Lorenzo Olivas, MPH
Regional Minority Health Consultant, US Public Health Service, Region VIII

Neal Adams, MPA
Associate Regional Health Administrator for Minority Health, US Public Health Service, Region VIII

Tuei Doong, PhD
Deputy Director, Office of Minority Health, 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?

Grace Wang, MD, MPH
Medical Director, Seattle/King County Department of Public Health

Presented the King County Ethnicity and Health Survey which has as its goal to describe the health status, access to health services and behavioral risk factors pertaining to the larger ethnic minority populations in King County. In addition the survey would contribute to discussions with community partners to identify health priorities and action strategies within these diverse populations.

• Need to look at county level data to "unmask" some problems hidden in national data sources.
• Access and barriers to care need to be the focus, rather than disease outcome data.
• Private-public partnerships are key.
• Cross-cutting issues need to be addressed at the systems level, e.g., access and quality.
• We need to build in systems accountability.
• Strategies must be community-based.
• Remember the importance of political will and the strength of coalitions.

Linda Burhansstipanov, DrPH, RN, FAAN
Director, Native American Cancer Research Program

Addressed the dire need for better data on racial and ethnic populations that are not addressed in the current data system for Healthy People.

Key messages:

• Need to over sample in national surveys, or use alternative data sources that are already collected at the local level.
• There are no data in HP on urban Indians, of which 2/3 of American Indians and Alaska Natives in the U.S. live in urban areas.
• Insufficient baseline data currently exists in many communities, making it hard to apply to grant review panels.
• No more funds are needed to collect data, we need to use the local data that already exists and use the funds for PROGRAMS.
• Grants need to be long term. These are poor communities and cannot sustain support after the pilot programs are over.
• Recommendations are as follows: support collection of accurate data in urban areas; funding for AI/AN epidemiology centers; over sampling in NHIS, NHANES; statement on poor data sources for HP2010; and federal and state mechanisms to support local and national efforts to collect accurate AI/AN data relevant to HP2010.

• Documenting disparities seems to be less important than looking at data bases that tell us something about WHY these disparities exist. This could lead to corrective action.

• We need the political will to translate what we know now into policy changes.

• Public health communities need to embrace CBOs as an integral part of the public health system.

• People are more comfortable with the "familiar", therefore we need to increase the diversity of the workforce in public health.

• African Americans experience discrimination on a daily basis; the perceived discrimination statistic is grossly underestimated.

• When you are working with the community to develop or implement a program, it generally takes longer and therefore one must increase the time line.

• Support the use of "data not available."

• "Better than the best" is ambivalent in regard to social justice. This will not prevent funding from going to a group that only needs to make a small increment in change, yet still demonstrates a need, rather than pushing the group at the very bottom.

• Even "white" is a mixture of cultures and beliefs.

• Disparities should include ALL underserved groups.

• Website needed for sharing data sources.

• Education of minorities in the health professions is needed, especially in the emergency rooms which is often the point of entry for many minorities into the health care system.

• There are no programs that provide cultural competency training to medical students.

• There is a basic problem with "trust" in sharing data with the states from the American Indian community.

• Need to measure racism in some manner because of its contribution to the problems.

• Fear is often associated with going into many of the communities which have the worst health problems due to violence, etc.

• Don’t forget the importance of faith communities.

• We need to address problems with transportation, daycare, and lack of interpreters as barriers to seeking health care.

Seattle Transcripts and Summaries