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Chapter 7 ■ Health Disparities and the Social Determinants of Health
A Strategic Framework for Improving Racial/Ethnic (R/E) Minority Health & Eliminating R/E Health Disparities
1. Racial/Ethnic Minority Health Status Issues (i.e., preventable morbidity and premature mortality)
Long-Term Problems
2. Racial/Ethnic Health Disparities 3. Need for a Systems Approach
1. Individual Level: • Knowledge • Attitudes • Skills • Behaviors • Biological/Genetic Risks 2. Environmental/Community Level:
Contributing Factors
• Physical Environment • Social Environment
• Community Values • Community Assets • Community Involvement
• Economic Barriers 3. Systems Level:
• Components and Resources • Coordination and Collaboration • Leadership and Commitment
• User-Centered Design • Science and Knowledge
1. Individual Level: • Efforts to Increase Knowledge • Efforts to Promote Attitudes Conductive to Good Health • Efforts to Build Skills • Efforts to Promote Healthy Behaviors • Efforts to Address Biological or Genetic Risks 2. Environmental/Community Level: • Efforts to Increase Knowledge
Strategies and Practices
• Efforts Aimed at the Social Environment • Efforts to Address Economic Barriers 3. Systems Level:
• Efforts to Strengthen Components and Resources • Efforts to Promote Coordination and Collaboration • Efforts to Foster Leadership and Commitment • Efforts to Promote User-Centered Design to Address Racial/Ethnic Minority Needs Through • Racial/Ethnic Minority Participation • Health-care Access/Coverage • Culturally and Linguistically Appropriate Service • Workforce Diversity • Racial/Ethnic Data Collection • Efforts to Improve Science and Knowledge 1. Individual Level: • Increased awareness/knowledge about disease prevention or risk reduction • Increased health-care provider skills in providing culturally & linguistically appropriate services • Increased patient adherence to prescribed treatment regimens • Reduced morbidity & mortality 2. Environmental/Community Level: • Decreased exposure to risks in the physical environment • Increased public awareness about racial/ethnic health disparities • Increased health-care access & appropriate utilization • Increased plans & policies that promote health & well-being at the local, state, & national levels • Reduced morbidity & mortality 3. Systems Level: • Increased inputs & other resources for racial/ethnic minority health-/health disparities-related priorities • Increased partnerships & collaborations for greater effectiveness & efficiency • Increased strategic planning, with goals & objectives, evaluation, & performance monitoring • Increased system design characteristics to minimize barriers for minority users • Increased knowledge development/science base about “what works” 1. Increased quality and years of healthy life for racial/ethnic minorities 2. Reduced and, ultimately, eliminated racial/ethnic health disparities 3. Systems approach to racial/ethnic minority health improvement and health disparities reduction
Outcomes and Impacts
Figure 7-6 Logic model of a strategic framework for improving racial and ethnic health disparities. (Source: Reference [60])
Long-Term Objectives and Goals
Office of Minority Health
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