyzes how child and adolescent well-being has changed among black, Hispanic, and white children from 1985 to 2004.
  
  
• 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. This issue paper reviews what is known about health disparities among children and describes health plans' innovative approaches to reduce disparities and ensure cultural competence.
  
  
• Indian Health Service. 2006. Facts on Indian health disparities. Rockville, MD: Indian Health Service. This fact sheet presents health statistics about the American Indian and Alaska Native population compared to the entire population in the United States.
  
  
• Johnson K, Theberge S. 2007. Reducing disparities beginning in early childhood. New York, NY: National Center for Children in Poverty (NCCP). This issue brief highlights patterns of disparities in early childhood health risks, access to services, and outcomes and provides recommendations for reducing disparities in early childhood.
  
  
• 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). This book about minority women's health presents data about life expectancy, major causes of death, behavior and lifestyles, risk factors, prenatal health care services, access to health insurance and services, and morbidity and mortality. The book concludes with recommendations to improve the health of minority women.
  
  
• Maternal and Child Health Bureau (MCHB). 1989-. Child health USA 1989-. Rockville, MD: Maternal and Child Health Bureau (MCHB). This annual book presents data about the health status and health services utilization of infants, children, adolescents, children with special health care needs, and women of childbearing age and gives insight into the nation's progress toward ensuring quality of care, eliminating barriers and health disparities, and improving the health infrastructure and systems of care for this population.
  
  
• Maternal and Child Health Bureau (MCHB). 2002-. Women's health USA 2000-. Rockville, MD: Maternal and Child Health Bureau (MCHB). This annual data book includes information and data on population characteristics, health status, and health services utilization for women in the United States and highlights racial and ethnic disparities and gender differences in women's health.
  
  
• 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. This policy brief examines the racial and ethnic disparities in the burden of asthma among those with active asthma. The brief also examines disparities in access to care and exposure to indoor environmental triggers that may contribute to the asthma burden experienced by racial and ethnic minorities.
  
  
• Moiduddin E, Massey DS. 2006. Segregation, the concentration of poverty, and birth weight. Princeton, NJ: Center for Research on Child Wellbeing. This paper examines the relationship between neighborhood conditions experienced by pregnant women of various racial and ethnic groups and the weights of the infants they ultimately deliver, controlling for individual and family characteristics.
  
  
• National Commission on Prevention Priorities. 2007. Preventive care: A national profile on use, disparities, and health benefits. Washington, DC: Partnership for Prevention. This report examines utilization of clinical preventive services for the nation as a whole and for racial and ethnic populations and estimates the number of lives that would be saved if utilization improved.
  
  
• National Institutes of Health (NIH). 2008. NIH launches center to study genomics and health disparities. Bethesda, MD: National Institutes of Health (NIH). This press release announces the establishment of the NIH Intramural Center for Genomics and Health Disparities (NICGHD), a new venue for research about the way populations are impacted by diseases, including obesity, diabetes, and hypertension.
  
  
• 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. This report describes the results of a survey of 20 organizational representatives to determine what key stakeholders are doing to address racial and ethnic health disparities, the extent to which interest in and concern about these health gaps have been translated into action, the lessons to be learned from their involvement and activities, and ways to enhance awareness of racial and ethnic disparities so that an increased commitment to action among a broader range of stakeholders might result.
  
  
• 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). This report examines the evidence addressing the contention that health professions diversity will lead to improved population health outcomes.
  
  
• Smedley BD, Stith AY, Nelson AR, eds. 2003. Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press. This landmark book examines how racial and ethnic disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. The book offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas.
  
  
• Urban Indian Health Commission. 2007. Invisible tribes: Urban Indians and their health in a changing world. Washington, DC: Urban Indian Health Commission. This report examines the health care issues facing urban American Indians and Alaska Natives and the specific health topics of diabetes, depression, and cardiovascular disease. The report recommends actions to address the urban Indian health crisis.
  

  

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.
  
  
• Data2010: The Healthy People 2010 Database. Contains the most recent monitoring data for tracking Healthy People 2010. Data can be searched by a specific population group for each focus area. This data set is provided by the National Center for Health Statistics (NCHS) via CDC Wonder.
  
  
• 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). HCUP statistical briefs include
  
  Racial and ethnic disparities in hospital patient safety events, 2005. (2008).
  
  Racial and ethnic disparities in potentially preventable hospitalizations, 2003. (2006).
  
  
• 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). Recent statistical reports include
  
  Racial and ethnic differences in health insurance coverage and usual source of health care, 2002. (2006).
  
  
• 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).
  
  
• Computer Retrieval of Information on Scientific Projects (CRISP). Contains information about federally funded biomedical research projects conducted at universities, hospitals, and other research institutions. Search CRISP to identify scientific concepts, emerging trends and techniques, or specific projects and investigators. Type racial ethnic disparity in the search term box of the Query Form and click on And. Click on Submit Query to get your results. Narrow your search by selecting a grant activity, fiscal year, or state, or use the CRISP Thesaurus to identify additional search terms. The database is maintained by the Office of Extramural Research at the National Institutes of Health (NIH).
  
  
• Maternal and Child Health 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 Maternal and Child Health 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 Maternal and Child Health 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 17 million citations for biomedical articles that date back to the 1950s. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full-text articles and other related resources. To identify many articles 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. Then, click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Humans; click on Languages: English; and select Tag Terms: MeSH Major Topic. Selecting Type of Article and/or adding additional search 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) will further limit the search. Use MeSH to identify additional search terms. PubMed is a service of the National Library of Medicine (NLM).
  
  
• Also see the National Center for Cultural Competence (NCCC) Resource Database.
  

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 Disparities Community Solutions Database. Contains information about public health programs and initiatives around the country that are working to address the problem of disparities in health. Some of the programs are still in existence, while others have been discontinued. The database is sponsored by the American Public Health Association (APHA).
  
  
• 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).
  
  
• Maternal and Child Health 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. Lists are also available for sources of foreign-language materials and Spanish-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

• Families USA: Minority Health 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

• 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.
  
  
• Cultural Diversity, Health Disparities and Public Health. Presents a Webcast that aims to provide public health professionals with a broad overview of cultural diversity issues with a focus on race, ethnicity, and gender. Health disparities are discussed using cultural diversity as the conceptual framework for thinking about the role of the public health community and health policy solutions for addressing these issues. The Webcast, presented by the Alabama Department of Public Health, originally aired November 28, 2007. Handouts and assignments accompany the Webcast.
  
  
• 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 Midwest Center for Life-Long-Learning in Public Health.
  
  
• 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.
  
  
• 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. Recent 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.
  
  Incorporating cultural and linguistic competence in the diagnosis and treatment of depression. (2008). [Online continuing medical education activity].
  
  
• 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. Recent publications include
  
  Language access in health care statement of principles. (2007).
  
  Language access: Understanding the barriers and challenges in primary care settings. Perspectives from the field. (2008). [Report].
  
  Serving patients with limited English proficiency: Results of a community health center survey. (2008). [Report].
  
  
• 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. Recent resources and initiatives include
  
  National standards on culturally and linguistically appropriate services (CLAS). (2007).
  
  Think Cultural Health. Offers online courses accredited for continuing education credit as well as supplementary tools to help health professionals promote cultural competence in health care.
  
  
• 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. This compendium provides culturally relevant resources and actions that health insurance plans, physicians and clinicians, and health care organizations can integrate into organization-wide initiatives and incorporate in everyday communications with health care consumers. Topics include types of health information requested by consumers; consumer views and attitudes on the collection of data by race, ethnicity, and primary language by health insurance plans, hospitals, and others; a review of current research on improving access and cross-cultural communications; recommendations to improve consumer knowledge and awareness of health disparities; and culturally and linguistically appropriate health care messages and services.
  
  
• National Quality Forum (NQF). 2008. National voluntary consensus standards for a framework and preferred practices for measuring and reporting cultural competency [DRAFT]. Washington, DC: National Quality Forum (NQF). This draft document presents a national framework/core competencies for evaluating cultural competence across all health care settings, as well as a minimum set of preferred practices based on the framework. Also see the announcement about the draft framework and request for comments on the draft.
  
  
• Office of the Surgeon General. 2006. Proceedings of the Surgeon General's Workshop on Improving Health Literacy. Washington, DC: Office of the Surgeon General. These proceedings describe a workshop to present the state of the science in the field of health literacy. Participants identified the public health consequences of limited health literacy and established an evidence base for taking action. Panels covered health literacy, literacy, and health outcomes; meeting the health literacy needs of non-English speakers, minority populations, older adults, and children; and helping the public become more involved in meeting their health-information needs. Following the workshop, the Department of Health and Human Services (DHHS) held a series of town hall meetings to learn about promising health literacy practices and to obtain input into a national action plan. View the town hall meeting summaries and a collection of resources for improving health literacy.
  
  
• 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. This paper adds to and complements the existing literature on language access by focusing on the consumer's perspective, including consumers' descriptions of how language affects enrollment in insurance and use of health care services and the strategies used to reduce the impact of LEP.
  
  
• See the American Medical Association (AMA) publications, Assessing the nation's health literacy: Key concepts and findings of the National Assessment of Adult Literacy (NAAL) (2008) and Office guide to communicating with limited English proficient patients, 2nd ed. (2007).
  
  
• See the Commonwealth Fund reports, Cultural competency and quality of care: Obtaining the patient's perspective (2006), Improving quality and achieving equity: The role of cultural competence in reducing racial and ethnic disparities in health care (2006), and Resident physicians' preparedness to provide cross-cultural care: Implications for clinical care and medical education policy (2007).
  
  
• See the Robert Wood Johnson Foundation issue brief, Sound of success: Efficient and effective language services becoming a reality in some hospitals (2008) and the Speaking together toolkit (2008).
  
  
• Also see the Maternal and Child Health Library.
  

  

Resources for Consumers

Find Care

• Health Resources and Services Administration (HRSA): Find a Health Center. Offers contact information for community health centers that provide free or low-cost care to underserved populations. Search by county, city, or state.
  
  
• Indian Health Service (IHS): Telephone Contact List. Presents a directory of telephone numbers and Web site links (when available) to the IHS headquarters and area offices and to IHS offices that focus on specific health topics that range from HIV/AIDS to women's health.
  
  
• Insure Kids Now/Asegure a sus Hijos Ahora. Provides information about the State Children's Health Insurance Program (SCHIP). Telephone: (877) 543-7669 (English or Spanish).
  
  
• Maternal and Child Health Bureau (MCHB) Hotline. Offers a hotline number to help pregnant women and mothers with newborns identify free or low-cost services for themselves and their infants. Telephone: (800) 311-2229.
  
  
• National Alliance for Hispanic Health. Offers two health toll-free helplines to help individuals and families find culturally and linguistically proficient health information and referrals to local services:
  
  National Hispanic Prenatal Helpline. Call for a referral to local prenatal care services that provide care in English and Spanish or for culturally appropriate prenatal care information in English and Spanish. Telephone: (800) 504-7081 (English or Spanish).
  
  Su Familia: The National Hispanic Family Health Helpline. Call for a referral to a health professional in your community or for information in Spanish and English on a wide range of health topics. Telephone: (866) 783-2645 (SU-FAMILIA) (English or Spanish).
  
  
• Also see the Community services locator: An online directory for finding community services for children and families.
  

  

Web Sites for Consumers

• MedlinePlus: Health Disparities. Gives links to information in English and Spanish about health differences between groups of people, including racial and ethnic minorities.
  
  
• MedlinePlus: Health Information in Multiple Languages. Gives links to health information in languages other than English.
  
  
• MedlinePlus: Population Groups Topics. Gives links to health information in English and Spanish for African Americans, Asian Americans, Hispanic Americans, and Native Americans.
  
  
• MySistahs. Presents information by and for young women of color about sexual and reproductive health issues. Includes a peer educator question-and-answer service.
  
  
• National Women's Health Information Center (NWHIC): Minority Women's Health. Gives links to information about the health risks of special concern to women who are African American, American Indian, Asian American, Hispanic American, Native Alaskan, and Native Hawaiian and from other Pacific Island groups.
  
  
• Office of Minority Health (OMH): Health Topics. Presents publications and Web sites on health issues affecting African Americans, American Indians and Alaska Natives, Asian Americans, Hispanic Americans, and Native Hawaiians and other Pacific Islanders.
  

  

Author: Susan Brune Lorenzo, M.L.S., Maternal and Child Health 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., Maternal and Child Health Library.