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Workshops
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Workshop
A-4: Addressing racism and discrimination in health care
While researchers and health activists acknowledge that race plays a
role in both the creation of and elimination of disparities, the role
of race, racism and racial discrimination in health is not central to
the debate about how to measure disparities or how to address them. In
this workshop, three speakers will explore the role of community, researchers
and policymakers in addressing racial disparities in health. The panel
will focus on (1) the legal challenges to confronting racial discrimination
in health and care, (2) the importance of measuring the relevant variables
to capture the effects of racism and discrimination in health research,
and (3) the role of communities in setting the legislative/policy agenda
to address the seemingly intractable issues of race, racial discrimination
and racism as they relate to health.
Discussant
Humberto Brown, is the Director of Health Disparity Initiatives
and New Constituency Development for the Arthur Ashe Institute for Urban
Health (AAIUH). He is a loaned executive to the AAIUH from SUNY Downstate
Medical Center. Mr. Brown directs the AAIUH’s seminar series on health
disparities and is a member of the research team for AAIUH’s National
Cancer Institute funded research study, Prostate Cancer Control with
Community Barbers. He conducts focus groups with and trains African
American and Caribbean barbers on a variety of issues to support them
as prostate health advocates in their shops. Mr. Brown is part of the
leadership team for the Community Partnership to Increase Diversity
in the Health Care Professions, a 40 member coalition committed to
offering a community grounded voice to this issue in New York City. He
is also part of a collaborative team from SUNY Downstate, AAIUH and the
Brooklyn Borough President’s Office that is developing Brooklyn’s
Center for Health Care Disparities.
Humberto
R. Brown
Director, New Constituency Development/Health Disparities Initiatives
SUNY Downstate Medical Center
Arthur Ashe Institute for Urban Health
483 Hudson Avenue
Brooklyn, New York
718-222-5953 phone
718-222-4462 fax
hbrown@downstate.edu
http://downstate.edu
http://www.arthurasheinstitute.org
Measuring Race/Ethnicity, Racism,
Discrimination and Socioeconomic Position in Health Research
There has also been a lot of discussion about the inadequacy of measures
of socioeconomic status and the need to take other variables into account,
such as the impact of racism and discrimination on health, as well as
behavioral risk factors. . The failure to explain racial and ethnic differentials
in health outcomes has prompted research efforts to capture racism and
discrimination as explanatory variables. The focus of this presentation
will be on measurement of race and racism in public health research. Dr.
Carter-Pokras argues that the collection of data on race is necessary
in public health research in order to monitor trends over time at national,
state and local (growing socioeconomic inequality & worsening health
with acculturation among Hispanics); to evaluate programs; to understand
etiologic process and identify points of intervention; and, to monitor
and enforce the Civil Rights Act. According to Dr. Carter-Pokras “…measurable
gains in advancing a civil rights agenda to bring all Americans into the
economic, political & social mainstream would have been extremely
difficult, if not impossible if we did not have adequate information on
racial and ethnic groups.” She will discuss innovative measurements
and promising research directions.
In addition to learning about innovations in measuring racism and discrimination
in health research, participants will have gain a better understanding
of how to best use such research to improve the health of the community,"
Dr. Carter-Pokras says. "Research should be conducted in a way that
allows community leaders to work with decision-makers to develop and target
the programs that were researched”
Dr. Olivia
Carter-Pokras is an Associate Professor in the Department of
Epidemiology and Preventive Medicine at the University of Maryland School
Of Medicine. Prior to joining the faculty at the University of Maryland,
Dr. Carter-Pokras was the Director of the Division of Policy and Data
at the Office of Minority Health in the Department of Health and Human
Services. Dr. Carter-Pokras teaches Health Survey Research Methods and
is currently conducting health assessments of Latinos in Baltimore and
Montgomery County in close partnership with local government and community
based organizations. Her numerous publications and presentations center
around health disparities, racial and ethnic data, Latino health, children’
environmental health. A second-generation Bolivian, Dr. Carter-Pokras
applies her research training and expertise, and knowledge of health policy,
to work with community and government officials to improve access to care
and eliminate health disparities.
Olivia
Carter-Pokras, Ph.D
Associate Professor
Division of Gender-Based Epidemiology
University of Maryland
Room 219, Howard Hall
660 West Redwood Street
Baltimore, Maryland 21201
Phone: (410) 706-0463
Fax: (410) 706-4433
opokras@epi.umaryland.edu
A Community Legislative Agenda to Address Racial Disparities in Health
This presentation will focus on the development and implementation of
a legislative agenda to address racial and ethnic disparities in health
. Specifically offered will be a discussion on “how to network with
and educate state and federal health officials on the value of cultural
competence in addressing racial and ethnic health disparities” as
well as “how to build community coalitions with providers, interpreters,
and ethnic communities to address access, quality, and workforce issues
all of which influence racial disparities in health”.
Bronx Health REACH was developed in 1999 by the Institute for Urban Family
Health, in collaboration with the Center for Health and Public Services
Research of New York University, and three community-based organizations.
Since its inception, the Coalition has grown to include over 30 member
organizations, including community based organizations, faith-based organizations,
and health care providers. Bronx Health REACH receives funding from the
U.S. Centers for Disease Control and Prevention and the New York State
Department of Health.
The Coalition’s goal is to eliminate racial and ethnic disparities
in health outcomes in the Southwest Bronx, where 95% of the population
is black or Latino, and the rates of diabetes and heart diseases, as well
as the rates of poor outcomes such as blindness and amputations are exceptionally
high. In pursuit of this goal, Bronx Health REACH has implemented a variety
of initiatives, such as a faith-based outreach initiative, a community
health advocacy program, a nutrition and fitness initiative, a public
health education campaign, and a legal and regulatory campaign.
In addition to developing and implementing model community programs,
Bronx Health REACH has developed a statewide policy agenda to mobilize
community leadership to educate leaders in government. With such a broad-based
approach, Bronx Health REACH serves as a model for communities to address
health disparities that exist throughout the state and country. In response
to the dire situation that underrepresented minorities face when dealing
with the health care system, REACH has positioned itself to affect change
system-wide. REACH’s statewide advocacy agenda includes the seven
issues which we believe are imperative to the elimination of racial and
ethnic disparities in health outcomes.
With its slogan “Make Health Equality a Reality”, REACH is calling
for a seven step legislative agenda.
Bronx Health REACH has achieved the development of a successful, diverse,
and growing coalition that addresses issues in health care, prevention,
and the underlying causes of disparities in health outcomes; and increased
community awareness and knowledge of diabetes prevention, care and self
management through such interventions as the faith-based outreach initiative
and the community health advocacy program.
Maxine
Golub, Senior Vice President for Planning and Development,
provides leadership to the Institute’s development activities, and
serves as liaison to community-based and funding partners. Ms. Golub was
instrumental in developing the Bronx Health REACH program, funded by the
US Centers for Disease Control, to address racial disparities in health
outcomes in diabetes in the Southwest Bronx. She also serves as the Project
Director for the Metropolitan Region of the New
York State Area Health Education System, designed to increase diversity
in the healthcare workforce.
Ms. Golub has worked in the community health for more than 20 years, developing
health outreach, primary care, and training programs, striving to address
the challenges faced by community residents and health care providers
within the complex urban health care system. In 2003, Ms. Golub received
the Rosemarie Forstner Award from the Community Health Center Association
of New York State for her outstanding dedication to making health care
more accessible to the medically underserved.
Maxine
L. Golub, M.P.H.
Senior Vice President for Planning and Development
Institute for Urban Family Health
16 East 16th Street
New York, NY 10003
Phone: (212) 633-0800 ext. 291
Fax: (212) 989-2840
mgolub@institute2000.org
The Civil Rights Dimension of Racial
and Ethnic Disparities in Health Status
It is hard to talk about race. Discussions about race in general and
racial discrimination in particular are potentially unnerving, which perhaps
explains why such conversations are so few and far between.
This presentation will focus on the role of race and racial discrimination
in explaining disparities in health. Mr. Perez will discuss the elimination
of disparities as both a public health and civil rights challenge. His
presentation will explore the legal issues involved in addressing the
role of race and racial discrimination in creating disparities and offer
solutions for addressing these factors.
Any effort to eliminate disparities must look first at the root causes.
Mr. Perez acknowledges that some of these causes–economics, geography,
genetic predispositions, lifestyle, education–are frequently cited
as reasons why "communities of color are behind the curve in terms
of a number of health indicators." In this presentation he will discuss
the issue of racial discrimination as a factor in understanding and addressing
racial disparities in health. Participants will learn about the challenges
of and opportunities for employing legal approaches to address racial
disparities in health.
This presentation focuses on the role of discrimination in explaining
racial and ethnic disparities in health status, inequities in access to
health care for minorities, and the often separate and unequal treatment
afforded minorities in the health care system. Professor Perez is a civil
rights lawyer whose teaching, scholarship and public service focuses on
the intersection of health care and civil rights. This provocative presentation
will address the role that racial discrimination plays in explaining racial
and ethnic disparities, and outline a series of solutions that can address
this important dimension of the challenge.
Tom Perez
was elected to the Montgomery County Council on November 5, 2002, Perez
serves on the Council's Transportation and Environment Committee, where
he is lead Councilmember on the Environment, and on the Health and Human
Services Committee. He comes to the Council from a distinguished career
in public service, both in the federal government and in the community.
A first generation Dominican American, Perez began his career as an entry-level
attorney in the United States Department of Justice's Civil Rights Division
and rose through the ranks to become Deputy Assistant Attorney General
for Civil Rights. During the last two years of the Clinton administration,
Perez was Director of the Office of Civil Rights at the Department of
Health and Human Services under Secretary Donna Shalala, leading a 225-person
agency with a $28 million budget. After resigning his position with the
change in administration, Perez became an Assistant Professor of Law and
Director of the Clinical Law programs at the University of Maryland School
of Law.
Tom Perez
Councilmember
Montgomery County Council
100 Maryland Ave, 6th Floor
Rockville, MD 20850
(240) 777-7966
Councilmember.Perez@montgomerycountymd.gov
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