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Strategies to Address Racial and Ethnic Disparities in Health and Health Care for Chronic Conditions : An Evidence
Toyin Lamina1, Hamdi I Abdi1, Kathryn Behrens1
1Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota (T.L., H.I.A., K.B., R.P., K.C., A.M.C., J.D., S.W.G., L.H., R.J., M.N., M.B.).
Background:
Racial and ethnic disparities in health and health care persist in the United States, adversely affecting outcomes in prevention and treatment of chronic conditions among adults.
Purpose:
To map interventions aimed at reducing racial and ethnic disparities and improving health outcomes in the prevention and treatment of chronic conditions in adults.
Data Sources:
Searches of MEDLINE, CINAHL, and Scopus from January 2017 to April 2024, supplemented with gray literature.
Study Selection:
U.S.-based studies of interventions targeting racial and ethnic disparities in adults with chronic conditions.
Data Extraction:
Information on intervention types, targets, outcomes, study designs, study settings, chronic conditions, and delivery personnel was extracted and categorized.
Data Synthesis:
Among 174 unique studies, 12 intervention types were identified, with self-management support and patient navigation the most common. Most interventions targeted patient behaviors; few studies addressed disparities directly or focused on underrepresented racial and ethnic marginalized groups.
Limitations:
The lack of standardized terminology and the underrepresentation of certain racial and ethnic groups limit the evidence base. Although the literature search accurately reflects the current state of the literature, it also limits the body of evidence by excluding health disparities research conducted before January 2017, so significant findings from earlier studies may have been overlooked.
Conclusion:
The literature highlights diverse interventions targeting health disparities, but few studies evaluated their effectiveness in reducing the health disparities gaps. There is an urgent need for research focused on underrepresented racial and ethnic groups, particularly in promising areas such as patient navigation for cancer and diabetes self-management. Future research should prioritize robust study designs to assess the long-term effect and broader applicability of interventions, thus helping organizations and stakeholders to tailor strategies to community-specific needs.
Primary Funding Source:
Agency for Healthcare Research and Quality.
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