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Policy Points Artificial intelligence (AI) is disruptively innovating health care and surpassing our ability to define its boundaries and roles in health care and regulate its application in legal and ethical ways. Significant progress has been made in governance in the United States and the European Union. It is incumbent on developers, end users, the public, providers, health care systems, and policymakers to collaboratively ensure that we adopt a national AI health strategy that realizes the Quintuple Aim; minimizes race‐based medicine; prioritizes transparency, equity, and algorithmic vigilance; and integrates the patient and community voices throughout all aspects of AI development and deployment. Artificial intelligence (AI) is disruptively innovating health care and surpassing our ability to define its boundaries and roles in health care and regulate its application in legal and ethical ways. Significant progress has been made in governance in the United States and the European Union. It is incumbent on developers, end users, the public, providers, health care systems, and policymakers to collaboratively ensure that we adopt a national AI health strategy that realizes the Quintuple Aim; minimizes race‐based medicine; prioritizes transparency, equity, and algorithmic vigilance; and integrates the patient and community voices throughout all aspects of AI development and deployment. [ABSTRACT FROM AUTHOR]

Objectives. To determine the prevalence of COVID-19–related discrimination among major US racial/ethnic groups and estimate associations between discrimination, race/ethnicity, and other sociodemographic characteristics. Methods. We conducted a nationally representative online survey of 5500 American Indian/Alaska Native, Asian, Black/African American, Hawaiian/Pacific Islander, Latino (English and Spanish speaking), White, and multiracial adults from December 2020 to February 2021. Associations between sociodemographic characteristics and COVID-19–related discrimination were estimated via multinomial logistic regression. Results. A total of 22.1% of the participants reported experiencing discriminatory behaviors, and 42.7% reported that people acted afraid of them. All racial/ethnic minorities were more likely than White adults to experience COVID-19–related discrimination, with Asian and American Indian/Alaska Native adults being most likely to experience such discrimination (discriminatory behaviors: adjusted odd ratio [AOR] = 2.59; 95% confidence interval [CI] = 1.73, 3.89; and AOR = 2.67; 95% CI = 1.76, 4.04; people acting afraid: AOR = 1.54; 95% CI = 1.15, 2.07; and AOR = 1.84; 95% CI = 1.34, 2.51). Limited English proficiency, lower education, lower income, and residing in a big city or the East South Central census division also increased the prevalence of discrimination. Conclusions. COVID-19–related discrimination is common, and it appears that the pandemic has exacerbated preexisting resentment against racial/ethnic minorities and marginalized communities. Efforts are needed to minimize and discredit racially driven language and discrimination around COVID-19 and future epidemics. (Am J Public Health. 2022;112(3):453–466. https://doi.org/10.2105/AJPH.2021.306594) [ABSTRACT FROM AUTHOR]

The purpose of this paper was to analyze the forms of protection and fulfillment of human rights by local governments against the followers of the Tolotang faith in accessing their right to health service as minority group in Sidenreng Rappang District, South Sulawesi Province. The type of research used was normative legal research using a statutory approach. The results showed that The followers of the Tolotang faith have been recognized by the state, and weregiven space to worship based on their beliefs. Also Tolotang faith have recognize by the local government as part of the community in Sidenreng Rappang who have the same access in order to get health service from any medical stuff, doctor, clinic, hospital whenever they need it.The findings of this article can provide insights into the forms of protection and fulfillment of human rights by local governments against the followers of the Tolotang faith inin in accessing their right to health service as minority group in Sidenreng Rappang District, South Sulawesi Province.The followers of the Tolotang faith have been recognized by the state, and weregiven space to worship based on their beliefs. Also Tolotang faith have recognize by the local government as part of the community in Sidenreng Rappang who have the same access in order to get health service from any medical stuff, doctor, clinic, hospital whenever they need it [ABSTRACT FROM AUTHOR]

The present study focused on determining how public health workers access and utilize research in their daily practice and how they can better utilize research in order to improve practice, policy, and training as it relates to minority health care. We interviewed 13 community health workers utilizing a semi-structured interview protocol. Data analysis involved multi-stage, team-based coding into increasingly higher analytical levels from codes to categories to themes. Themes included: (1) "fighting for social justice," (2) improving minority data collection, (3) setting priorities and determining applicability of research, (4) increasing collaboration between researchers and practitioners, and (5) making research accessible to practitioners. Culminating in our development of a local collaboration model, we underscore the urgent need for forging proactive community-based partnerships between researchers and practitioners in order to aid our efforts toward realizing our mutually shared goal of reducing minority health disparities and fostering more equitable health care. [ABSTRACT FROM AUTHOR]

Background: Understanding the psychosocial stressors of people with psychoses from minority ethnic groups may help in the development of culturally appropriate services. This study aimed to compare psychosocial factors associated with attendance at an emergency department (ED) for six ethnic groups. Preventing crises or supporting people better in the community may decrease hospitalization and improve outcomes. Method: A cohort was created by retrospective case note analysis of people of East-Asian, South-Asian, Black-African, Black-Caribbean, White-North American and White-European origin groups attending a specialized psychiatric ED in Toronto with a diagnosis of psychosis between 2009 and 2011. The psychological or social stressors which were linked to the presentation at the ED that were documented by the attending physicians were collected for this study. Logistic regression models were constructed to analyze the odds of presenting with specific stressors. Results: Seven hundred sixty-five clients were included in this study. Forty-four percent of the sample did not have a psychiatrist, and 53% did not have a primary care provider. Social environmental stressors were the most frequent psychosocial stressor across all six groups, followed by issues in the primary support group, occupational and housing stressors. When compared to White-North American clients, East-Asian and White-European origin clients were less likely to present with a housing stressor, while Black-African clients had decreased odds of presenting with primary support group stressor. Having a primary care provider or psychiatrist were predominantly protective factors. Conclusion: In Toronto, moving people with chronic mental health conditions out of poverty, increasing the social safety net and improving access to primary care and community based mental health services may decrease many of the stressors which contribute to ED attendance. [ABSTRACT FROM AUTHOR]

The chronic care model (CCM) concerns both the medical and the cultural and linguistic needs of patients through the inclusion of cultural competence in the delivery system design. This literature review attempted to@@ identify the domains of the CCM culturally competent (CC) interventions that the adults from ethnic minorities suffering from type 2 diabetes mellitus report. We identified the CCM and the CC components in the relevant studies published between 2005 and 2014. Thirty-two studies were included. Thirty-one articles focused on self-management and 20 on community resources. Twenty-three interventions integrated cultural norms from the patients' backgrounds. CC interventions reported the CCM at the individual level but need to address the organizational level more effectively. The scope of CC interventions should be expanded to transform health care organizations and systems. [ABSTRACT FROM AUTHOR]

Hospitalizations of those living with HIV are expensive and often indicate failures in access to, or retention in, primary care. Higher rates of hospitalizations among individuals with HIV have been reported in some US ethnic minorities, yet little information is available for Native Hawaiians and Asian subgroups. All hospitalizations in Hawai'i of individuals aged >13 years from December 2006-December 2010 were considered. Hospitalizations of individuals with HIV were identified using ICD-9 diagnosis codes of 042 and V08; 613 hospitalizations with an HIV diagnostic code were found. Using Hawaii State Department of Health 2010 data, estimated rates of hospitalizations among HIV positive individuals by race/ethnicity among the 2,600 Hawai'i residents living with HIV were calculated along with estimated rate ratios (using Whites as the reference group). Multivariable adjusted estimated rate ratios (aRR) were calculated with negative binomial models, adjusting for age, sex, and payer type. Demographic and clinical differences among hospitalized patients with HIV were also compared by race/ethnicity. Native Hawaiians (aRR: 3.21; 95%CI: 2.11-4.88), Japanese (aRR: 2.27; 95%CI: 1.38-3.72), and Filipinos (aRR: 1.62; 95%CI: 1.01-2.59) living with HIV all had higher likelihood of a hospitalization compared to Whites, even when controlling for age, sex, and payer. Chinese did not vary significantly from Whites. Also of note, the average age of HIV positive individuals who were hospitalized varied significantly across groups (P-value < .001), with Native Hawaiians as the youngest (45 years), followed by Filipinos (47 years), Whites (49 years), Chinese (50 years) and Japanese (54 years). Disparities appear to exist in hospitalizations among HIV positive individuals for Native Hawaiians and Asian subgroups. Further research is warranted to investigate the reasons for these health disparities. [ABSTRACT FROM AUTHOR]

Immigrants and ethnic minorities have been identified as vulnerable groups in health, in general, and in what concerns therapeutic non-adherence (TA) in particular; i.e., (not)following health-care providers' therapeutic recommendations. The general aim of this paper is presenting a literature review of immigrants'/ethnic minorities' TA determinants. We will start by highlighting the reasons as to why immigrants'/ethnic minorities' therapeutic (non)adherence should be a topic of concern. Then, we will present a review of the main determinants of immigrants'/ethnic minorities' TA, at different levels of analysis (e.g., broad structural level; social and community networks; material and social conditions) and emphasize that non-adherence among immigrants/ethnic minorities is mostly non-intentional, seeing as how it is associated with issues such as: low socio-economic conditions, language barriers and cultural mismatches. Finally, we will highlight the role of health-care providers in tackling this health-related problem and reflect about the importance of promoting development and training of health-care providers' multicultural abilities. [ABSTRACT FROM AUTHOR]

Objectives Care transitions are an especially vulnerable juncture in the course of patient care. Patients from ethnic minority populations face additional unique challenges during hospital to community care transitions due to language and cultural barriers, yet, this phenomenon is understudied. This study examines the quality of care transitions of minority patients (immigrants) versus the general population, and specifically assesses the association between in-hospital provider–patient communication and the quality of minority care transitions. Design Prospective study of older hospitalized adults. Setting A large teaching hospital. Participants Participants (n = 385) were patients hospitalized for non-disabling medical conditions, from one of the two groups: the general Israeli population (Hebrew speakers) or immigrants from the former Soviet Union (Russian speakers). Main outcome measures One-month phone follow-up assessed the quality of patients’ transitional care using the care transitions measure. Results Russian speakers rated their transitional care on average 10% lower than Hebrew speakers (54.4 versus 64.2, respectively, P = 0.002). On average, Russian speakers’ ratings on the physician interpersonal-communication scale were significantly lower than Hebrew speakers’ ratings. For Russian speakers, but not Hebrew speakers, the interpersonal physician communication scale was significantly positively associated with the quality of care transitions in multivariate analyses (P = 0.01), controlling for gender, education, economic status and length of stay. Conclusions Minority patients experience lower quality of care transitions than the general population. Interpersonal physician–patient communication during the hospital stay is associated with better care transitions of ethnic minority patients and should be considered in efforts to improve the quality of minority patients’ care transition processes. [ABSTRACT FROM PUBLISHER]

Medically underserved Asian Americans, Native Hawaiians, and Other Pacific Islanders (AA&NHOPIs) and other racial/ethnic minorities are often left out of the health center system (OMB, 1997; Papa Ola Lokahi, 2007). The Department of Human and Health Services is updating its Proposed Rule, which determines key population health indicators for medically underserved areas (MUA) and health professional shortage designations. This is important as revisions could increase Community Health Center (CHC) health care access for underserved AA&NHOPIs. We recommend that Limited English Proficiency be used as one of the measures in determining MUAs, as it is a scientifically valid and available measure that can identify where underserved AA&NHOPIs and other minorities who face an added language barrier can access needed health services. [ABSTRACT FROM AUTHOR]

The authors examined changes in medical care experiences of racial/ethnic groups (non-Hispanic white, Asian and Pacific Islander, Hispanic, and non- Hispanic black) between 1996 and 2002, using data from the Household Component of Medical Expenditure Panel Surveys. Proportions and adjusted odds ratios for each group's primary care experience are presented. Comparisons are made between groups at each time period and within groups between the two time periods. Multivariable analyses control for demographic and socioeconomic characteristics, health care needs and source of care, and health insurance. Racial/ethnic minorities experienced worse medical care than non-Hispanic whites, but results differed among groups. Non-Hispanic blacks were no different from non-Hispanic whites and showed a slight improvement over time, except for lower odds of having a usual source of care and worse sociodemographic and health indicators. Hispanics had worse experiences than whites in 5 of 8 indicators in 2002 (vs. 3 in 1996). Asians assessed their experience as worse than that of whites in 6 of 8 indicators in 2002 (vs. 3 in 1996), yet had higher self-rated health and education than non-Hispanic whites. Disparities in medical care experience have increased for some groups, and efforts must be made to reduce financial and nonfinancial barriers to care for racial/ethnic minority populations. [ABSTRACT FROM AUTHOR]

Objective. We sought to test methods for generating epidemiological evidence on health conditions of small, dispersed minority communities. Methods. We used community-based mixed methods including a cross-sectional survey in 5 purposely selected settlements of Khorakané Romá (Gypsies of Muslim culture) in Italy to study the living conditions and health status of children aged from birth to 5 years. Results. In the 15 days prior to the survey, 32% of the children had suffered diarrhea and 55% had had a cough. Some 17% had experienced respiratory difficulties during the past year. Risk factors associated with these outcomes included years spent living at the camp, overcrowding, housing conditions, use of wood-burning stoves, presence of rats, and issues related to quality of sanitation and drains. Qualitative information helped define the approach and the design, and in the interpretation and consolidation of quantitative results. Conclusions. Guided by the priorities expressed by dispersed minority communities, small studies with little resources can provide a solid base to advocate for evidence-based participatory planning. Exact intervals appeared to be robust and conservative enough compared with other intervals, conferring solidity to the results. (Am J Public Health. 2008;98:2035-2041. doi:10.2105/AJPH.2007.129734) [ABSTRACT FROM AUTHOR]

While a lack of health insurance or interrupted coverage has been shown to lead to poorer health status among preretirement populations, this phenomenon has not been examined among a large population of younger, working-age adults. We analyzed a nationally representative data set of persons born between 1957 and 1961, the National Longitudinal Survey of Youth-1979, to examine the links between insurance continuity and self-assessed physical and mental health at age 40. Among respondents turning 40 in 1998 or 2000, 59.8% had been continuously insured during the decade before they reached age 40. In unadjusted analysis, persons who were continuously covered had the highest scores for both physical and mental health. After controlling for respondent characteristics, insurance coverage was not significantly associated with perceived physical or mental health. [ABSTRACT FROM AUTHOR]

An increase in the participation rates of British South Asian Muslim communities in sport and physical activity is a high priority in both the sport and health sectors. Interventions emanating from the sport development sector have to date achieved little significant growth of activity. However, interventions within the health sector appear to be more successful in engaging South Asian communities in activity. This paper is based on field research in a Healthy Living Centre in Blackburn, a town with a large South Asian Muslim community. The research suggests that within such communities a mode of delivery grounded in physical activity and personal health is likely to be more successful than one based on sport and competition. However, it also identifies other cultural factors that will need to be addressed if participation rates are to be further increased. [ABSTRACT FROM AUTHOR]

Recently, attention has been drawn to the quality of the patient-provider relationship as a mediator of health outcomes for racial and ethnic minorities. The purpose of this study was to examine the provider-patient relationship in reproductive health care for low income African American teens and to identify effective techniques they use in caring for teens. We conducted focus groups with providers at two clinics serving six low-income neighborhoods on the Southside of Chicago. Sessions were audio-taped then transcribed verbatim. ATLAS/ti 5.0® (a qualitative data analysis software program), was used for coding, text retrieval, data management and analysis of data. Providers in community clinics use a number of tactics when working with teens. First, they forge strong relationships through the use of language, shared background experiences, honesty and spending extra time with teens. Second, clinic employees work collectively to care for the patients with all staff members, both professional and clerical, contributing to the provider-patient relationship. Third, providers seek opportunities for contraceptive counseling even attempting to reach males outside of clinic. Techniques used by providers in neighborhood clinics may provide important insights for providing reproductive health care to low income, African American teens. [ABSTRACT FROM AUTHOR]

The article presents an editorial that discusses how the access to health care services is related to health disparities between racial and ethnic minorities and their non-minority peers. The authors believe that changing non-medical determinants of health care, such as the environment, health behaviors, and community resources, can improve public health and decrease health disparities in the U.S. The authors discuss how state and local efforts, along with national reforms, can reduce disparities in health.

Background: Despite therapies proven effective for heart failure with systolic dysfunction, the condition continues to cause substantial hospitalization, disability, and death, especially among African-American and other nonwhite populations. Objective: To compare the effects of a nurse-led intervention focused on specific management problems versus usual care among ethnically diverse patients with systolic dysfunction in ambulatory care practices. Design: Randomized effectiveness trial conducted from September 2000 to September 2002. Setting: The 4 hospitals in Harlem, New York. Patients: 406 adults (45.8% were non-Hispanic black adults, 32.5% were Hispanic adults, 46.3% were women, and 36.7% were ≥65 years of age) who met eligibility criteria: systolic dysfunction, English- or Spanish-language speakers, community-dwelling patients, and ambulatory care practice patients. Intervention: During a 12-month intervention, bilingual nurses counseled patients on diet, medication adherence, and self-management of symptoms through an initial visit and regularly scheduled follow-up telephone calls and facilitated evidence-based changes to medications in discussions with patients' clinicians. Measurements: Hospitalizations (in 406 of 406 patients during follow-up) and self-reported functioning (in 286 of 406 patients during follow-up) at 12 months. Results: At 12 months, nurse management patients had had fewer hospitalizations (143 hospitalizations vs. 180 hospitalizations; adjusted difference, -0.13 hospitalization/person-year [95% CI, -0.25 to -0.001 hospitalization/person-year]) than usual care patients. They also had better functioning: The Short Form-12 physical component score was 39.9 versus 36.3, respectively (difference, 3.6 [CI, 1.2 to 6.1]), and the Minnesota Living with Heart Failure Questionnaire score was 38.6 versus 47.3, respectively (difference, -8.8 [CI, -15.3 to -2.2]). Through 12 months, 22 deaths occurred in each group and percentages of patients who were hospitalized at least once were similar in each group (30.5% of nurse management patients vs. 36.5% of control patients; adjusted difference, -7.1 percentage points [CI, -16.9 to 2.6 percentage points]). Limitations: Three nurses at 4 hospitals delivered interventions in this modest-sized trial, and 75% of the participants were from 1 site. It is not clear which aspects of the complex intervention accounted for the results. Conclusions: Nurse management can improve functioning and modestly lower hospitalizations in ethnically diverse ambulatory care patients who have heart failure with systolic dysfunction. Sustaining improved functioning may require continuing nurse contact. [ABSTRACT FROM AUTHOR]

The article considers the place of minority ethnic health in the priorities of the British National Health Service (NHS). It identifies some of the NHS priorities, such as the promotion of health and the prevention and management of disease. The extent to which the NHS address the health needs of minority ethnic groups in the country is examined. It stresses the need for a balanced and considered approach to priority setting within the NHS.

Describes a binational academic collaborations in minority health research between the U.S. and Mexico. Border health issues in the region; Academic facilities that underwent research on public health issues; Challenges and recommendations.

Background. Racial and ethnic disparities exist in reported childhood asthma prevalence, but it is unclear if disparities stem from true prevalence differences or a different likelihood of receiving a diagnosis from a health professional. Concern has been raised that asthma may be underdiagnosed, particularly among minority children who have more restricted access to high-quality health care. Objective. To examine racial/ethnic differences among currently symptomatic children in acquiring an asthma diagnosis to determine if relative underdiagnosis among minorities exists. Children for whom no symptoms were reported (a group that includes those with well-controlled symptoms) were excluded from the analysis. Methods. The 1999 National Health Interview Survey includes a nationally representative sample of children with reported wheezing symptoms. We included children 3 to 17 years old in the study and analyzed racial/ethnic differences in asthma diagnosis, controlling for young age, gender, parental education, single-parent household, central-city residence, region of residence, health insurance, having a usual place of care, and parent- reported severity of wheezing symptoms. Results. Among those reported to have wheezed in the past year (n = 946), 83% of Puerto Rican, 71% of non-Hispanic black, and 65% of Mexican children were diagnosed with asthma compared with 57% of non-Hispanic white children. Using non-Hispanic white children as the reference group, the approximate adjusted relative risk for physician diagnosis of asthma given wheezing in the past year was 1.43 (95% confidence interval [CI]: 1.04, 1.63) for Puerto Rican, 1.22 (95% CI: 1.03, 1.37) for non-Hispanic black, and 1.19 (95% CI: 0.94, 1.39) for Mexican children. Minority children were reported to have greater severity of wheezing symptoms. Even after accounting for this increased severity, children in racial and ethnic minority groups were as or more likely to have a reported... [ABSTRACT FROM AUTHOR]

Background. Towards the end of 2001, the Scottish Executive Health Department published a unique report, ‘Fair for All’, on the issue of addressing the health needs of ethnic minorities. One of the recommendations contained within the report was that different groups and organizations within communities should work together to provide services to minority groups. This descriptive paper is an illustration of how a settled community, in this case a Muslim community, was encouraged to become involved in its own health care by holding a health fair at its mosque. Planning. The health fair was organized by the Minority Ethnic Health Inclusion Project, in collaboration with the Local Health Care Co-operative, and in cooperation with Edinburgh Central Mosque. The health fair was held over two consecutive Fridays in May 2003 and focused primarily on diabetes, high blood pressure, healthy eating and oral hygiene, as well as providing information on cancer and Local community services. Outcomes. The health fair was well received on both days, with around 200 men and 120 women participating. In total, there were 99 recorded blood pressure measurements and 81 blood glucose checks, and the community dental service was very well received. Evaluation. Strong participation by the community shows that people from ethnic minorities are interested in their health and will participate in health-related activities arranged for them. The success of this health fair shows that, as proposed by the Scottish Executive, different groups and organizations within the community can work together to provide services to minority ethnic groups. [ABSTRACT FROM AUTHOR]

Racial and ethnic disparities in health have been well described, with data showing that minority Americans suffer disproportionately from cardiovascular disease, diabetes, asthma, cancer, and human immunodeficiency virus/acquired immunodeficiency syndrome, among others. Several factors lead to these disparities, including the fact that minority Americans suffer from adverse social determinants (such as poverty and lower levels of education) at greater rates and are more likely to be uninsured. A recent Institute of Medicine report has also highlighted that minorities tend to receive lower-quality care even when they have insurance and access to the health system. The Institute of Medicine report identified various sources that contribute to racial/ethnic disparities in health care; among them was health care providers' susceptibility to stereotyping minority patients, leading to disparate clinical decision making. This review dissects the process of clinical decision making--and the environment in which decisions are made--to present a model for understanding how even well intentioned physicians may be susceptible to stereotyping and unknowingly contribute to racial/ethnic disparities in health care. Several strategies to counteract this process, both systematically and individually, are also described. [ABSTRACT FROM AUTHOR]

The purpose of this article is to review conceptual/ theoretical and review/agenda setting nursing literature on the health care of racial/ethnic minority men [specifically African American/Black, Hispanic/Latino, American Indian/ Alaskan Native and Asian/Pacific Islander men] in one of the four targeted areas of health disparities. CINAHL and MEDLINE computer databases were searched from 1983 to the present using a combination of manual and computer-based methods to identify the nursing literature that included any racial/ethnic men in the sample and addressed at least one of the four areas of health disparities targeted by Department of Health and Human Services (DHHS) that affect adults: heart disease, malignant neoplasms (cancer), diabetes mellitus and Human Immunodeficiency Virus (HIV)/AIDS. This review provides an overview of health disparities experienced by racial/ethnic minority men in the targeted areas and of the types of conceptual and agenda-setting articles published in scholarly nursing literature in those targeted areas. [ABSTRACT FROM AUTHOR]

In the context of current concerns about health inequalities among minority ethnic groups in the UK, this paper addresses perceptions of mental health services among members of an African-Caribbean community in a South England town. Efforts to reduce health inequalities must take account of the views of local community members on the sources of those inequalities and on local health services. The statistical existence of inequalities in diagnosis and treatment of African-Caribbeans in the UK is well-established, supported by sociological explanations of these inequalities which centre on social exclusion in a variety of forms: institutional, cultural and socio-economic. However, detailed studies of the perspectives of local communities on mental health issues and services have received less attention. In this case study of community perceptions of mental health services, we find that social exclusion comprises an explanatory framework which is repeatedly invoked by community members in describing their interaction with mental health services. Interviewees assert that experience and expectation of racist mis-treatment by mental health services are key factors discouraging early accessing of mental health services, and thereby perpetuating mental health inequalities. We conclude that participation and partnership are vital means by which to generate both the objective and subjective inclusion that are requirements for an accessible and appropriate health service. [Copyright &y& Elsevier]

Provides tips to improve health practice services to meet the needs of diverse patients. List of scenarios reflecting different stages of development toward cultural competency; Percentage of minority patients in medical practices; Lack of services and facilities to serve non-English speaking patients. INSETS: KEY POINTS;WHO IS A MINORITY?;'WHAT DID HE SAY?'.

Keywords: Race, minority health, access to health care, socioeconomics, ethnicity. [ABSTRACT FROM AUTHOR]

This article reviews the composition and characteristics of the health professions, the demographics of the national population, and factors that influence access to health care and satisfaction with care for ethnic/racial minority populations in the United States. In addition, an overview of publicly funded US health insurance programs for the poor is provided along with a discussion of the impact that managed care is having on the American health care system. Finally, the paper summarizes conference discussions regarding the problems, strategies, and approaches that the UK and the US have experienced with respect to providing quality health care for ethnic/racial minority populations. [ABSTRACT FROM AUTHOR]

This paper examines informal care and the empowerment of minority communities with respect to health care and health promotion in the USA and the UK based upon work prepared for the workshop, 'Involving Black and Minority Ethnic Users in Delivery of Services and Empowering Communities' presented during the bi-national 1997 USA, UK. Conference, 'Health Gain for Black and Minority Ethnic Communities' and the information gained from that Conference. 'Informal care' is operationally defined as 'the practice of alleviating distressful physiological and psychological dysfunctions through all others (e.g. traditional healers, family members, self, etc.) using measures that do not require a physician's prescription or intervention (e.g. lifestyle modifications) typically outside of formal, institutionally based care mechanisms (e.g. homes and communities). Informal care is a significant force in health maintenance, health promotion, and disease prevention. In the USA, at least one-third of the population is estimated to engage in unconventional medical practices, and perhaps, one-half of racial/ethnic populations use informal care. An enormous potential exists to better utilize informal care because informal care is culturally more compatible, relatively low cost, and flexible. The policy of the Indian Health Service in accepting the use of traditional medicine was cited. The US Congress recognized the potential of alternative medicine by establishing such an Office within the National Institutes of Health. 'Empowerment of racial/ethnic minority communities is the right for minority populations to determine their own destinies. In the USA, racial/ethnic minority populations are Blacks, Hispanics, Asians or Pacific Islanders, and American Indian/Alaska Native. These classifications are based upon self-report; in the UK, the black and minority classifications are based upon countries of birth rather than self-reported racial/ethnic identities. Empowerment of these communities is important both demographically and historically. In demographic terms, racial/ethnic minority populations are increasing at higher rates than the majority population in the USA and hence, the health status of minorities will become the health status of the nation in the next half century. Historically, racial/ethnic minorities have not been empowered. As a consequence of the 1985 Secretary's Task Force Report on Black and Minority Health Federal measures to address disparities in the health status of minorities were initiated. In March 1994, the UK Government initiated the Ethnic Health Unit within the National Health Service. These measures are not mature enough to evaluate their impact. However, progress in implementing measures to empower minorities in the UK have begun and are illustrated by the work reported by Dr Pui-Ling Li, the UK counterpart to the workshop, 'Involving Black and Minority Ethnic Users in Delivery of Services and Empowering Communities'. Recommendations are made to increase use of informal care and the empowerment for racial/ethnic minority communities and to build upon the works in progress in both the USA and the UK. [ABSTRACT FROM AUTHOR]

Explores the potential effect of an unregulated transformation to managed care on minority physicians who serve poor and minority communities in the U.S. Background on the transformation of the medical industry from fee-for-service to managed care; Arguments on the likelihood that the transformation toward managed care will expose physicians to more damaging forms of racial discrimination; Discussion on potential solutions.

The authors discuss the role of public health in building an evidence base for change regarding immigration and health care reform. They advocate the consistent disaggregation of data regarding immigrant populations including Asian Americans, Native Hawaiians and Pacific Islanders who are the focus of this issue. They support the use community-based participatory research (CBPR) methods.

The article presents an overview of research done in the United States in 2008 which evaluated the effectiveness of work done by health care advocates who were working to narrow medical care disparities among racial and ethnic groups. The research found that despite decades of efforts to raise awareness about the disparities and to reduce them, the gaps seen in certain areas of medical care in the United States have not changed and still remain for racial and ethnic groups. Methods which have been used to address the issue of health disparities in the U.S. are discussed.

The article features news and announcements from women's health centers around the world, as of November 2005. It includes information on the Office of Minority Health's National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health in January 2006, the availability of the 2nd edition of the National Vulvodynia Association's teaching program for healthcare professionals, and the Sex and Gene Expression Conference to be held in conjunction with the workshop on Steroid Hormones and Brain Function in Colorado in March 2006.

The author discusses the importance of developing a long-term strategy for improving men's health in the U.S., specifically men of color. It involves moving toward a universal health care system that would transcend the focus on separate incremental strategies for each and every demographic group and ensure access to timely affordable and appropriate care regardless of age, race, family status or job status.

The U.S. is witnessing a growing debate about the apparent disparities between the health status of white Americans and racial minorities, most notably African Americans and Hispanics. In 1993, the U.S. government admitted that there are significant differences and responded by establishing the Minority Health Initiative to investigate and redress these discrepancies. The U.S. National Cancer Institute started the Center for Reducing Cancer Health Disparities in 2000, and last spring, the National Academies of Sciences' Institute of Medicine in Washington DC, released a study sponsored by the government's Department of Health and Human Services entitled 'Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.'

The article discusses a study which conducted interviews on inner-city minority patients admitted for recurrent diabetic ketoacidosis (DKA) associated with non-compliance to insulin therapy. It says that among the reasons for non-compliance were lack of funds, absence of insurance and reduced doses of insulin. It pinpoints deprivation and lack of education as substantial factors, adding that the financial reasons behind insulin discontinuation was a reflection on the U.S. healthcare system.

The article reports on a study which was reported in the April 22, 2008 issue of "Health Affairs". Researchers involved in the study found that low levels of compensation from U.S. Medicaid programs contribute to racial and ethnic disparities in medical care in the U.S. The study also concluded that primary care doctors with predominantly black and Latino patients have a larger patient case load, provide more charity care, spend less time with minority patients than with white patients, and earn less than colleagues who treat fewer minority patients.