The community health advisor program and the deep South network for cancer control: health promotion programs for volunteer community health advisors

The Community Health Advisor program is a proven, community-driven health promotion program that identifies and trains natural helpers who then seek to improve the health of individuals and their communities. This article details the basis of the Community Health Advisor model and describes early pilot programs in the Mississippi Delta. Also described is the formation of the Community Health Advisor Network, which provides technical assistance to Community Health Advisor programs and the proliferation of Community Health Advisor programs nationally. Specifically, details are presented of the modification of the model for the Deep South Network for Cancer Control and of early findings showing a decrease in health disparities in Alabama.     

The public health approach to eliminating disparities in health

Reducing and eliminating disparities in health is a matter of life and death. Each year in the United States, thousands of individuals die unnecessarily from easily preventable diseases and conditions. It is critical that we approach this problem from a broad public health perspective, attacking all of the determinants of health: access to care, behavior, social and physical environments, and overriding policies of universal access to care, physical education in schools, and restricted exposure to toxic substances. We describe the historical background for recognizing and addressing disparities in health, various factors that contribute to disparities, how the public health approach addresses such challenges, and two successful programs that apply the public health approach to reducing disparities in health. Public health leaders must advocate for public health solutions to eliminate disparities in health.     

Environmental justice research and action: a case study in political economy and community-academic collaboration

Community-university partnerships increasingly are being created to study and address environmental injustices. This article describes a case study of one such effort and its contributions to a decade-long community struggle to curb the growth of industrial hog operations and their adverse health effects in the United States' rural south. Worldwide transformation of livestock production from family farms to large-scale industrial agricultural complexes has resulted in the degradation of local environments, with negative impacts on public health. In the rural south, the concentration of industrial livestock operations has been most pronounced in low income African-American communities. Using political economy and community-based participatory research (CBPR) as a conceptual framework, this article explores the partnership between a strong community-based organization, Concerned Citizens of Tillery, and researchers at the University of North Carolina, Chapel Hill, School of Public Health to study and address this problem. The political, economic, and historical context of the partnership is examined, as are the challenges faced, and the partnership's contributions to maintaining grassroots community organizing and activism and affecting local policy change. Implications for other CBPR partnerships are discussed.     

The role of the federal government in eliminating health disparities

Minorities live sicker and die sooner from too many acute and chronic illnesses. To eliminate racial and ethnic disparities in health, Congress and the Bush administration must address the serious challenge of increasing minorities' access to health care and improving the quality of care they receive. We clearly need to expand Medicaid and the State Children's Health Insurance Program (SCHIP), but we must also develop and train culturally competent providers, increase the diversity of the health care workforce, collect better race/ethnicity health data, and make a greater investment in public health.     

The inaugural SOPHE summit on eliminating racial and ethnic health disparities

As we break the 20-year mark for the release of the 1985 Secretary's Task Force Report on Black and Minority Health by the Department of Health and Human Services, the disparity gap measured by excess death has widened. Although we continue to recognize the importance of setting disparity goals based on excess death reduction, we believe there is a greater need to focus on the social contexts that create vulnerability to disease from which minorities die in disproportionate numbers. This theme issue focuses on articles written mostly by scholars who were invited to participate at the Society for Public Health Education (SOPHE) inaugural summit to develop a transdisciplinary research agenda on eliminating racial and ethnic health disparities.     

重庆市2010年城乡居民期望寿命及减寿情况分析

目的分析上海市闵行区颛桥镇2014-2016年恶性肿瘤发病与死亡状况,为制定恶性肿瘤防治策略提供依据。方法收集颛桥镇2014-2016年恶性肿瘤发病与死亡数据,运用Excel软件进行整理分析。结果颛桥镇辖区户籍人口2014-2016年登记报告恶性肿瘤新发病例共1 139例,恶性肿瘤登记报告的粗发病率为423.85/10万,标化发病率为273.21/10万;恶性肿瘤死亡病例582例,恶性肿瘤登记报告的死亡率为216.58/10万,标化死亡率为87.95/10万。恶性肿瘤发病数居前5位的为肺癌、甲状腺癌、胃癌、乳腺癌、结肠癌;恶性肿瘤死亡前5位为肺癌、胃癌、肝癌、胰腺癌、结肠癌。结论肺癌和消化系统癌症是威胁颛桥镇居民健康的主要恶性肿瘤,是今后恶性肿瘤防控的重点,40岁以上者为重点防控人群,同时应做好甲状腺癌的防控工作。     

Women's priorities for lay health home visitors: implications for eliminating health disparities among underserved women

While racial, ethnic, and socioeconomic health disparities in maternal and child health persist among women, few studies describe experiences of low-income women during pregnancy. We undertook a qualitative study of women's self-reported experiences with home visitors to gain understanding of priorities for participation and service delivery. Lay health home visitors provided satisfactory services and maintained close relationships with their clients. The mother-to-mother relationship is critical in facilitating continued participation in and ensuring positive health and social outcomes from lay health home visitation services. Many women lacked sufficient social support during their pregnancy and received this from the health visitor. Appropriate integration of lay health visitors with traditional prenatal care may alleviate many of the deleterious stressors that low-income women experience and may ultimately impact racial, ethnic, and socioeconomic disparities in maternal and child health.     

The cancer prevention and control research network

The Cancer Prevention and Control Research Network is a national network recently established to focus on developing new interventions and disseminating and translating proven interventions into practice to reduce cancer burden and disparities, especially among minority and medically underserved populations. Jointly funded by the Centers for Disease Control and Prevention and the National Cancer Institute, the Cancer Prevention and Control Research Network consists of sites administered through Prevention Research Centers funded by the Centers for Disease Control and Prevention. The five sites are located in Kentucky, Massachusetts, South Carolina, Texas, Washington State, and West Virginia. The Cancer Prevention and Control Research Network's intervention areas include primary prevention of cancer through healthy eating, physical activity, sun avoidance, tobacco control, and early detection of cancer through screening. The Cancer Prevention and Control Research Network uses the methods of community-based participatory research and seeks to build on the cancer-relevant systematic reviews of the Guide to Community Preventive Services. Initial foci for the Cancer Prevention and Control Research Network's research work groups include projects to increase screening for breast, cervical, and colorectal cancers; to promote informed decision making for prostate cancer screening; and to validate educational materials developed for low-literacy populations.     

The organizational huddle process--optimum results through collaboration

The St. Joseph's Regional Medical Center in Paterson, New Jersey, initiated a methodology called The Organizational Huddle Process in the fall of 1999. This communication vehicle enhances operational performance through a fast, focused, and highly collaborative process. The results of this initiative have been most impressive. Hundreds of problems have been resolved before escalating to crisis levels, with an increase in stakeholder satisfaction. This process is appropriate for all levels within an organization, is effective for both interdisciplinary and departmental groups, and has minimal associated implementation costs. This article reviews the rationale and benefits of The Organizational Huddle Process, a recommended implementation strategy, and a nurse manager's review on the application of this methodology.     

An overview: eliminating racial, ethnic, and SES disparities in health care

The papers featured in this issue of the Health Care Financing Review were presented at "Eliminating Racial, Ethnic, and SES Disparities in Health Care: A Research Agenda for the New Millennium." This conference was held on October 15, 1999, in the Washington, DC., area and was co-sponsored by the Health Care Financing Administration (HCFA), the Agency for Healthcare Research and Quality (AHRQ) (formerly the Agency for Health Care Policy and Research), and the Henry J. Kaiser Family Foundation. The conference was undertaken in response to the challenge posed by President Clinton's national goal of eliminating racial and ethnic disparities in six health domains by the year 2010.     

High-quality health care: the essential route to eliminating disparities and achieving health equity

In the past decade and a half, the United States has witnessed major advances in the recognition and reporting of health and health care disparities. Now is the time to move beyond describing these disparities to actually eliminating them. Because of the interlocking nature of disparities in health, disparities in health care, and the role of social determinants, there is a need to focus our efforts on one primary goal: achieving health equity by securing access for the entire population to the highest possible quality of health care. Access to high-quality care for populations of color can have the same impact as it has for majority populations: improving population health, improving patients' experiences of care, and reducing health care costs.