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Eliminating
Barriers and Disparities
Overview
Eliminating barriers such as lack of education, language,
or cultural competence in health services is an important
step on the way to eliminating health disparities. Eliminating
health disparities is a major national goal for this
decade, as reflected in our Nation's prevention agenda,
Healthy
People 2010. In addition to the Healthy
People 2010 initiative, HRSA's main goal is
“100 percent access to health care and 0 health
disparities for all Americans.” National attention
to this important issue has resulted in resources being
made available to communities to help eliminate disparities
from agencies such as the Health
Resources and Services Administration (HRSA), Office
of Minority Health Resource Center (OMHRC), Minority
Health Professions Foundation, and the Centers
for Disease Control and Prevention (CDC).
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Stories
and Models from the Field
YWCA Enhances Community Health and Well-Being
Minneapolis, Minnesota, EZ (Round I)
The Minneapolis Empowerment Zone is an area challenged
by racial disparity and poverty. The majority of Minneapolis'
minority population resides within the EZ, and close
to one-third of all EZ households are on public assistance.
The extreme poverty of EZ residents coupled with racial
discrimination directly affects the health of EZ children
and their families.
In order to reduce health disparities and promote good
health among EZ residents, the YWCA, the EZ, the Minneapolis
Public School System, and local government agencies
partnered to build the Midtown Community and Urban Sports
Center. Located at 21st Avenue and East Lake Street,
the facility lies in the heart of this underserved community
and gives residents a chance to improve their health
more conveniently than ever.
The YWCA Midtown Community and Urban Sports Center
is a 90,000- square-foot, state-of-the-art facility,
which offers childcare, health, and fitness programs
to youth and other EZ residents. The Urban Sports Center
features a 4-lane, 200-meter indoor running track and
boasts the largest indoor field house in the city. During
school hours, the facility accommodates students of
nearby Edison Project for Pride in Living Elementary
and South High School for health and physical education
classes. The space is also used for sports practices,
clinics, camps, and community recreation events. Community
programs are available evenings, weekends, and throughout
the summer.
Funding for the facility includes a $100,000 grant
from the EZ and a $2.1 million grant from the Minneapolis
Public School System. In exchange, all public school
students are able to use the facility at no cost until
the year 2020. "The Minneapolis Empowerment Zone governing
board granted funds for the new YWCA recognizing the
importance of promoting the health and wellness of all
of the city's residents," says Kim W. Havey, Director
of the Minneapolis EZ. "The midtown facility will provide
the opportunity for both young and old to improve their
health and lead healthier and longer lives." Click
here for more information on activities in the Minneapolis
EZ.
From the HUD RC/EZ/EC website
New Farm Workers Health Care Facility
Central California Enterprise Community (Round I)
The Central California Enterprise Community assists
the distressed rural communities of Orange Cove, Parlier,
Huron, and Tule River with economic and community development.
All the areas served are located in the Central Valley
of California, a largely agricultural region with high
concentrations of migrant and farm laborers. The majority
of the residents are low-income and Hispanic; some are
Spanish-speaking only. The EC, in partnership with Pacific
Family Health, Inc. and the local city council, plans
to open the New Farm Workers Health Care Facility in
September 2001 which will target this highly underserved
population. The facility will offer healthcare services
that aim to decrease the rate of diseases that disproportionately
affect this community, such as diabetes, osteoporosis,
and HIV/AIDS. Bi-lingual, low to no cost services will
be provided.
Clinic Partners to Overcome Transportation Barriers
Charleston, South Carolina, EC (Round I)
The City of Charleston, in partnership with the Greater
Charleston Empowerment Corporation, the Medical University
of South Carolina, the City of North Charleston, and
EC residents, built a state-of-the-art healthcare facility
in the heart of the Union Heights neighborhood in May
1999. The clinic was much needed by the predominately
low-income, African American residents. Before its opening,
EC residents had to visit other facilities as far as
10 miles away. The location of the clinic eliminates
transportation barriers for many who are dependent on
public transportation or walking. The clinic also works
with local churches, the public transportation system,
Medicaid, and volunteers to coordinate transportation
by vans, buses, and cars for EC residents who need access
to the facility.
Communities
Successfully Moving Toward 100% Access and 0 Health
Disparities
This website provides information and success stories
about HRSA's Bureau of Primary Health Care's 100% access
and 0 health disparities initiative. Click on "Communities
Successfully Moving Towards 100% Access and 0 Health
Disparities". The success stories focus on coalition
building, church/community health promotion, economic
engines, foundation support, free care, hospital financing,
and managing care.
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Tools
Office of Minority Health Resource
Center, Resource Persons Network
The Resource Persons Network (RPN) is
a group of professionals who volunteer their services
in support of OMHRC's mission to improve the health
status of racial and ethnic minority groups in the United
States. The primary goal of the RPN is therefore, to
provide advice and technical assistance to community
based organizations and institutions on behalf of the
OMHRC for the purpose of assisting local efforts to
improve minority health.
To access the RPN, call the Resource Center
toll free at 1-800-444-6472. Information Specialists
handle your requests for technical assistance by conducting
a database search. In accordance with your request,
experts who have experience with particular minority
populations and health topics are identified. You receive
a print-out that describes experts' qualifications,
geographical location, and contact information. You
contact experts directly to request assistance.
Members of the RPN are a critical component
of the OMHRC outreach effort providing technical assistance
to community-based organizations and institutions serving
minority populations.
Typical activities include:
- Reviewing grant proposals
- Speaking at conferences and workshops
- Serving as advisor to committees and workgroups
- Assisting with program/organizational development
- Offering guidance on preparing reports and speeches
- Serving as subject expert for the media
Click
here for more information.
Access to Electronic Spanish-Language Patient Education
Materials: A Utah Community Project
Funded by the National Library of Medicine, the Eccles
Health Sciences Library and the Office of Outpatient
Education have created a website that offers medical
information in Spanish. The website also lists a toll
free number where additional information is provided
in both English and Spanish. For English-Spanish translations,
click
here.
Closing
the Health Gap
Closing the Health Gap is a national campaign, sponsored
by the U.S. Department of Health and Human Services
and the ABC Radio Networks, to bring targeted health
information to African American communities. The website
contains information on health conditions that that
affect African Americans, consumer health resources,
health messages on ABC radio, and campaign
materials.
A
Guide to Ethnic Minority Neighborhood Outreach
This 32-page guide, prepared by American Health Decisions,
is aimed at uncovering strategies for including diverse
ethnic groups in a range of community-based initiatives.
In this guide, you will find recommendations for reaching
out to and communicating with diverse groups, engaging
leaders within distinct populations, establishing credibility,
and developing shared goals and objectives.
Health
Information for Minority Women
Includes fact sheets about the major health concerns
of minority women and information about the educational
campaign Pick
Your Path to Health.
Maternal
and Child Health Project Database
The Maternal and Child Health Project Database is an
online catalog of projects funded by the Maternal
and Child Health Bureau (MCHB). MCHB funds several
projects that address racial and ethnic disparities.
To identify them, enter the term "minority groups"
in the simple search field of the database search form.
 | These technical assistance resources for RC/EZ/ECs were
funded by the Office of the Assistant Secretary for Planning and Evaluation,
U.S. Department of Health and Human Services (HHS), through a cooperative
agreement administered by the Health Resources and Services Administration
(HRSA), and prepared by the Public Health Foundation. Duplication
and adaptation, with credit, are encouraged. |  |
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Tips
for RC/EZ/ECs
- Encourage local hospitals, clinics, and doctors'
offices to carry culturally appropriate education
materials.
- Know your community. Work with your local health
department and civic organizations to learn about
behaviors and disparities.
- Work to increase socio-economic status and educational
levels in the RC/EZ/EC by keeping children in school
to increase job attainment level, promoting after-school
activities, and working to develop vocational-technical
programs.
- Encourage businesses to take advantage of the Welfare
to Work Tax Credit.
- Work with the media to help increase RC/EZ/EC awareness
of the barriers and disparities in the area.
- Use community voices to increase awareness of barriers
and disparities in the local health department, the
local board of health, and to policy makers.
- Work with the local Chamber of Commerce to develop
recommendations on flexible employment policies that
decrease barriers to participating in healthful behaviors.
- Encourage health care providers to tap into translating
services available in your area.
- Encourage health care providers to hire a translator.
Preferably someone from within the RC/EZ/EC.
- Encourage local hospitals and clinics to partner
with public schools and take advantage of the Qualified
Zone Academy Bonds in order to increase language skills.
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Links
U.S. Department
of Health and Human Services, Initiative to Eliminate
Racial and Ethnic Disparities in Health
On February 21, 1998, the President committed the
Nation to an ambitious goal by the year 2010: eliminate
the disparities in areas of health status experienced
by racial and ethnic minority populations while continuing
the progress we have made in improving the overall health
of the American people. This web site provides resources,
funding opportunities, and information on Initiative
activities.
U.S. Department of
Health and Human Services, Office of Minority Health
Resource Center
The mission of the Office of Minority Health is to
improve the health of racial and ethnic populations
through the development of effective health policies
and programs that help to eliminate disparities in health.
Browse the OMH web site for information on minority
health issues, funding opportunities, conferences, legislative
action in Congress, publications, useful information
links, and other information.
The
Henry J. Kaiser Family Foundation, Minority Health
The Foundation's activities in minority health are
focused on efforts to reduce racial and ethnic disparities
in health care access. Click
here for a complete archive of the Foundation's
publications.
The University
of North Carolina at Chapel Hill, School of Public Health,
Minority Health Project
The UNC-CH Minority Health Project provides information
about UNC, National and worldwide efforts to eliminate
health disparities. Click
here for a list of web sites related to urban health
and health disparities.
Health Departments Take Action: A Compendium of
State and Local Models Addressing Racial and Ethnic
Disparities in Health.
This publication includes descriptions of state and
local public health agency programs that address health
disparities. These programs reflect the diversity of
strategies being used to meet the diversity of community
needs and target problems such as chronic disease, poor
access to care, environmental health, and teen pregnancy.
The compendium can be purchased through the National
Association of County and City Health Officials bookstore
for $25.00.
Agency
for Healthcare Research and Quality: Minority Health
Section
This site contains a variety of resources for eliminating
health disparities, specific to health care, Asian American
and Pacific Islander Initiative, minority women, and
career opportunities for minority students. The site
also contains recent press releases and a series of
research articles on health disparities issues.
Eliminating
Health Disparities in the United States
This reports talks about HRSA's targeted health disparities
programs: diabetes, cardiovascular disease, infant mortality,
HIV/AIDS, cancer screening and management, and immunizations.
The
Provider's Guide to Culturally Appropriate Services
"A new web resource to assist health care professionals
in providing quality culturally and linguistically appropriate
services to multicultural populations." The site
provides a good overview on cultural competence and
modules on common health problems in selected minority,
ethnic and cultural groups, and understanding immigrant,
refugee, and minority populations. "Each module
contains readings, mnemonics, exercises, references
and annotated links to other relevant Web resources."
Families USA-The
Voice for Health Care Consumers
"This web site provides information about children's
health, the uninsured, managed care, Medicare, Medicaid,
prescription drugs and communities of color. Families
USA also provides training and technical assistance
to, and work collaboratively with, state and community-based
organizations as they address critical health care problems
in their communities."
Cross
Cultural Health Care Program
"The Cross Cultural Health Care Program provides
information and resources for addressing broad cultural
issues that impact the health of individuals and families
in ethnic minority communities. The site also includes
a list of suggested models for the use of interpreter
and translator services. Tips and lessons learned from
working with culturally diverse communities can also
be found on this site."
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