Dear SDOH colleagues,

That's the title of a press release issued on September 1 by the Society for 
Public Health Education.  Please see below.  For more information, email Carmen 
Head at [log in to unmask]

Let me also put in a plug for the current "Call for Applications" for the 
Kellogg-funded initiative, "Racial and Ethnic Health Disparities: Schools and 
Graduate Programs of Public Health Respond as Engaged Institutions", due 
October 10, 2005.  The initiative aims to advance many of the ideas and 
recommendations described below.  For more information, visit www.ccph.info

Lastly, we invite you to join the CBPR listserv today at
http://mailman1.u.washington.edu/mailman/listinfo/cbpr

Eliminating Racial and Ethnic Health Disparities Requires More Community-Based 
Research, Partnerships and Funding

Washington, DC - Eliminating racial and ethnic health disparities will
require a new and resolute commitment to population- and community-based
dissemination research and implementation, according to an invitational
summit sponsored by the Society for Public Health Education (SOPHE) on
August 8-9.

Community members must be central participants in such research, working
in collaboration with multidisciplinary researchers who represent public
health as well as non-health perspectives.  Increased and sustained
funding is also needed from public and private sources for developing
more context-based qualitative and quantitative measurement tools.  Such
tools are critical to bridging data gaps related to social context,
culture, and power in health disparities investigations, concluded some
85 invited researchers and practitioners convened for the two-day
meeting in Alexandria, Virginia.

"Data that are gathered with the community and grounded in the
community's specific needs are essential for eliminating health
disparities," said Nina Wallerstein, DrPH, of the University of New
Mexico, who has devoted her career to conducting research with Native
American and other disadvantaged populations.  "As researchers, we need
to do a better job of communicating the strength that community members
bring to disparities research and to forge closer collaboration between
research and practice."

A key objective of the summit was to identify new research needs related
to the social contexts in which people live and often contribute to
racial and ethnic health disparities. SOPHE President Collins
Airhihenbuwa, PhD, MPH, Penn State University, pointed out that, "The
current disparities focus on morbidity and mortality has overshadowed
more holistic research approaches, which can help illuminate the social
structures that increase vulnerability to disease and death."

A related problem in disparities research is that whites are typically
used as the reference population. This research approach assumes that
whites have optimum health when in fact some white populations in other
countries have better health status than whites living in the U.S.,
explained Shiriki Kumanyika, PhD, MPH, RD, of the University of
Pennsylvania and Summit keynoter.   "Focusing on disease frames the
issue in medical or health system terms, while de-emphasizing structural
variables that contribute to it," she said.  "It also puts a tremendous
burden on the health sector to solve all the health disparities problems
when there are economic, environmental, and many other contributing
factors."

In contrast, a population-based approach to disparities research
considers the community and its attributes; healthcare and
non-healthcare factors; environmental, biological and lifestyle issues;
and the cultural and political contexts.  "The disease-specific and
population-based approaches to disparities have advantages and
disadvantages from both the practical and political perspectives,"
Kumanyika noted.  "The challenge before us in bridging these domains is
how we can leverage the advantages of both sides to improve the health
of ethnic and minority populations."

Beyond the definition of health disparities, the heterogeneity among and
between members of ethnic groups, and influence of culture, Summit
conferees wrestled with other challenges of health disparities research.
According to Stanley Sue, PhD, professor emeritus at the University of
California at Davis, such studies often involve small sample sizes of
populations who may be difficult to recruit; are expensive to conduct,
particularly in an era of limited research support; often do not have
significant theory, methodologies or measures to use as baseline or
reference; and are challenged to address proximal and distal causes of
disparities.  Nonetheless, Sue concluded, "Data and information on
social and structural variables that impact health, such as housing,
crime and pollution, are critical if we will forge any progress in
eliminating health disparities."

According to Mindy Fullilove, MD, noted author and psychiatrist at
Columbia University, lessons from urban renewal and population
displacement have painfully demonstrated how social structures can
create environments that perpetuate disparities. She cited historical
examples in which lower-income populations have been forced to move when
their land is designated for economic development.  "Poor people have
been the land bank of the rich," said Fullilove, and we must work
together to prevent this structural barrier to health.

Following various Summit plenary and panel presentations, conferees
identified the following critical research questions to help eliminate
racial and ethnic health disparities:

*                   How do economics and the built environment such as
the availability of housing and sidewalks affect health, and how we can
encourage the urban design and planning of communities to eliminate
health disparities?

*                   How does power operate in different social contexts
to create and maintain disparities?

*                   What factors exist in certain populations that
protect them from major health issues; for example, what can we learn
from African American female teens who experience less drug abuse than
other teens.  How can health educators and society promote such
protective factors?

*                   How can we culturally tailor interventions to
influence access to health services?

*                   How do we engage and partner with policy makers in
diffusing relevant research?

*                   What information are consumers getting on health,
and how does this information differ by race, ethnicity, socioeconomic,
and cultural group?

*                   What is the impact of health literacy on health
status, and how can we improve message tailoring to reach different
groups?

*                   Does engagement in community-based participatory
research alter engagement in community structures, processes, and other
attributes?

*                   How can we develop more evaluation instruments that
assess dynamic, changing, and social conditions such as social event
history analysis?

*                   How can we improve the measurement of both intended
and unintended effects and outcomes in evaluation studies?

Summit participants also endorsed the need for more academic recognition
of the scholarship of engagement, community-based participatory
research, and other types of community-grounded investigation as the
basis for faculty promotion and tenure.  Curricula in public health,
medicine, and the other health professions must be strengthened in terms
of cultural competency, health literacy and health disparities, while
improved systems are needed to attract, track and monitor a diverse
student workforce.

"We need to make sure that every health professional who graduates from
our schools has the competence to provide care for all people, not
because our community is becoming more diverse ethnically and
culturally, but because it's part of quality care," said Sandra Millon
Underwood, PhD, RN, University of Wisconsin, Milwaukee.  "If we really
want to frame the solution and affect change... we've got to integrate
the content into our curriculum."

The need for translating and disseminating community-based research
outcomes to consumers, other professionals, and policymakers also was
stressed.  Researchers were encouraged to develop trusted relationships
with their elected officials and staffs by inviting them to serve on
research advisory boards; sending them issue briefs about research
findings and request that such information be circulated to other
policymakers; participating in background briefings for policymakers;
and serving as a general resource or sounding board on health
disparities policy issues.

Transcripts of the plenary presentations from the Summit are available
on the Kaiser Family Foundation website at 
http://www.kaisernetwork.org/healthcast/sophe/08aug05

As a next step, SOPHE will circulate the list of research questions for 
additional comments and input at various professional meetings.  A CD-ROM also 
will be produced for use in professional preparation programs, while the Summit 
proceedings and related commentaries will be published next
summer in complementary issues of SOPHE's journals, Health Education &
Behavior and Health Promotion Practice.

************************************************************************
Community-Campus Partnerships for Health is a nonprofit organization
that promotes health through partnerships between communities and
higher educational institutions.  Become a member today at www.ccph.info

Join CCPH for our 9th Conference, May 31-June 3, 2006 in Minneapolis, MN!
Workshop & poster proposals are due October 7, 2005.  Visit www.ccph.info
************************************************************************

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