Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Reducing disparities downstream: prospects and challenges.

Peter Franks1, Kevin Fiscella

  • 1Center for Healthcare Policy and Research, Department of Family and Community Medicine, University of California at Davis, Sacramento, CA, USA. pfranks@ucdavis.edu

Journal of General Internal Medicine
|January 25, 2008
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The Role of Behavioral Friction for Patients and Clinicians in a Text-Based Home Blood Pressure Monitoring Program: A Realist Evaluation.

Research square·2026
Same author

Effects of pica practice on oral bacteriome and mycobiome profiles among pregnant women: A comparative study.

PloS one·2026
Same author

The Role of Trust in Text Messaging for Promoting Patient Portal Activation Among Low-Income Patients: Quality Improvement Project.

JMIR formative research·2026
Same author

Translating the ABCSs into HIV Care: A Stepped Wedge Cluster Randomized Clinical Trial.

Journal of general internal medicine·2026
Same author

Cariogenic microorganisms induce oral epithelial atypia through host-microbiome-high sugar diet interactions.

NPJ biofilms and microbiomes·2026
Same author

Surveying Correctional Health Staff on Medication for Opioid Use Disorder Diversion: Barriers and Mitigation Strategies.

Journal of correctional health care : the official journal of the National Commission on Correctional Health Care·2026
Same journal

Impact of Health Insurance Coverage on Diabetes Care Quality: A Systematic Review and Meta-analysis of Racial, Ethnic, and Gender Disparities in U.S. Adults with Type 2 Diabetes.

Journal of general internal medicine·2026
Same journal

Assessment of Physician Advocacy Engagement: A Scoping Review and Proposal of an Assessment Tool.

Journal of general internal medicine·2026
Same journal

Relative Burden of Social Determinants of Health on Diverse Populations of Health Resources and Services Administration Health Centers.

Journal of general internal medicine·2026
Same journal

Addressing Moral Distress Among Gender-Affirming Healthcare Professionals.

Journal of general internal medicine·2026
Same journal

Trainee-Led Patient Education to Increase Advance Care Planning in a Geriatric Primary Care Clinic.

Journal of general internal medicine·2026
Same journal

Scholarly Outcomes of a Small Projects Grant Program.

Journal of general internal medicine·2026
See all related articles

Reducing healthcare disparities requires addressing root causes and implementing downstream interventions. This framework defines disparities and proposes interventions within health systems to improve equitable outcomes.

Area of Science:

  • Health Services Research
  • Public Health
  • Health Equity Studies

Background:

  • Healthcare disparities stem from fundamental causes like poverty and unequal access to education and healthcare.
  • While addressing root causes is crucial, downstream interventions targeting health system consequences are also necessary.
  • Existing health systems require adaptation to effectively reduce disparities.

Purpose of the Study:

  • To define healthcare disparities and establish a framework for downstream interventions.
  • To propose that healthcare is a social good and outcome disparities indicate quality issues.
  • To adapt the chronic care model for a hierarchical intervention approach.

Main Methods:

  • Defining healthcare disparities and key principles for intervention.

Related Experiment Videos

  • Adapting the chronic care model to a three-domain intervention hierarchy: health system, provider-patient interactions, and clinical decision-making.
  • Analyzing challenges in implementing downstream changes within healthcare systems.

    • Main Results:

    • A framework is presented for addressing healthcare disparities through downstream interventions.
    • The chronic care model is adapted to guide interventions across multiple levels of the health system.
    • Identified key domains for intervention: health system, provider-patient interactions, and clinical decision making.

    Conclusions:

    • A dual approach of addressing fundamental causes and implementing downstream interventions is essential for reducing healthcare disparities.
    • Viewing healthcare as a social good and disparities as quality problems provides a foundation for change.
    • Implementing interventions across health systems, provider-patient interactions, and clinical decision-making is critical for achieving health equity.