392 Index. community health workers, 317 home assessment, 318 intervention outcomes, 321, 322 overview, 316, 317 participants, 318

Transcription

1 A ABC, see Association of Black Cardiologists Access healthcare professional diversity benefits, 124, 125 patient communication, 226, 227 race/ethnicity differences, 32 34, 43, 44, 48 Access Health Solution (AHS) access optimization, 355, 356 case managerial support, 356, 357 cost savings, 360 information systems, 357 minority physician network evaluation, 343, 344, 360, 361 origins, 342 rationale for study, patient satisfaction survey factor analysis, sample description, 348, 349 scores, physician practice patterns, 357, 358 physician support, 356 principles, 342, 343 African Americans cultural heterogeneity, 46 demographic trends in United States, 22, 23, 46, 47 disease risk profile coronary heart disease, diabetes mellitus, 52 diabetes mellitus, 52 end-stage renal disease, 54 heart failure, 51, 52 hypertension, 50 overview, 48 stroke, 52, 53 health insurance, 47 healthcare access, 48 life expectancy, 46 poverty rate, 46 Agency for Healthcare Research and Quality (AHRQ) establishment, 209 mission, 210 reports, Aggasiz, Louis, 5, 6, 15 AHRQ, see Agency for Healthcare Research and Quality AHS, see Access Health Solution AIAN, see American Indians/Alaskan Natives Alaskan Natives, see American Indians/Alaskan Natives Alexander vs Choate, 180 American Indians/Alaskan Natives (AIAN) cultural diversity, 58 demographics, 57, 58 disease risk profile, 58, 59 An American Health Dilemma, 17 APIA, see Asian/Pacific Islander Americans Area-based socioeconomic measure, see Public Health Disparities Geocoding Project Asian/Pacific Islander Americans (APIA) disease risk profile cancer, 55, 56 coronary heart disease, 56, 57 diabetes mellitus, 57 hepatitis B, 56 mortality causes, 57 stroke, 57 tuberculosis,

2 392 Index geographic distribution, 55 overview, 54, 55 Association of Black Cardiologists (ABC) financial status, 310 initiatives clinical trial participation, 311, 312 community education, 310, 311 origins, 307 structure Center for Continuing Medical Education, 309, 310 Center for Women s Health, 308, 309 Epicenter, 309 personnel, 308 volunteerism, 312 Asthma Better Homes for Asthma Project assessment, 323 baseline information, 324, 325 interventions, 323, 324 limitations, 325 overview, 322, 323 participant selection, 323 Breathe Easy Homes Project evaluations, 330 home visits, 329, 330 interventions, 327, 328 overview, 326, 327 participants, 327 community-based health initiatives, 232, 233 health disparities, 313, 314 home visitation by community health workers, 315, 330, 331 housing condition improvement, 331, 332 intervention spectrum in Seattle, 316 Seattle-King County Healthy Homes Project action plan, community health workers, 317 home assessment, 318 intervention outcomes, 321, 322 overview, 316, 317 participants, 318 B Better Homes for Asthma Project assessment, 323 baseline information, 324, 325 interventions, 323, 324 limitations, 325 overview, 322, 323 participant selection, 323 Breathe Easy Homes Project evaluations, 330 home visits, 329, 330 interventions, 327, 328 overview, 326, 327 participants, 327 Brown vs the Board of Education, 12, 13 Buffon, G. L. L., 6 C CACHE, see Carolina Association for Community Health Equity Calhoun, John C., 9 Carolina Association for Community Health Equity (CACHE) board of directors and executive committee, 371 goals, 370 historical perspective, Mecklenberg County, NC demographics, 366 healthcare disparities, 365, 366 partners, 372 prospects, Cartwright, Samuel A., 15 CDC, see Centers for Disease Control Census tract, see Public Health Disparities Geocoding Project

3 Index 393 Center for Continuing Medical Education, Association of Black Cardiologists, 309, 310 Center for Linguistic and Cultural Competence in Healthcare (CLCCHC), establishment, 214 Center for Women s Health, Association of Black Cardiologists, 308, 309 Centers for Disease Control (CDC) mission, 204, 205 REACH 2010 program, 205 CHD, see Coronary heart disease Chlamydia screening, quality improvement programs, 155, 156 Chronic disease, health disparities burden, Civil Rights Act, Title VI, 179, 180, 182, 183, 187, 188 CLAS, see Cultural and linguistically appropriate services CLCCHC, see Center for Linguistic and Cultural Competence in Healthcare Cobb, W. Montague, 12, 13 Communication healthcare professional racial/ethnic diversity and patient communication, 126, 127 Institute of Medicine report findings on provider patient communication, 86, 97 Community definition, 223 health status determination roles access, 226, 227 income and poverty, 225, 226 overview, social relationships, 27 initiatives to eliminate health disparities advantages, 228 challenges, 228 examples asthma, 232, 233 breast and cervical cancer, 233, 234 diabetes, 232 tobacco, 232 strategies Community Action Model, 230 community health workers, 230 convening stakeholders, 229, 230 faith-based initiatives, 230, 231 organization of residents, 229 success features, 228, 229 Coronary heart disease (CHD) African Americans, Asian/Pacific Islander Americans, 56, 57 C-reactive protein (CRP), race/ethnicity differences, 32 CRP, see C-reactive protein Cultural and linguistically appropriate services (CLAS), promotion, 382 Cultural diversity definition, 42 race classification, 42, 43, 60 D Decision making, Institute of Medicine report findings, DeGrasse John V., 1 Delaney, Martin Robison, 12 Demographics race classification, 42, 43, 60 race trends in United States, 22, 23, 121 Depression, quality improvement programs in management, 157, 158 Derham, James, 11 Diabetes mellitus Access Health Solution program evaluation, 359 African Americans, 52

4 394 Index Asian/Pacific Islander Americans, 57 community-based health initiatives, 232 quality improvement programs in management, 160 Dialysis, quality improvement programs, 161 Dred Scot decision, 8 Drew, Charles Richard, 12 Drug review, evidence-based medicine application and implications, 107, 108, E EBM, see Evidence-based medicine Emancipation Proclamation, 9 End-stage renal disease (ESRD) African Americans, 54 dialysis quality improvement programs, 161 Epicenter, Association of Black Cardiologists, 309 Epstein, Richard, Equity, quality component, 237, 238 ESRD, see End-stage renal disease Ethnology, historical perspective, 5, 6 Evidence-based medicine (EBM) decision making considerations, drug review application and implications, 107, 108, external validity, flexibility and clinical judgment, 110 healthcare disparity effects, 117 individualized medicine, intent, 114 minority subject participation, 101, 102 overview, 99, 100 policy tools, F Florida Healthy People 2010, goals, 341 G Gall, Franz Joseph, 7 H HA, see Hispanic Americans Harvey, William, 11 HBCUs, see Historically Black Colleges and Universities HealthCare Antidiscrimination Act goals data collection and reporting, discrimination recognition, 184 fines and enforcement, 187 Health Care Council establishment, 185 prevailing party attorney fees, 185 punitive damages, 185 report cards, 187 right of action, 184, 185 tests, 184 rationale, 183, 184 Healthcare disparities community and societal factors, 147, 148 elimination principles data monitoring, 382, 383 goal setting, healthcare professional diversity, 380, 381 insurance and access, patient-centered care, 381, 382 health disparities versus healthcare disparities, 142 organizational factors, 146, 147 overview, 144, 145, 148 patient factors, 145, 146 provider factors, 146 quality improvement, see Quality improvement Healthcare professionals patient communication, 86, 97

5 Index 395 racial/ethnic diversity beneficial effects access, 124, 125 patient choice and satisfaction, 125, 126 patient communication, 126, 127 quality of training, 127, 128 research and health policy, 128, 129 improvement strategies accountability, 133, 134 bridge programs, 131, 132 financial aid, 132 institutional policies and practices, 132, 133 leadership, 134 Project , 129, 130 public school desegregation, 130, 131 overview, 123, 124 promotion, 380, 381 prospects, 134, 135 Health disparities definition, 22, 23 evidence, 100 healthcare disparities versus health disparities, 141, 142 limitations and challenges in data comparison, overview, politics, 68 Health information technology, needs, 213, 214 Health insurance African Americans, 47 political straw men, 47 provision for all Americans, race distribution, 378, 379 Health Resources and Service Administration (HRSA) minority health programs, 205, 206 mission, 205 Healthy Homes Project, see Seattle- King County Healthy Homes Project Healthy People 2010 evidence-based medicine intent, 114 goals, 23 Heart failure, African Americans, 51, 52 Heckler, Margaret, 198, 201 Hepatitis B, Asian/Pacific Islander Americans, 56 Hispanic Americans (HA) cultural heterogeneity, 45 disease risk profile, 44, 45 education, 44 healthcare access, 43, 44 socioeconomic status, 45, 46 Historically Black Colleges and Universities (HBCUs), government support, 208, 209 Howard, Edward C., 12 HRSA, see Health Resources and Service Administration Hypertension African Americans, 50 quality improvement programs in control, race/ethnicity differences, 32 I IHS, see Indian Health Service Imhotep, 10, 11 Immunization, quality improvement programs adults, 160, 161 children, 154 Indian Health Service (IHS), history and mission, 199, 200 Institute of Medicine (IOM), health disparity report committee, 85 findings clinical decision making, major findings, 85

6 396 Index mistrust, 89, 90 provider patient communication, 86, 87 origins, 84, 95 political straw men discrimination and racism, 72, 73 insurance coverage and ability to pay, 69 minority physician beliefs and attitudes, 72 uncertainty and discretion, variations in clinical circumstances, 71, 72 recommendations, Insurance, see Health insurance IOM, see Institute of Medicine J Jarvis, Edward, 8, 9 Jefferson, Thomas, 4, 5 Johnson, John Beauregard, 12 Johnson, Lyndon, 13 K Klick, Jonathan, Ku Klux Klan, 14, 15 L Life expectancy average, 41 health disparities burden, 24, 25 Lincoln, Abraham, 9 Locke, John, 4, 5 M Mammography, quality improvement programs, 156, 157 Medicaid, Title XIX, 179 Medicare, Title XVIII, 179 Minority physician network, see Access Health Solution Mistrust, Institute of Medicine report findings, 89, 90 Morality, race and health disparities, Morbidity, health disparities burden, 28, 29 Mortality causes of death by race, 27, 28 health disparities burden, 24, 25 Morton, Samuel George, 6, 7 N National Healthcare Disparities Report (NHDR), findings, 198 National Healthcare Quality Report (NHQR), findings, National Institutes of Health (NIH), minority health programs, 206 NHDR, see National Healthcare Disparities Report NHQR, see National Healthcare Quality Report NIH, see National Institutes of Health O Obesity, race/ethnicity differences, 30, 31 Office of Minority Health (OMH) establishment, 201, 202 functions educational and resource activities, 203 funding activities, 204 overview, 202, 203 programs and initiatives, 203, 204 state partnerships, 206, 207 Office of the National Coordinator for Health Information Technology (ONCHIT), establishment, 213, 214 OMH, see Office of Minority Health ONCHIT, see Office of the National Coordinator for Health Information Technology Onesimus, 11

7 Index 397 P Papan, 11 Peck, David John, 11 Performance incentive program definition, 238, 239 design and implementation recommendations, 246, incentives flow, 239, 240, 246 measures, 241, 247, 248 triggers, 240, 247 types, 240, 246, 247 outcomes, 244, 245 potential impact on disparities narrowing, 242 neutral, 241, 242 widening, 243, 244 Plessy vs Ferguson, 12 Primus, 11 Public Health Disparities Geocoding Project applications and prospects, 296, 297, 299 area-based socioeconomic measures evaluation criteria, 267 generation, 269 census tract analysis, , 299 historical context, key findings, overview, 260, 261 rationale, 262, 263 study base, study design, zip code data versus Zip code tabulation area, 298, 299 Q QI, see Quality improvement Quality of care, race/ethnicity differences, Quality improvement (QI) initiation of programs disparity identification, 163 intervention implementation, 164 race/ethnicity data collection, 163 initiatives, 162, 163 model programs for disparity elimination Chlamydia screening, 155, 156 depression management, 157, 158 diabetes management, 160 dialysis, 161 Harlem cancer education and demonstration project, 157 hypertension control, immunization adults, 160, 161 children, 154 mammography, 156, 157 rationale, 148, 149 strategies, 149, 150 targets, 151 tools community-based interventions, 154 cultural competency training, 153 organizational change/practice redesign, 153, 154 outreach, 152 patient activation/ empowerment, 153 patient education, 152, 153 practice guidelines, 152 provider education, 152 provider feedback, 150, 152 reminders, 150 Quality of life, health disparities burden, 29, 30 R Ray, Peter W., 12 REACH 2010 program, functions, 205 Reconstruction, historical perspective, 9, 10, 14 Risk factors, race/ethnicity differences, 30 32

8 398 Index S Satel, Sally, Seattle-King County Healthy Homes Project action plan, community health workers, 317 home assessment, 318 intervention outcomes, 321, 322 overview, 316, 317 participants, 318 Simkins vs Moses H. Cone Memorial Hospital, 13 Single origin theory, historical perspective, 6, 7 Slavery roots, 3, 4 scientific arguments, 5 8 Smallpox, inoculation, 11 Smith, James McCune, 11 Smith, Samuel Stanhope, 6 Social exclusion, minorities, 143, 144 Social Security Act, Title IX, 179 Socioeconomic status, see Public Health Disparities Geocoding Project Stroke African Americans, 52, 53 Asian/Pacific Islander Americans, 57 T TCUs, see Tribal Colleges and Universities Textbook of Black-related Diseases, 16 Thompson, Tommy, 68 Title VI, see Civil Rights Act Tobacco, community-based health initiatives, 232 Tribal Colleges and Universities (TCUs), government support, 209 Tuberculosis, Asian/Pacific Islander Americans, 56 Tuskegee syphilis experiment, history and lessons, 200, 201 U Unequal Treatment: Confronting Racial/Ethnic Disparities in America, see Institute of Medicine, health disparity report W Weiss, M. M., 15 White, Charles, 7 Wigglesworth, Edward, 41 Williams, Daniel Hale, 12 Z Zip code tabulation area, see Public Health Disparities Geocoding Project