A Genetic Counseling Cultural Competence Toolkit

Health Disparities

The concept of health disparities is critically important to the rationale for providing culturally and linguistically competent health care. “Health disparities” are gaps in the quality of health and health care across racial, ethic, and socio-economic groups, as described by the U.S. Department of Health and Human Services. Health disparities surely exist in genetic counseling practice, although there has been limited research, mainly in the area of genomics and cancer genetics.

CDC Health Disparities and Inequalities Report-United States, 2011 (.pdf).
http://www.cdc.gov/mmwr/pdf/other/su6001.pdf

HHS Action Plan to Reduce Racial and Ethnic Health Disparities, 2011
http://minorityhealth.hhs.gov/npa/files/Plans/HHS/HHS_Plan_complete.pdf
 

Suther, S. & Kiros, G. (2009). Barriers to the use of genetic testing: A study of racial and ethnic disparities. Genetics in Medicine, 11(9), 655-662.

Hall, M. J. & Olopade, O. (2006). Disparities in genetic testing: Thinking outside the BRCA box. Journal of Clinical Oncology, 24(14), 2197-2203.

Vogel, K. J., Murphy, V.S., Dudley, B., Grubs, R.E., Gettig, E., Ford, A., Thomas, S. B. (2007). The use of family health histories to address health disparities in an African American Community.
Health Promotion Practice, 8(40), 350-357.

Halbert, C.H., Kessler, L., Troxel, A.B., Stopfer, J.E., Domchek. (2010). BRCA 1/2 Counseling and Testing of African Americans. Public Health Genomics (March 17): 1-9.

It is particularly relevant for the genetic counseling community to consider the ‘big picture’ on health disparities. Some authors make the case that genetic factors probably play a minor role in alleviating health disparities. Indeed, they suggest that ‘overemphasis on genetics as a major explanatory factor in health disparities could lead researchers to miss factors that contribute to disparities more substantially, and may also reinforce racial stereotyping, which may contribute to disparities in the first place.” Access the following article to read more about this important perspective.

Sankar, P., Cho, M.K., Condit, C.M., Hunt, L.M., Koenig, B., Marshall, P., Lee, S. (2004). Genetic research and health disparities. J.A.M.A. 291(24):2985-2989.

This section of the Genetic Counseling Cultural and Linguistic Competence Toolkit provides links to many resources to learn more about health disparities, especially from government sponsored sites.

We suggest beginning this section of the toolkit by reviewing the narrated PowerPoint presentation on health disparities. (Depending on your connection speed, this file may take several minutes to load.) This presentation is 50 minutes long. If you save it to your computer and click on slide show, the slides will advance automatically.
Health Disparities slide presentation

Back to Top

---

Links:

• http://minorityhealth.hhs.gov/

• Unequal Treatment: An Institute of Medicine Report (book)

• Crossing the Quality Chasm: A New Health System for the 21st Century (book)

• Advisory Committee on Minority Health - Healthcare Access Report

• U.S. Dept. of Health and Human Services - Health Disparities

• National Institute on Minority Health and Health Disparities
  
  
• CDC Office of Minority Health and Health Disparities
  
  
• Center to Reduce Cancer Health Disparities of the National Cancer Institute
  
  
• American Society of Clinical Oncology (ASCO) Health Disparities
  
  
• American College of Physicians - Racial and Ethnic Disparities in Health Care, Updated 2010
  
  
• HRET - Health Research and Educational Trust Disparities Toolkit
  
  
  • HRET Disparities Toolkit: A Toolkit for Collecting Race, Ethnicity, and Primary Language Information from Patients
    
    
• Robert Wood Johnson Foundation - The National Health Plan Collaborative Toolkit
  
  
• Race Consciousness and the Health of African Americans
  
  

---

Videos:

• Bridging the Great Divide: Health Disparities in America
  (Kaiser Permanente's short video on health disparities shows some of the causes and costs of differences that result in poor health outcomes, and offers solutions to this nationwide problem)
  
  
• Healthcare Inequalities in LGBT People-Video by Healthcare Equality Index
  
  
• Unnatural Causes Video Clips

Back to Top