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Strategies

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

  1. 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.
  2. 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.
  3. 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.
  4. 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

  1. 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.
  2. 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.
  3. 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.