While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically. The articles in this issue of the Journal of General Internal Medicine, organized by researchers at Finding Answers: Disparities Research for Change, offers organizations a new "roadmap" based on wisdom gained over seven years of grantmaking, reviewing literature, and providing technical assistance to organizations working to reduce health disparities.
"A Roadmap and Best Practices for Organizations to Reduce Racial and Ethnic Disparities in Health Care" is accompanied by five systematic reviews of disparities interventions in HIV, colorectal cancer, cervical cancer, prostate cancer and asthma. The roadmap's architects hope it will provide direction for effective and sustainable interventions as the health disparities field shifts from measuring the problem to taking action. The lead paper highlights the need for recognizing disparities and committing to their reduction, and suggests that programs to reduce disparities should be integrated into broader quality improvement efforts at clinics, hospitals, and other health systems.
Across the five systematic reviews, effective disparities interventions were found to utilize team care, patient navigation, cultural tailoring, collaboration with non-health care partners, such as families or community members, and interactive skill-based training. The reviews also identified potential targets for reducing health disparities that have not yet been examined. For example, the majority of interventions targeted patient knowledge and behavior, rather than looking at other components of the health care system.
While offering general guidelines for best practices, the authors point out that the specifics of any effort to reduce disparities must be custom-fit to the patient population and community that an organization seeks to help. The roadmap also emphasizes the importance of continually evaluating whether a particular intervention is working, making adjustments as needed, and considering the financial sustainability of efforts to reduce disparities.
Finding Answers: Disparities Research for Change is a national program of the Robert Wood Johnson Foundation's portfolio of initiatives to reduce racial and ethnic disparities in health care.