Equity & Inclusion Resources

Click the + for links to resources about the following topics.

Accessibility

  1. Americans with Disabilities Act (ADA) National Network: Provides information, guidance, and training on how to implement the Americans with Disabilities Act.
  2. Center for Accessible Living: Offers resources and advocacy for disability rights and accessibility.
  3. Disability Rights Education & Defense Fund (DREDF): A national law and policy center dedicated to protecting and advancing the civil rights of people with disabilities.
  4. National Council on Independent Living (NCIL): Advocates for the human and civil rights of people with disabilities and provides resources on accessibility.
  5. Office of Disability Employment Policy (ODEP): The ODEP “is a non-regulatory federal agency that promotes policies and coordinates with employers and all levels of government to increase workplace success for people with disabilities.”  Its website offers resources regarding the Americans with Disabilities Act (ADA), disability employment statistics, and research on many accessibility topics.

Health Equity

  1. Health Affairs: A leading journal of health policy thought and research. It includes resources on health equity on various themes such as: tackling structural racism, disability and health, racism and health, and incorporating equity into health care quality measurement, among other themes.
  2. The Joint Commission: Provides accreditation and certification for health care organizations, with resources on improving the quality and safety of long-term care.
  3. Robert Wood Johnson Foundation (RWJF): Supports research and programs targeting some of America’s most pressing health issues. Its focus areas are: Health Systems, Healthy Communities, Healthy Children and Families, and Leadership for Better Health.

Legislation/Policy

  1. Center for American Progress – Health Policy: The CAP is a think tank that offers progressive views and policy proposals on a number of issues, including health care issues.
  1. Kaiser Family Foundation (KFF) – Health Policy: Offers in-depth information on health policy issues, including legislative analysis on a number of issues, for example: racial equity and health policy, long-term care, Medicare and Medicaid coverage, and state health policies.
  1. National Conference of State Legislatures (NCSL) Health: Provides research, analysis, and information on a number of policy topics, including health policy, to state legislators and legislative staff. They include a database that tracks state bills/legislation.

LGBTQIA+ Health Care

  1. CenterLink: An international nonprofit organization and member-based association of LGBTQ+ centers and organizations.  Its LBTGQ HealthLink program supports its member centers to improve health and human services for LGBTQ communities.
  2. The Fenway Institute: Offers extensive resources on LGBTQ health, including research, training, and policy advocacy.  “The mission of The Fenway Institute is to optimize health and well-being for sexual and gender minorities (SGM), and those affected by HIV.”
  1. GLMA: Health Professionals Advancing LGBTQ Equality: Provides resources and advocacy for LGBTQ health equity, including provider directories and best practices. “GLMA is a national organization committed to ensuring health equity for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities and equality for LGBTQ+ health professionals in their work and learning environments.”
  2. Human Rights Campaign (HRC) Foundation – Healthcare Equality Index (HEI):  The HEI is a national benchmarking tool that evaluates health care facilities’ policies and practices related to the equity and inclusion of LGBTQ patients, visitors, and employees.
  3. National LGBTQIA+ Health Education Center: Provides educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for LGBTQIA+ people.

Long-term and Ambulatory Care

  1. Agency for Healthcare Research and Quality (AHRQ): Offers resources on improving the quality, safety, efficiency, and effectiveness of health care for all Americans, including outpatient care.
  2. National Association for Home Care & Hospice (NAHC): Represents the interests of home care and hospice organizations. NAHC also provides information and resources related to home health care.
  3. National Institute on Aging (NIA):  NIA is the primary federal agency supporting and conducting Alzheimer’s disease research.  Its website offers resources and research on aging, including aspects of long-term care.  Their website includes information on health disparities research.
  4. LeadingAge: An association of nonprofit providers of aging services, including long-term care.

Mental Health

  1. National Institute of Mental Health (NIMH): The lead federal agency for research on mental disorders.
  2. American Psychological Association (APA): Provides resources on psychology and mental health, including guidelines for practitioners.
  3. Mental Health America (MHA): Community-based network dedicated to helping all Americans achieve wellness by living mentally healthier lives.
  4. National Alliance on Mental Illness (NAMI): Offers education, advocacy, and support for individuals with mental illness and their families.

Key Studies and Articles on Equity and Inclusion in Health Care (by date)

  1. The Economic Burden of Racial, Ethnic, and Educational Health Inequities in the US” (2023):

This study assesses the economic impact of health inequities among racial and ethnic minorities and individuals with limited education in the U.S. The analysis reveals staggering economic burdens, with racial and ethnic health disparities estimated at $421-451 billion and education-related disparities at $940-978 billion in 2018. The study underscores the urgent need for continued investment in research, policies, and practices to eliminate these unacceptable health inequities at federal, state, and local levels.

  1. The Effect of Race and Sex on Physicians’ Recommendations for Cardiac Catheterization” (1999):

Investigating potential disparities, this study reveals that both race and sex independently influence physicians’ recommendations for managing chest pain. Women and Black individuals were less likely to be referred for cardiac catheterization compared to men and whites, respectively. The findings suggest the influence of race and sex on physicians’ decision-making in the management of chest pain.

  1. Hospital Care in Black and White: How Systemic Racism Persists” (2020):

Examining the impact of systemic racism on health care, this article focuses on the enduring health disparities experienced by Black New Yorkers, particularly during the COVID-19 pandemic. The study highlights how structural racism influences where patients receive hospital care, with historical discrimination contributing to a lack of trust in medical care. The article urges action, proposing measures to scrutinize and penalize discriminatory hospitals.

  1. Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance” (2021):

 The Commonwealth Fund’s analysis reveals pervasive racial and ethnic disparities in U.S. health care. Even in states with high-performing health systems, people of color consistently receive inferior health care. The report emphasizes the urgent need for policy changes to ensure universal, affordable, and equitable health coverage, strengthen primary care, reduce administrative burdens, and invest in social services, stressing the importance of addressing structural racism.

  1. Trends in Health Disparities, Health Inequity, and Social Determinants of Health Research :A 17-Year Analysis of NINR, NCI, NHLBI, and NIMHD Funding” (2018):

This study analyzes 17 years of funding data from key NIH institutes, including NINR, focusing on health disparities, inequities, and social determinants of health (SDOH). The findings reveal a significant disparity in funding, with health disparities projects receiving 14–19 times more funding than health inequity and SDOH projects. NINR consistently allocates more funding for disparities projects compared to other institutes, and NIMHD leads in funding for disparities, inequities, and SDOH combined. However, the study notes a funding lag in health equity-oriented research, especially for inequities and SDOH, raising implications for nurse scientists seeking NIH support.

  1. Structural racism and health inequities in the USA: Evidence and Interventions” (2017): This report, part of a series on equity and equality in health in the USA, addresses the reluctance to identify racism as a root cause of racial health inequities. It explores the impact of structural racism on population health and health inequities, encompassing interconnected systems such as housing, education, employment, and health care. Emphasizing the need to confront structural racism, the report suggests that such a focus provides a practical and promising avenue for advancing health equity and improving overall population health.
  1. Eight Americas: New Perspectives on U.S. Health Disparities” (2006): This study classifies the U.S. population into eight groups with varying mortality patterns, highlighting a significant 21-year life expectancy difference between the highest-risk (America 8) and lowest-risk (America 1) groups. Despite comparable child mortality to OECD countries in disadvantaged Americas, young and middle-aged individuals in these groups experience mortality rates up to twice as high as the worst-performing OECD nation, primarily due to chronic diseases. Unique risk profiles for tobacco, alcohol, and obesity in each America underscore the need for targeted public health interventions, especially focusing on chronic diseases, blood pressure, and cholesterol management, potentially exploring innovative strategies like the Polypill.

Books – Reads on various equity and inclusion issues (by author)

  1. Allen Williams, Richard: Healthcare Disparities at the Crossroads with Healthcare Reform. A 2011 book that provides a comprehensive overview of health care disparities in the United States, especially in the context of health care reform. Williams discusses the historical and societal factors contributing to these disparities and proposes solutions.
  2. Applewhite, Ashton. This Chair Rocks: A Manifesto Against Ageism: This 2016 book examines ageism, its stereotypes, and impacts on health and work, offering a humorous and insightful look at combating ageist beliefs in society.
  3. Banaji, Mahzarin R. & Greenwald Anthony G. Blind Spot: A 2016 book discussing the concept of implicit biases or “blind spots,” exploring their origins and ways to overcome them, featuring the Implicit Association Test.
  4. Beydoun, Khaled A. American Islamophobia: A 2018 book analyzing the rise of Islamophobia in America post-9/11, exploring media influence, government policies, and public perception of Muslims.
  5. Bowen Matthew, Dayna. Just Medicine: A Cure for Racial Inequality in American Health Care: This work, published in 2015, focuses on racial disparities in the American health care system. Matthew combines legal analysis with health care research to propose strategies for overcoming systemic racism in health care.
  6. Brown, Leighton & Riemer, Matthew. We Are Everywhere: A portrayal of the queer liberation movement’s history, showcasing photographs and narratives from 19th century Europe to the Stonewall Riots, providing a visual journey through LGBTQ+ history. It was originally published in 2019.
  7. Chavez, Leo R. The Latino Threat: A 2008 examination of U.S. immigration politics and media portrayal of Latinos, particularly Mexicans, analyzing stereotypes and their influence on national policies and conversations.
  8. Coates, Ta-Nehisi. Between the World and Me: A #1 New York Times bestseller, published in 2015, offering an emotional analysis of the Black experience in America, blending history and personal stories to depict the impact of race.
  9. Fadiman, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures: First published in 1997, Fadiman’s book is a compelling narrative that highlights the cultural clashes between a Hmong family and the American medical system. It’s a powerful exploration of how cultural misunderstandings can impact health care.
  10. Harts, Minda. The Memo: This book, published in 2019, offers insight into the challenges faced by women of color in the workplace, including micro-aggressions and the wage gap, with strategies for allies and leaders to facilitate change.
  11. Katz, Michael B. In the Shadow of the Poorhouse: A Social History of Welfare in America: While not exclusively about health equity, Katz’s 1996 book offers critical insights into the history of welfare and social services in America, including health care. It explores the intersection of poverty, race, and health, and is a valuable resource for understanding the broader context of health disparities.
  12. Kendi, Ibram X. How to Be an Antiracist: Kendi’s 2020 book is an exploration of racism and offers insights into how to actively oppose racism in our thoughts and actions, advocating for a transformative concept of antiracism.
  13. Kendi, Ibram X. Stamped from the Beginning: This 2017 book is a historical analysis of racism in America, tracing its roots and evolution. Kendi challenges deeply entrenched ideas about race and offers a new perspective on how to understand and confront racist thought and systemic injustice.
  14. Marmot, Michael. The Health Gap: The Challenge of an Unequal World: This 2015 book delves into the social determinants of health, explaining how factors like income, education, and environment can lead to health disparities. Marmot provides a global perspective on health inequality and suggests practical solutions.
  15. Oluo, Ijeoma. So You Want to Talk About Race: A 2018 bestseller addressing how societal systems contribute to racism and oppression, offering practical advice for discussing race, white privilege, intersectionality, and more.
  16. Shapiro, Joseph P. No Pity: A 1994 book providing insight into the experiences of people with disabilities, drawing on history to understand their struggles and contributions to the civil rights movement.
  17. Smedley, Brian D. & Stith, Adrienne Y. & Nelson, Alan R. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care by the Institute of Medicine, edited by: Published in 2003, “Unequal Treatment: is a seminal publication analyzing  racial and ethnic health disparities in the United States.  It looks at how disparities in treatment and how aspects of the clinical encounter can contribute to those disparities.  The book offers evidence-based recommendations for policy and health care practice to address and reduce these disparities.
  18. Wu, Frank H. Yellow: Published in 2003, Wu’s book is an exploration of Asian-American experiences, focusing on stereotypes, the model minority concept, and the impact of globalization and immigration, based on personal narratives and research.

CCHCP Resources

Language Access/Medical Interpreter Resources