1. Healthcare Matters: Providing Health Services to Diverse Populations Susan Barkan & Maria Carlos Susan Barkan & Maria Carlos Public Health – Seattle & King County Public Health – Seattle & King County Melanie Whitfield Melanie Whitfield People of Color Against AIDS Network People of Color Against AIDS Network Christine Achre Christine Achre Beacon Therapeutic Diagnostic and Treatment Center Beacon Therapeutic Diagnostic and Treatment Center Susan Kline Susan Kline Public Health – Seattle & King County

2. One Size Does Not Fit All Overweight? Blame Your Zip Code Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments Invisible Tribes: Urban Indians and Their Health in a Changing World

3. Health Disparities Goldberg, J., Hayes, W., and Huntley, J. "Understanding Health Disparities." Health Policy Institute of Ohio (November 2004), page 3. From http://en.wikipedia.org/wiki/Health_disparities, retrieved 2/6/08.http://en.wikipedia.org/wiki/Health_disparities Are “population-specific differences in the presence of disease, health outcomes, or access to health care.”

4. Health Disparities Affects a population group – ethnicity, race, gender, age, sexual orientation, geographic Affects a population group – ethnicity, race, gender, age, sexual orientation, geographic Inequality or Inequity Inequality or Inequity Unjust or unfair Unjust or unfair A chain of events signified by differences in: A chain of events signified by differences in: 1. Environment 2. Access to, utilization of, and quality of care 3. Health status 4. A health outcome that deserves scrutiny Carter-Pokras, OC & Baquet, C. What is a “health disparity”? Public health reports, 2002, 117:426-434.

5. Institute of Medicine Report Inequity in healthcare is the consequence of:  patient-provider interactions -stereotypes -clinical uncertainty -prejudice held by providers  the systems of care Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. 2003. http://www.nap.edu/openbook.php?record_id=10260&page=R1

6. Health is More Than Healthcare* “…social conditions are as important to our health as our genes, our behaviors, and even our medical care.” “…social conditions are as important to our health as our genes, our behaviors, and even our medical care.” “The single strongest predictor of our health is our position on the class ladder.” “The single strongest predictor of our health is our position on the class ladder.” “Racism imposes an added health burden.” “Racism imposes an added health burden.” “Chronic stress can be deadly.” “Chronic stress can be deadly.” 10 Things to Know about Health. Unnatural Causes…is inequality making us sick? www.unnaturalcauses.org/default.html

7. Eliminating Health Disparities Patient- Provider Interaction System Change Societal Change System Change Patient- Provider Interaction

8. Eliminating Health Disparities Patient- Provider Interaction System Change Societal Change

9. Eliminating Health Disparities Societal Change System Change Patient- Provider Interaction

10. Health care Matters: Providing Healthful Living Conditions Services to Diverse Populations Susan Barkan & Maria Carlos Susan Barkan & Maria Carlos Public Health – Seattle & King County Public Health – Seattle & King County Melanie Whitefield Melanie Whitefield People of Color Against AIDS Network People of Color Against AIDS Network Christine Achre Christine Achre Beacon Therapeutic Diagnostic and Treatment Center Beacon Therapeutic Diagnostic and Treatment Center Susan Kline Susan Kline Public Health – Seattle & King County

11. What can advocates do? Practice preparing for health visits with clients Know what to expect during a visit Know what to expect during a visit American Academy of Family Physicians http://familydoctor.org/online/famdocen/home.html American Academy of Pediatrics http://www.aap.org/parents.html MedlinePlus www.medlineplus.gov www.medlineplus.gov Make a list of questions Make a list of questions Practice key questions/statements – “Is this the usual care people get?” Or “I don’t have permanent housing right now so making any change would be hard.” Practice key questions/statements – “Is this the usual care people get?” Or “I don’t have permanent housing right now so making any change would be hard.” Establish care with a sole provider team – a Health Home

12. What can advocates do? Organizational Strategies Communication with patients Communication with patients Services that are available when patients are Services that are available when patients are Provider Education Provider Education Research Research Societal Strategies

13. www.unnaturalcauses.org/default.html

14. To Learn More About Health Disparities Minority Health Topics Institute of Medicine of the National Academies Minority Health Topics Institute of Medicine of the National Academies http://www.iom.edu/CMS/18007.aspx Innovation in Medical Education Video Library http://videos.med.wisc.edu/event.php?eventid=2 Innovation in Medical Education Video Library http://videos.med.wisc.edu/event.php?eventid=2 http://videos.med.wisc.edu/event.php?eventid=2 Families USA Minority Health Initiative Families USA Minority Health Initiative http://www.familiesusa.org/issues/minority-health/

15. Resources for Healthcare Providers National Health Care for the Homeless Clinicians’ Network www.nhchc.org National Health Care for the Homeless Clinicians’ Network www.nhchc.orgwww.nhchc.org Association of Clinicians for the Underserved www.clinicians.org Association of Clinicians for the Underserved www.clinicians.orgwww.clinicians.org Homeless Resource Center www.nrchmi.samhsa.gov Homeless Resource Center www.nrchmi.samhsa.gov www.nrchmi.samhsa.gov