There is much that is unknown about the determinants of health disparities
such as why some individuals are more adversely affected and why some
people with fewer resources fare better in some health conditions than
the population as a whole. Projects need to be undertaken to gain knowledge
and understanding of the impacts and determinants of health disparities.
These issues need to be jointly explored together by the residents
of neighborhoods most affected by health disparities, policy makers,
funders, and service providers to understand how the synergistic effects
of biological, cultural, socio-economic, racism, and political factors
influence health outcomes.
As cited in the Centers for Disease Control and Prevention Performance
Plan XV: Eliminating Racial and Ethnic Disparities, the health
status areas targeted are infant mortality, cancer screening and
management, cardiovascular disease, diabetes, HIV infection/AIDS,
and child and adult immunizations. In addition the Surgeon General
of the United States has produced two new specific reports that emphasize
issues related to mental health, substance abuse, and a call to action
to address suicides.
Eliminating racial and ethnic disparities in health will require new
knowledge about causes of health disparities, enhanced efforts at preventing
disease, innovative methods of promoting health and delivering culturally
competent and linguistically specific preventive and clinical services.
Research dedicated to a better understanding of the relationships
between health status and different racial and ethnic minority backgrounds
will help us acquire new insights into eliminating the disparities
and developing new ways to apply our existing knowledge toward this
goal. This initiative will require working more closely with providers
to deliver preventive and clinical services and with the community,
to identify needs, and to plan and conduct research.
Citizenry should be empowered to develop programs to promote healthy
lifestyles. Collaborations between local merchants, civic organizations,
and service providers need to work together to build opportunities
for health behavior changes.
The Austin/Travis County Health and Human Services Department proposes
a model for reducing health disparities which will utilize the services
and maximize the resources of private and public clinics, community-based
organizations, and the CAN partners for wellness and prevention services.
This model incorporates two tracks to providing prevention and wellness
services to targeted neighborhoods where health disparities are most
prevalent. The components of this model includes the implementation
of:
- Community-based education and screening services; and
- Community-based prevention and outreach services.
The Community-based education and screening services would be incorporated
into services provided at six neighborhood centers. These centers are
located in sections of the community where health disparities are the
most prevalent. These services would complement, not compete with,
the primary care system. Services would focus on preventing disease
and illness by providing:
- Early screening services for both chronic and communicable diseases;
- Health education classes and one-on-one counseling to improve
healthy behaviors;
- Disease case management;
- Violence and injury prevention counseling and education;
- Women's health services; and
- Environmental health services.
Linkages and enrollment to other health partners' services would also
be streamlined to improve access. The centers would act as a hub for
a community outreach team to interact with the local neighborhood to
gain understanding and help eliminate barriers to wellness and prevention
services. The centers would serve as the main source of information
and connection to health and human services for individuals living
in neighborhoods where economic and infrastructure services are not
equal to the greater community at large.
To fully implement this model a minimum staffing for each center would
include:
- A Site Manager;
- A Community Liaison (Health Educator);
- Three Community Outreach Workers;
- A Social Worker; and
- A Public Health Nurse
Where possible individuals from the targeted neighborhoods would be
recruited to work at the Community-based centers.
The Community-based prevention and outreach services would reach out
to neighborhoods not in close proximity to a community center, which
are primarily rural areas. The services would be similar to those of
the community-based centers and would require similar staffing. This
outreach service would employ the utilization of a mobile health van
currently in use. Using the community centers as staging areas, the
unit also would rotate among the centers to supplement their services.
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