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Closing the Gap: Solutions to Race-Based Health Disparities, 2005

10 Key Recommendations for Addressing Racial and Ethnic Disparities in Health.
From Closing the Gap: Solutions to Race-Based Health Disparities

1. Eliminate disparities in access to health insurance.
Expand public health programs such as Medicaid and work toward a universal health care system guaranteeing basic access.

2. Improve health care in medically underserved areas, which are often communities of color.
Support community health clinics that provide high-quality care to underinsured and uninsured patients.

3. Develop health care institutions that are welcoming and respectful to people of differentraces and ethnicities.
Improve access to quality care for people of color by minimizing financial barriers to patient/doctor communication, training staff in culturally appropriate care, and building a diverse workforce.

4. Track racial disparities in health care provision.
With proper data collection, health care institutions can be held accountable for eliminating these disparities and meeting high quality-of care standards for all patients.

5. Provide medical interpretation services for all clinical encounters.
Federal, state, and local governments, as well as insurers and health care providers, should fund language services as a medical necessity.

6. Improve access to traditional and non-Western treatments.
Insurers should be required to cover alternative and culturally appropriate health care. Health care providers should be provided training and access to research about alternative and non-Western medical practices.

7. Adopt and enforce policies that promote safety and health.
The adoption of worker protections and environmental standards are necessary to address root causes of health inequality.

8. Include public health experts and community organizations in community development and planning processes.
Health concerns must be at the forefront in discussions about housing, transportation, and economic development.

9. Provide funding and support for improved nutrition, physical education, and health education in schools.
School environments that emphasize health can lead to improved health outcomes and higher academic achievement.

10. Support programs that incorporate cultural traditions.
Connecting people to their cultural heritage can be an effective way to improve individual and community health.

The report documents the persistent problems experienced by communities of color attempting to access health care services across the nation. With a review of the latest research on health disparities, in-depth field research and comprehensive case studies, Closing the Gap reinvigorates the debate over what may be the nation's greatest public health challenge—the persistent racial divide in access to comprehensive, quality health services.

"The health care system as a whole provides vastly unequal access and treatment based on race, language, and ethnicity. Racism within the health system is literally making people of color sick," noted Will Pittz, organizer at the Northwest Federation of Community Organizations and lead author of the report. "The report's case studies articulate real solutions to the difficult problem of race-based health inequality. From an edible garden in Berkeley, to city-wide reform of the public health system in Washington, D.C., Closing the Gap highlights successes at the critical intersection of racial justice and health policy."

Closing the Gap describes the institutional and structural barriers that block access to quality care for people of color. Disputing the claims that racial disparities in health are based in biology or entirely attributable to socioeconomic status, "Closing the Gap" reveals that race and socioeconomic status together shape the obstacles individuals face as they seek quality health care.

Its key recommendations include:

Eliminating disparities in access to health insurance;
Developing health care institutions that are welcoming and respectful to people of different races and ethnicities;
Tracking racial disparities in health care provision;
Providing medical interpretation services for all clinical encounters;
And improving access to traditional and non-Western treatments.
Closing the Gap also features case studies gathered from across the nation:
Building a System of Accessible, Welcoming, High Quality Care : The Southcentral Foundation, Anchorage, Alaska
Providing Language Access for All : Bellevue Hospital, New York City
Expanding Health Coverage : D.C. Healthy Families, Washington, D.C.
Improving Diet and Exercise : Tohono O'odham Community Action, Sells, Arizona
Improving School Nutrition : The Edible Schoolyard, Berkeley, California
Addressing Community Problems From a Health Perspective : St. Thomas Health Services, New Orleans, LA

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