Christina Perez
Regional Minority Health Consultant, DHHS

Regina Lee, JD
Special Assistant to the Director, OMH, US DHHS

Provided overview of the Healthy People goal of eliminating health disparities and raised key questions for consideration during the public comment period.

Key messages:

• Should the Eliminating Disparities goal in Healthy People 2010 be applied across all health focus areas?
• Although the 2010 guidelines suggest a "better than the best" approach to target-setting, this has not yet been applied uniformly and consistently across the current set of proposed objectives. Let us hear your comments about these approaches and target-setting.
• No data, no official problem; no problem, no action; no action, persistent and increased gaps. Do we want to show where data gaps exist?
• If we are truly going to "close the gap", a greater amount and rate of change will be required for those who are least healthy than for those who are healthiest--while, at the same time, improving health for all.
• How, if at all, should we address existing disparities by gender, age, functional status, and income? Should similar or different approaches be implemented? Are there other variables that need to be considered?

George Flores, MD
Director of Public Health Sonoma County, Public Health Officer

Discussed the key barriers to eliminating health disparities and the shift we need to make in looking at wellness, rather than to focus on disease

• Minorities are not to be regarded as victims.
• Barriers include cost of care; lag-time for appointments; immigration status; language; and location.
• We can not have a "one-size-fits-all" approach.
• Communities with disparities have many assets, they are not only consumers, they are not victims.
• We need to focus on resource optimization within the communities.
• Lets talk about health, and predeterminants of wellness—not disease.
• For many, such as immigrants, exclusion from benefits means exclusion from health.
• We need to have advocacy...Policy makers must be able to change in order to achieve Healthy People 2010.
• Need universal access to care.
• Remember, when we talk of the target. It is NOT just a number, it represents the health of people.

Vanessa Hill
Acting Director, Center for Minority Health, Arizona Department of Health Services

Addressed disparities from the perspective of a state office of minority health

Key messages:

• Support the use of lay ministers of health trained by the state, for problems such as hypertension, diabetes, and the adverse effects of a sedentary lifestyle.
• Churches, while often a focus as an able partner, do not always represent the people in the surrounding community. Need to expand beyond the church.
• School-based clinics can bring in other members of the family in addition to the student, such as siblings and parents.
• Health problems are also economic problems.
• Most people in public health are not trained in public health and are not racially and ethnically diverse.

Hardy Spoehr
Executive Director, Pap Ola Lokahi Program

Addressed key issues within the Native Hawaiian community

Key messages:

• We need to celebrate who and what we are.
• Native Hawaiians are generally under the state average for income.
• Child abuse and neglect are increased for Hawaiians.
• Of the 6,000 full Hawaiians, 80% are diabetic.
• We need to focus on wellness and take a holistic approach, including traditional healing practices, physical, mental, and spiritual.
• Allocate resources based on needs, issues, and concerns.
• If you are going to have an impact on changing a population, you have to target the youngest members.
• Bring members of the ethnic community into the health professions
• Affordability, accessability, and availability

• Even if you adjust for SES, race still becomes an important health outcome variable.

• Working conditions can present adverse health outcomes, e.g., farm workers.

• Many minorities hold down several jobs in order to sustain income for survival, yet do not have health benefits.

• We need to measure the impact of discrimination.

• How do we get more minorities into health care?

• National surveys do not measure small groups.

• The reasons for disparities are multifactorial and one model does not fit all.

• Before we can focus on medical issues, we need to meet people where they are...which may mean addressing housing, transportation, etc.

• Where are all the other partners we need in order to eliminate disparities?

• Use data at the local and state levels to model data sources.

• Complementary medicine should not be overlooked. Since it is trusted by those populations in which this is part of their culture.

• Spiritual does not necessarily mean religious, but one must BELIEVE.

  Sacramento Transcripts and Summaries