Health Disparities, Health Equity, and Bias

The term health disparity refers to a population-specific difference in disease, health outcome, quality of health care and/or access to health care service. In order to minimize health care disparities, it is imperative for health care providers to be educated on the prevalence, root causes and consequences of these disparities. The following resources can be used for educators and students to explore resources related to the examination and education regarding health disparities.

Data

  • National Healthcare Quality & Disparities Reports. Agency for Healthcare Research and Quality (AHRQ). These AHRQ reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care.
  • The State of Health Equity Research: Closing Knowledge Gaps to Address Inequities. Association of American Medical Colleges (AAMC). AAMC and Academy Health partnered to review all US-based, health disparities-focused health services research funded between 2007 and 2011. Over 2,000 abstracts were analyzed to understand where this crucial research is taking place and who’s funding it, to identify gaps in the populations and health outcomes being studied, and to assess trends in the funding of solution-focused health equity research.
  • CDC Health Disparities & Inequalities Report. Centers for Disease Control and Prevention. The CDC Health Disparities and Inequalities Report is a consolidated assessment generally collected yearly which highlights health disparities and inequalities across a wide range of diseases, behavioral risk factors, environmental exposures, social determinants, and health-care access by sex, race and ethnicity, income, education, disability status and other social factors.
  • Census.gov. The Census website can be used to gather crucial demographic data at the national, state, county, and city level.
  • Commonwealth Fund health System Data Center. This tool allows users to explore regional performances and rankings for several health outcomes.
  • Healthy People 2020 Data2020 Tool. DATA2020, the Healthy People 2020 interactive data tool, allows users to explore the data and technical information related to the Healthy People 2020 objectives.
  • National Academy of Medicine (NAM, formerly Institute of Medicine). This website and the NAM reports provide objective and straightforward advice to decision makers and the public about a variety of topics which can be searched as far back as 1970.
  • National Cancer Institute (NCI) Health Disparities Surveillance Research Program. The Division of Cancer Control and Population Sciences (DCCPS) health disparities mission is to monitor the differential burden of cancer among Americans and promote and conduct research that identifies and addresses the economic, social, cultural, psychological, behavioral, and biological mechanisms contributing to these disparities across the cancer control continuum and throughout the human lifespan. This website contains data and statistics and multiple resources for providers and patients related to cancer disparities.
  • Robert Wood Johnson County Health Rankings & Roadmaps. The County Health Rankings & Roadmaps program is collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute that ranks the health of nearly every county in the nation.

Videos & Toolkits

Videos

  • American Denial. Public Broadcasting Service. This historical, political, psychological and sociological inquiry into the United States’ racial psyche is a lens for modern inquiry into how denial, cognitive dissonance, and unrecognized, unconscious attitudes continue to dominate racial dynamics in American life.
  • A Class Divided. Public Broadcasting Service. This video is about an Iowa schoolteacher who, the day after Martin Luther King Jr. was murdered in 1968, gave her third-grade students a first-hand experience in the meaning of discrimination. This is the story of what she taught the children, and the impact that lesson had on their lives. It is a 46 minute program in five consecutive chapters.
  • Exploring Unconscious Bias in Academic Medicine. Association of American Medical Colleges. This serves as a starting place for considering how implicit bias might interfere with the selection of medical school or PA program candidates as well as with the provision of care to patients. Watch this video and find a few other resources on this topic at AAMC’s website
  • Unnatural Causes: Is Inequality Making Us Sick? Public Broadcasting Service. An acclaimed seven-part documentary series broadcasted by PBS that explores racial & socioeconomic inequalities in health. The video is available for $295 for colleges at http://www.unnaturalcauses.org, including a DVD and site/local streaming license. Also available, the “Unnatural Causes” Facilitator’s Guide.
  • Worlds Apart. Fanlight Productions. A four-part series on cross-cultural health care. The documentary follows patients and families faced with critical medical decisions as they navigate their way through the health care system. It was shot in patients’ homes, neighborhoods, places of worship, hospital wards and community clinics, and provides a look at patient’s culture and the culture of medicine that may contribute to disparities. Organizations that wish to purchase or rent the films should contact Fanlight Productions. Also available, the “Worlds Apart” study guide.

TED Talks

Toolkits

  • Racial Equity Resource Guide. WK Kellogg Foundation. This resource guide has been prepared as a shared tool for building a community of connected, informed and engaged practitioners. It provides practical resources that will assist those community-based organizations engaged in the fields of healing, equity and inclusion, diversity and the elimination of structural racism. Within this guide, there are: guides for creating and organizing dialogues and action; toolkits for racial equity tactics; relevant books, articles, essays, and magazines; recommended documentaries and videos on issues of race and ethnicity; glossary of terms; and website links.
  • Working Together to End Racial and Ethnic Disparities: One Physician at a Time. American Medical Association Health Disparities Toolkit. This kit includes tools to help physicians and medical students eliminate gaps in health care based on race and culture. The kit contains a DVD featuring interviews with physicians, nurses, and patients discussing inequalities in health care, and a CD-ROM with facts on the components of health care disparities such as cultural competence and health literacy. It also includes a facilitation guide to help physicians and other health care providers work to improve the quality of care for all patients.

Lecture Presentations

Articles & Publications

Journal of Physician Assistant Education

Other Journals

Reports

  • Addressing Racial Disparities in Health Care: A Targeted Action Plan for Academic Medical Centers. AAMC
    This report, released in 2009, focuses on how academic health centers in the United States should commit to the goal of eliminating racial disparities in health care as part of their mission to prepare future generations of physicians to provide the highest quality of care for the U.S. population.
  • Heckler Report of the Secretary’s Task Force on Black and Minority Health. The Office of Minority Health (OMH) was created in 1986 and is one of the most significant outcomes of the 1985 Secretary’s Task Force Report on Black and Minority Health, also known as the “Heckler Report”. The Heckler report analyzed and synthesized the present state of knowledge in 1985 of the major factors that contributed to the health status of Blacks, Hispanics, Asian/Pacific Islanders, and Native Americans.
  • Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. In 1999, congress requested the Institute of Medicine study the extent of disparities in the types and quality of health services received by U.S. racial and ethnic minorities and non-minorities; explore factors that may contribute to inequities in care; and recommend policies and practices to eliminate these inequities. The report from that study, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, found that a consistent body of research demonstrated significant variation in the rates of medical procedures by race, even when insurance status, income, age, and severity of conditions are comparable. The research indicated that U.S. racial and ethnic minorities were less likely to receive even routine medical procedures and experience a lower quality of health services and is one of a few landmark documents that outlined health disparities as a major contributor to poor outcomes.
  • Disparities in child and adolescent mental health and mental health services in the US. William T. Grant Foundation. This report, released in March 2015, discusses the role of disparities in mental health care services for at risk populations and examines the barriers to mental health care for these groups.

Websites

  • AAMC MedEd Portal Publications. MedEdPORTAL Publications promotes educational scholarship and collaboration by facilitating the open exchange of peer-reviewed health education teaching and assessment resources. The publications can be searched for topics related to “disparities” and how to implement these interventions in various settings.
  • Physician Assistants for Health Equity. This website was created by a special interest group in the American Academy of Physician Assistants and contains links to articles and websites about health disparities.
  • Healthy People 2020. Launched in 2010, the US Department of Health and Human Services created Healthy People 2020 which is a list of the nation’s 10 year goals and objectives for health promotion and disease prevention.
  • National Institute on Minority Health and Health Disparities (NIMHD). The NIMHD leads scientific research to improve minority health and eliminate health disparities. Specifically, NIMHD conducts and supports research, training of a diverse workforce, research capacity and infrastructure development, public education and information dissemination.
  • National Information Center on Health Services Research and Health Care Technology. This website compiles a variety of resources related to health disparities including news related to disparities, data and statistics, as well as grants, funding and fellowship opportunities.

Evaluation & Curricular Assessment Tools