Intersecting at the Crossroads of Health, Race, Ethnicity, and Disability: A Review of the National Health Disparities Conference

On April 25^th and 26^th, 2013 researchers and advocates in the field of health disparities related to disability, racial and ethnic groups came together in Washington, D.C. for the Health Disparities Research at the Intersection of Race, Ethnicity, and Disability National Conference to focus on and discuss the current and future health and healthcare needs of people with disabilities in underserved racial and ethnic groups.

Day one of the conference focused on current and future research in the field of health disparities research for individuals with disabilities within classically underserved racial and ethnic populations. The morning session featured of a panel discussing personal experiences of accessing healthcare by adults with disabilities from diverse racial and ethnic groups—many of which astounded and alarmed the audience. The panel was followed by two research presentations and panels:  Findings from Project Intersect and Approaches to Addressing Disparities.  The afternoon was comprised of the following concurrent sessions:

• Health Provider Knowledge, Attitudes, and Competence
• Care Coordination and Navigating the Health Care System
• Health Education and Health Promotion for Individuals with Disabilities
• Community Engagement and Empowerment Strategies
• Building Bridges:  Including Disability in the Health Disparities Agenda

Each break-out session included a brief presentation on research and interventions to reduce health disparities and/or to improve health outcomes.  Specifically, the Health Education and Health Promotion for Individuals with Disabilities session included two presentations on specific health promotion activities within Deaf and Latino populations:  Angela Weaver, MEd from the Oregon Office on Disability and Health (OODH) presented “Healthy Lifestyles for Latino Adults with Disabilities” a free health and wellness workshop program that promotes a holistic approach to health, self-determination, and self-efficacy, which is both culturally and linguistically appropriate to meet the needs of the Spanish-speaking participants.  Barbara Berman, PhD with the Department of Health Policy and Management at the UCLA Fielding School of Public Health presented “Community-Academic Partnered Cancer Prevention and Control Research among the Racially and Ethnically Diverse Deaf Population.”  Dr. Berman discussed a fifteen-year community-academic partnered program addressing two health topics:  tobacco use prevention among high risk adolescents and young adults, low-income multi-ethnic populations, and deaf and hard of hearing youth; and breast cancer prevention program for women who are Deaf or hard of hearing ages 40 and over.  The individual sessions initiated discussion on agenda setting (followed by an overall group discussion) and the formulation of several questions/comments to be addressed the following day by a group of guest panelists from the research and funding community.

Day two of the conference began with a keynote address and presentation by Camara Jones, MD, PhD, MPH, researcher at Social Determinants of Health and Equity in the Epidemiology and Analysis Program Office at the Centers for Disease Control and Prevention, and a family physician and epidemiologist whose work focuses on the impacts of racism on the health and well-being of the nation.  Dr. Jones presentation, “Parallel Intersections:  Braiding the Strains” illustrated the levels of health intervention using a model of a cliff, where the areas of health intervention can go awry, and where health disparities can arise.  Creating a three dimensional cliff, Dr. Jones illustrated how differences in quality of care and how that care is received, the differences in access to health care (including prevention and curative care), and differences in life opportunities, exposures, stressors can ultimately result in health disparities across the three dimensions of health interventions such as health services, social determinants of health, and social determinants of equity. Dr. Jones went on to define racism and list the level of racism in society while tying racism to overall health equity.  She asserted that the best approach to ensure health quality is by valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need. Only after health equity is achieved will health disparities be eliminated for all groups of individuals no matter race, ethnicity, ability, disability, gender, or sexual preference.

Dr. Jones was followed by the discussion panel “Federal Perspectives on Advancing Health Equity Research” moderated by Margaret Campbell, PhD, Senior Scientist for Planning and Evaluation at National Institute on Disability and Rehabilitation Research.  Panelists included:

• Charlie Lakin, PhD, Director, National Institute on Disability and Rehabilitation Research
• Gloria Krahn, PhD, MPH, Director, CDC Division of Human Development and Disability
• Dr. Ernest Moy, MPH, Medical Officer, Agency for Healthcare Research and Quality
• Ana Penman-Aguilar, PhD, MPH, Associate Director of Science, CDC Office of Minority Health and Health Equity
• Dr. Nathaniel Stinson, PhD, MPH, Director, Division of Scientific Programs, National Institute on Minority Health and Health Disparities

Panelists addressed questions formulated the first day of the conference as well as questions from the audience.  Attendees were interested in how to best present their research proposals for funding and how to optimize funding during a period where government budgets are being reduced and programs eliminated.

Presentation slides should be available within the next few weeks at the conference website.