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SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
Toward a Fourth Generation of Disparities Research to Achieve Health Equity
National Conference on Using Data to Promote Health Equity and Address Disparities
A Knowledge 4 Equity ConferenceSheraton Hotel
Silver Spring, MDNovember 13, 2012
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Stephen B. Thomas, PhD.Professor, Department of Health Services Administration
Director, Maryland Center for Health Equity
School of Public Health
The University of Maryland
www.healthequity.umd.edu
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SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
COE Goals: 1.To establish and sustain a community engaged research enterprise on critical health disparities;
2.To raise the visibility of racial and ethnic health disparities and promising solutions with Marylanders; and
3.To facilitate action for change in the structural determinants of health in Maryland.
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
THE OPPORTUNITY
Photo Credit: Sandra Quinn
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
AFFORDABLE CARE ACT of 2010
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
THE CHALLENGE
Photo Credit: Sandra Quinn
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
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The Social Context of Health Disparities
The ultimate aim is to uncover social, cultural and environmental factors beyond the biomedical model and address a broad range of issues. This approach includes, but not limited to, breaking the cycle of poverty, increasing access to quality health care, eliminating environmental hazards in homes and neighborhoods, and the implementation of effective prevention programs tailored to specific community needs.
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National Institute on Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH MARYLAND CENTER FOR HEALTH EQUITY
Defining Health Disparities and Health Equity
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National Institute on Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH MARYLAND CENTER FOR HEALTH EQUITY
Health Disparities and Health Equity
• According to Healthy People 2020
• In contrast, a health disparity is “…a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.”
• Health Equity is “…the attainment of the highest level of health for all people.”
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
THE FRAMEWORK
Photo Credit: Sandra Quinn
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National Institute on Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH MARYLAND CENTER FOR HEALTH EQUITY
Thomas, S. B., S. C. Quinn, et al. (2011). "Toward a Fourth Generation of Disparities Research to Achieve Health Equity." Annual Review of Public Health 32(1): 399-416.
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Infant Mortality Rates by Maternal Race/Ethnicity
Source: Centers for Disease Control and Prevention
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Disparities in Breast Cancer Incidence & Mortality
Female Breast Cancer
Incidence Rates by Race and Ethnicity, U.S., 1999–2007
Female Breast Cancer
Death Rates by Race and Ethnicity, U.S., 1999–2007
Source: Centers for Disease Control and Prevention
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National Institute on Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH MARYLAND CENTER FOR HEALTH EQUITY
AIDS Cases Among Adults and Adolescents by Race/Ethnicity
Last Modified: April 28, 2011Content Source:Divisions of HIV/AIDS PreventionNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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National Institute on Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH MARYLAND CENTER FOR HEALTH EQUITY
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Thomas, S. B., S. C. Quinn, Butler, J., Fryer, C..S., Garza, M.A. (2011). "Toward a Fourth Generation of Disparities Research to Achieve Health Equity." Annual Review of Public Health 32(1): 399-416
The Health Equity Action Research Trajectory:
A Platform for 4th Generation Disparities Research
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
INNOVATION
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2001 FEDERAL DHHS
TAKE A LOVED ONE TO THE DOCTOR DAY
4th GENERATION APPROACH:
TAKE A HEALTH PROFESSIONAL TO THE PEOPLE
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Health Advocates In-Research and Research (H.A.I.R.)Network of Black Barbershops & Beauty Salons
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National Institute on Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH MARYLAND CENTER FOR HEALTH EQUITY
DANGER AND OPPORTUNITY
Photo Credit: Sandra Quinn
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
The danger is to assume that:1. racism is not relevant in the scientific pursuit of
solutions for the elimination of health disparities;
2. that some populations will always suffer premature illness and death by virtue of their culture bound lifestyle choices; and thus,
3. that the elimination of disparities is impossible and health equity unachievable in a free market society.
Thomas, S. B., S. C. Quinn, Butler, J., Fryer, C..S., Garza, M.A. (2011). "Toward a Fourth Generation of Disparities Research to Achieve Health Equity." Annual Review of Public Health 32(1): 399-416
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
The opportunity is to recognize health disparities as an issue of justice because specific groups were subjected to systematic racial discrimination and denied the basic benefits of society, a violation of the social contract.
Boucher, David and Paul Kelly, eds. 1994.The Social Contract from Hobbes to Rawls, New York: Routledge
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
ACHIEVING HEALTH EQUITY
“…we can no longer be victims of inaction. Our role as scientists is to provide the knowledge and perspectives for effective practice and policies… We have a moral obligation in our society to do what is necessary to improve health, and the health disparities research community should be in the vanguard of that movement” (Ruffin, 2010, p. S9).
Ruffin J. 2010. The Science of Eliminating Health Disparities: Embracing a New Paradigm. American Journal of Public Health. 100:S8-S9
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National Institute of Minority Health and Health Disparities and Office of the Director, National Institutes of Health American Reinvestment and Recovery Act RC2MD004766; Principal Investigators: Sandra Quinn & Stephen Thomas
SCHOOL OF PUBLIC HEALTH CENTER FOR HEALTH EQUITY
Acknowledgement & Disclaimer The projects described are supported by Award
Numbers 7RC2MD004766 and PG60MD000207 from the National Institute on Minority Health And Health Disparities (NIMHD).
The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMHD or the National Institutes of Health.
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THANK YOU VERY MUCH !
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Stephen B. Thomas, PhD.Professor, Department of Health Services Administration
Director, Maryland Center for Health Equity
School of Public Health
The University of Maryland
www.healthequity.umd.edu