Janice Edmund Wells
Minority Health Liaison, Iowa Department of Public Health

Lou Fuller
Director, Office of Minority Health, Minnesota Department of Health

Panelists:
Regina Lee
Senior Advisor, 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?

Benjamin Germany
Chief, Missouri Department of Health

Spoke in general terms about the importance of coalition building at the community level in our global effort to eliminate disparities in health.

• There are 3 C’s to the elimination of disparities: community, coalition, and commitment.
• Communities must understand all of the local data so that they can own these health disparities.
• Too often people only want "our minority dealing with our minority". Instead, we want anyone and everyone to be interested in minority health.
• One untapped resource is the development of a "health ambassador", which could consist of getting people who live in housing developments to help deliver health care messages and services within their own developments.

• Commitment to this cause is the most important factor.

Julio Becerra
University of Illinois Medical Center, UIC Hospital

Spoke to the issue of cultural competency being a key component in public health programs

Key messages:

• Key barriers to using health care services are: too expensive; long waiting times; inconvenient clinic hours; no transportation; not knowing where to get the services; and cultural differences.
• Issues that have a significant impact on health include poverty, racism, education, employment, substance abuse, and violence.
• Health promotion should be adopted as a public priority.
• Comprehensive health education is needed at all levels.

• Target the disparities, then target the money to those disparities.

• In awarding block grants to the States, consider ways to direct the funding to the communities.

• Support the goal to eliminate disparities, support "better than the best" targets, provide racial and ethnic breakouts for all objectives, and use "no data" for all objectives where data is missing or not available.

• Programs need to be accountable and culturally and linguistically appropriate. Otherwise, these programs should not continue to get funding.

• Programs should meet the needs of the populations that they serve.

• Need to have the training of minorities in health professions as an objective in Healthy People 2010.

• One problem with current data systems is that they cannot generate data about the Asian Communities because of small numbers.

• Develop long-range and short-range plans for the goal to eliminate disparities. Go with "better than the best" model and place funding with those with the greatest disparities.

• "Better than the best" is what we absolutely have to have. This will be needed to drive action in the legislature.

• We need to get away from the "let us save you" complex and tap into the strengths and assets that are allowing families to survive.

• Let us leverage the strengths of our communities for problem solving rather than just focusing on the problems.

• Emergency rooms and walk-in clinics represent access to these vulnerable populations and should be used as a resource.

• The nonbiological, social aspects of health have not been addressed in Healthy People.

• It is important to assess progress that has been achieved as well as weather targets have been reached.

• We should look for better health for all, regardless of "eliminate" and "better than the best."

• There are no objectives on poverty and employment, which are key reasons for disparities.

• Need to look more at alternative therapies including oriental medicine.

Chicago Transcripts and Summaries