Recommended Institution Strategies for Addressing
Racial and Ethnic Health Disparities
On May 3, 2007 the College of Public Health convened a retreat at the
Ferndale 4 H Center that focused on Racial and Ethnic Health Disparities as part
of its participation in the Engaged Communities Initiative sponsored by W K
Kellogg foundation. Consultants, Thomas LaVeist, PhD and Vicki Ybarra, MPH, RN
facilitated large and small group discussions with more than 60 participants
including the COPH, COM, COP, CON, hospital administration and Chancellor Dodd
Wilson. (Click
Here) for a copy of the Summary Report detailing retreat and pre-retreat
activities and consultant presentations.
As a result of retreat discussions, recommendations to address racial and ethnic
disparities were made in the areas of education, policy, and diversity.
Following are the prioritized recommendations with brief statements of
justification and a list of those who will be on each working group.
Education:
Follow-up Working Group: Kate Stewart, Jan Richter, Ruth Eudy, Mike
Anders, Dianne Heestand, Charles Fields, Alan Van Bervliet, Anna Huff
Awareness of the importance of cultural sensitivity in working with
patients and communities, and in recruiting and training students is the
first step to improved cross-cultural communication.
Recommendation: Mandatory training for faculty and senior
administrators on the impact of culture on communication and patient care.
Information is needed to avoid duplication of effort and to determine
what is currently being taught on cultural competency, cross-cultural
communication, and health disparities.
Recommendation: A cross-campus review of the curricula should
be conducted.
A broader base of local expertise on health disparities, determinants,
and solutions is needed to build a critical mass of individuals dedicated to
change. Students need an incentive to gain more in-depth knowledge and
expertise.
Recommendation: A formal campus-wide certificate program in
health disparities.
Exposure to basic information on health disparities and cultural issues
can raise awareness of providers and others in the community and could also
be used to stimulate interest among pipeline students in the health
professions.
Recommendation: Explore the possibility of conducting a summer
institute (3 days to 2 weeks) with courses on health disparities and
cultural issues.
Policy:
Follow-up Working Group: Creshelle Nash, Willa Sanders, Glen Mays, Ty
Borders, John Wayne, Diane Mackey, Freeman McKindra, Donnie Smith
Many strategies to reducing disparities require and/or involve
legislative action. In addition, continuity is necessary to carry out
solutions, many of which are long-term. It is therefore necessary to educate
legislators on these issues on an ongoing basis and maintain a place for
disparities on the legislative agenda.
Recommendation: Encourage the legislature to introduce an
interim study proposal to conduct a comprehensive study to review all data
on disparities and develop a statewide strategic plan with recommended
action steps prior to the next legislative session.
Documentation of disparities is often necessary to stimulate efforts to
address them. It is important that UAMS be a leader within the state in
examining whether disparities exist within our own institution.
Recommendation: Collect and report quality of care indicators
by race and ethnicity in the University Hospital, outpatient clinics, and
AHECs.
Results from economic impact assessments are often used to influence
policy decisions. Based on this experience, and given the complex array of
social determinants of health, assessments of the potential impact on health
disparities of proposed non-health related policies may be an important tool
for change.
Recommendation: Seek pilot funding to conduct health impact
assessments looking at the impact of specific proposed policy changes on
health disparities.
Diversity:
Follow-up Working Group: Eddie Ochoa, Billy Thomas, Rev. Cooney, Mary
Olson, Alesia Ferguson, Vivian Flowers, Carmelita Smith, and Naomi Cottoms
In order to increase patient satisfaction, improve the quality of
patient care, educate the health care workforce, and respond to the changing
demographics of our patient population, it is important to know and reflect
the population being served.
Recommendation (1): Exhibit institutional commitment to
diversity by creating a cabinet-level position focused on diversity in all
facets of the enterprise (patient quality of care and satisfaction,
admission of students, recruitment and retention of faculty, research, etc);
thereby increasing the diversity of decision-making bodies such as the
Chancellor’s Cabinet to be more reflective of the racial and ethnic make-up
of the population served by the institution; making diversity an explicit
part of the institutional mission statement; and doing a 360 degree
organizational assessment of attitudes related to diversity.
Recommendation (2): Provide increased access for
underrepresented minorities to scholarships, pipeline programs, and
mentoring and support services.
Recommendation (3): Examine existing admissions procedures,
including selection criteria and assessment of representativeness of the
admissions committee. Consider putting a lay community representative on the
committee.
Recommendation (4): Think of diversity from an assets
perspective, as a component of excellence, instead of as a discussion about
barriers and deficits.
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