1. Collaborations for Health: Demonstrations designed to address Health Disparities Doriane C. Miller, MD Senior Director for Quality Health Research and Educational Trust The American Hospital Association

2. Collaborations for Health: Demonstrations designed to address Health Disparities Review of governmental rationale and context Review of governmental rationale and context Publicly funded initiatives Publicly funded initiatives Privately funded initiatives Privately funded initiatives Funding strategies Funding strategies

3. Collaborations for Health: Demonstrations designed to address Health Disparities: Context-HHS Component of President Clinton’s Initiative on Race Component of President Clinton’s Initiative on Race Linked to Healthy People 2010 Linked to Healthy People 2010 Public private funding partnership Public private funding partnership HHS sets agenda HHS sets agenda

4. Collaborations for Health: Demonstrations designed to address Health Disparities: HHS Priority Areas Cancer screening and management Cancer screening and management Cardiovascular disease Cardiovascular disease Child and adult immunizations Child and adult immunizations Diabetes Diabetes HIV infection/AIDS HIV infection/AIDS Infant Mortality Infant Mortality

5. Collaborations for Health: Demonstrations designed to address Health Disparities: HHS-GIH Recommendations for Action National Priority National Priority Communicating a vision Communicating a vision Multi-factorial causes Multi-factorial causes Diversity of needs Diversity of needs Information and communication Information and communication Community driven changes Data gaps Strategic partnerships Stable and sufficient funding

6. Collaborations for Health: Demonstrations designed to address Health Disparities: Context-Institute of Medicine (IOM) 1999 Congressional request 1999 Congressional request Controlled for access/financial issues Controlled for access/financial issues Sources of disparities Sources of disparities Recommendations for interventions Recommendations for interventions

7. Collaborations for Health: Demonstrations designed to address Health Disparities: IOM Recommendations Systemic strategies Systemic strategies Cross-Cultural Education for Health Professionals Cross-Cultural Education for Health Professionals Needed research Needed research

8. Collaborations for Health: Demonstrations designed to address Health Disparities: Needed Research Processes and Structure Processes and Structure Stereotyping and Bias/Clinical Decision-Making Stereotyping and Bias/Clinical Decision-Making Patient Level Influences of Care Patient Level Influences of Care Systems Level Influences of Care Systems Level Influences of Care Non-physician health professionals Non-physician health professionals Data lacking for non African-Americans Data lacking for non African-Americans Effectiveness of intervention strategies Effectiveness of intervention strategies Contribution of healthcare to the health gap Contribution of healthcare to the health gap

9. Collaborations for Health: Demonstrations designed to address Health Disparities: Publicly Funded Initiatives HHS Awards 11/02: $85 million, $10.5 for community and state initiatives HHS Awards 11/02: $85 million, $10.5 for community and state initiatives CDC: REACH 2010 CDC: REACH 2010 AHRQ: EXCEED AHRQ: EXCEED HRSA/BPHC: Health Disparities Collaboratives HRSA/BPHC: Health Disparities Collaboratives

10. Collaborations for Health: Demonstrations designed to address Health Disparities: Private Funder Strategies Public education Public education Insurance coverage Insurance coverage Access and quality Access and quality Nonprofit hospitals/community benefit Nonprofit hospitals/community benefit Data Collection Data Collection Minority health professions education Minorities in clinical trials Non-traditional partners Technical assistance Corporate partnership

11. Collaborations for Health: Demonstrations designed to address Health Disparities: Privately Funded Initiatives The Commonwealth Fund The Commonwealth Fund W.K. Kellogg Foundation W.K. Kellogg Foundation Kaiser Family Foundation Kaiser Family Foundation

12. Collaborations for Health: Demonstrations designed to address Health Disparities: Funding Partnerships The Robert Wood Johnson Foundation’s Local Initiative Funding Partners The Robert Wood Johnson Foundation’s Local Initiative Funding Partners

13. Collaborations for Health: Demonstrations designed to address Health Disparities: University/Community Linkage Rochester Childcare Telehealth Access Network Rochester Childcare Telehealth Access Network

14. Collaborations for Health: Demonstrations designed to address Health Disparities: Regional Funding Partners New York Regional Association of Grantmakers (NYC) New York Regional Association of Grantmakers (NYC) Rochester Grantmakers Forum Rochester Grantmakers Forum Western New York Grantmakers Association (Buffalo) Western New York Grantmakers Association (Buffalo) Give Tompkins (Ithaca) Give Tompkins (Ithaca) Grantmakers Alliance for Northeastern New York (Albany) Grantmakers Alliance for Northeastern New York (Albany)

15. Collaborations for Health: Demonstrations designed to address Health Disparities: Conclusion Alignment with Federal/State Initiatives Alignment with Federal/State Initiatives Funding Priorities of National and Local Philanthropies Funding Priorities of National and Local Philanthropies Seek Regional Partners Seek Regional Partners