Here is some recent medical literature and news related to the causes and effects of health care inequities and disparities. Use the RSS tool on the JAAPA Web site to have this column delivered personally to you each month, and e-mail j.eddy.anderson@gmail.com to let us know of related developments or information you may come across. For regular updates on health disparities and inequity literature and news, follow us on Twitter at EquityPA.

From the Journal of Primary Prevention comes Community-Based Organizational Capacity Building as a Strategy to Reduce Racial Health Disparities, a compelling look at how community-based organizations can play effective roles in decreasing racial inequities in care. The paper asserts that racial inequities in health remain significant, despite the rallying of resources to prevent and eliminate these disparities. Authors relate the persistent disparities to what they call “distal and pervasive disparities in education, justice, social and political power, and economics.” An intervention to improve “environmental conditions” is proposed, focusing on “enhancing the capacity of community-based organizations (CBOs) to identify community health needs and implement contextually and culturally appropriate health promotion and disease prevention interventions.”

A July 2010 issue of Social Science and Medicine offers another innovative look at big-picture strategies to decrease racial and ethnic health disparities. The authors propose a revised understanding of ethnicity, offering a definition that views ethnicity as a social construct that describes a group's cultural characteristics, as well as indexing of a group's position within a social hierarchy. The paper contends that such a refinement of the concept of ethnicity could enhance efforts to decrease health disparities, noting: “As ethnicity is both increasingly complex and increasingly central to social life, improving its conceptualization and measurement is crucial for advancing research on ethnic health inequities.”

The Department of Health from the state of Washington just released Cultural Competency in Health Services and Care: A Guide for Health Care Providers. The state of Washington passed legislation in 2006 mandating “multicultural awareness education and training,” and this nicely-done guide came from that legislation. The guide's stated purpose is “to begin the essential first step towards increasing knowledge, understanding, and skills among all health care providers in Washington State to effectively provide health care in cross-cultural situations.” And who can be against that? One of the notable features of the guide is its integration of health disparities into the mix of topics, making it timely, and grounding it in the international movement to assess and address racial and other cultural health disparities.

Finally, the most recent versions of the AMA's Ending Disparities e-Letter and the Kaiser Family Foundation's Monthly Update on Health Disparities provide their usual well-done compendium of recent happenings in the area of reducing health disparities. The AMA's e-Letter looks at reducing racial disparities in sepsis; cross-cultural challenges of managing depression; changing demand for interpreters; racial and cultural differences in Alzheimer's diagnosis and care; and a summary of upcoming disparities-focused meetings. The Kaiser update includes glimpses at poverty and HIV; the role of stigma on HIV rates in the African American community; disparities in dental care; resistance to electronic health records and its impact on disparities; racial and ethnic disparities and Direct-to-Consumer-Advertising; and HIV testing rates and race/ethnicity.
Jim Anderson is a physician assistant in the Department of Neurological Surgery at Harborview Medical Center in Seattle, Washington. He is a former chair of the AAPA's Committee on Diversity and a member of the JAAPA editorial board.