TY - JOUR
T1 - Interventions that Reach into Communities--Promising Directions for Reducing Racial and Ethnic Disparities in Healthcare
AU - Quiñones, Ana R.
AU - Talavera, Gregory A.
AU - Castañeda, Sheila F.
AU - Saha, Somnath
N1 - Funding Information:
This article is based in part on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Portland VA Medical Center, Portland OR and funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development. Dr. Quiñones is also supported by the American Diabetes Association (ADA 7-13-CD-08, Quiñones PI) and the Programs to Increase Diversity among Individuals Engaged in Health Related-Research (NIH/NHLBI, R25HL105430).
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Racial/ethnic disparities in healthcare are widespread in the United States and are prevalent across healthcare organizations, including the "equal access" Veterans' Affairs (VA) integrated healthcare system. Despite substantial attention to these disparities over the last decade, there has been limited progress in reducing them. Based on a review of evidence commissioned by the VA to guide its efforts to address racial and ethnic disparities, the conceptual framework describes the root causes of disparities in healthcare quality and outcomes, demonstrating why improvements in the quality of medical care have had limited influence over healthcare disparities that depend largely on social determinants of health. The recommended interventions-including care coordination, culturally-tailored health education, and community health workers-extend the reach of health systems beyond clinics and hospitals and into the communities and social and cultural contexts in which patients live, and in which most health promotion activities occur. To make inroads into addressing disparities, healthcare systems will need to move beyond conceptualizing care delivery as constrained to the clinical encounter and instead, incorporate an understanding of the social determinants of health.
AB - Racial/ethnic disparities in healthcare are widespread in the United States and are prevalent across healthcare organizations, including the "equal access" Veterans' Affairs (VA) integrated healthcare system. Despite substantial attention to these disparities over the last decade, there has been limited progress in reducing them. Based on a review of evidence commissioned by the VA to guide its efforts to address racial and ethnic disparities, the conceptual framework describes the root causes of disparities in healthcare quality and outcomes, demonstrating why improvements in the quality of medical care have had limited influence over healthcare disparities that depend largely on social determinants of health. The recommended interventions-including care coordination, culturally-tailored health education, and community health workers-extend the reach of health systems beyond clinics and hospitals and into the communities and social and cultural contexts in which patients live, and in which most health promotion activities occur. To make inroads into addressing disparities, healthcare systems will need to move beyond conceptualizing care delivery as constrained to the clinical encounter and instead, incorporate an understanding of the social determinants of health.
KW - Disparities
KW - Interventions
KW - Race/ethnicity
KW - Veterans
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U2 - 10.1007/s40615-014-0078-3
DO - 10.1007/s40615-014-0078-3
M3 - Article
C2 - 26413456
AN - SCOPUS:85008718283
SN - 2197-3792
VL - 2
SP - 336
EP - 340
JO - Journal of racial and ethnic health disparities
JF - Journal of racial and ethnic health disparities
IS - 3
ER -