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1.
Improved Population Health and Mental Health Status
 Dramatic
disparities in health status and outcomes among numerous cultural
and ethnic groups have been well described showing that
some members of these groups suffer disproportionately from cardiovascular
disease, infant mortality, birth defects, lower immunization
rates, asthma, diabetes, cancer, HIV/AIDS, injury, violence,
and mental
illness, among other conditions.1 Although the most
frequently noted disparities are those among ethnic, racial,
and low-income
groups, health outcomes are also differentiated along other factors
including gender, geographic location, sexual orientation, disability,
age, English proficiency, and literacy.2
There is a
risk that disparities may increase as the population ages and
becomes more diverse.3 Not only does this situation
affect the health status of culturally and linguistically diverse
populations,
it could also
adversely affect the health of our nation as a whole, because “all
members of a community are affected by the poor health status
of its least healthy members.”4
 Reduction of
health disparities is one of the top priorities for the U.S.
Department of Health and Human Services (Healthy
People
2010, 2000) and its Maternal and Child Health Bureau (MCHB
Strategic Plan, 2003). Health and mental health disparities
are also a
priority for many public health, health care organizations,
foundations, and advocacy groups.5 Addressing
health disparities requires a multifaceted strategy because
the underlying factors are so complex (Health
for
All, Prevention Institute, 2003).6
The elimination
of health disparities
will require public health leaders and professionals who
are knowledgeable, skilled, and committed and who are culturally
and linguistically
competent. They will need to understand the cultural, social,
linguistic, economic, environmental, and other factors
that contribute to health
disparities to improve the health and well-being of the
nation’s
diverse populations.
Racial
and ethnic mental health disparities are as prevalent as the previously
described health disparities. The literature
documents the complicated correlation of risk factors, disease incidence,
and social, biological, and behavioral factors that contribute
to these disparities.7 The IOM report (2001)
defines health broadly, including
the positive concept of well-being. According to the
IOM, almost half the U.S. deaths are linked to behavioral and
social factors.
This literature provides an evidence-base for the world
view
of many cultural groups whose beliefs systems integrate
physical, emotional, and spiritual well-being, and hold that
all three
are
necessary for their overall health and well-being.8
References
1 See
Office of Minority Health, CDC, DHHS, at http://www.cdc.gov/omh/AboutUs/disparities.htm
and http://www.cdc.gov/omh/AMH/dbrf.htm.
2 Health
for All, Prevention Institute, 2003.
3 Ibid.
4 Unequal Treatment, IOM, 2002.
5 e.g.,
the Commonwealth Fund; Annie
E. Casey Foundation; the California
Endowment; Kaiser-Permanente’s Institute for Culturally
Competent Care (see description);
the Connecticut
Health Foundation; Aetna (see press
release); the National Alliance of Multi-Ethnic Behavioral
Health Associations; the Federation of Families
for Children’s Mental Health; the American
Public Health Association; and the Center
for Health Policy Change.
6 Health for All, Prevention Institute, 2003
7 Surgeon
General, 1999, 2001;
IOM 2001; and President’s New Freedom Commission on Mental
Health, 2003.
8 Goode & Dunne, 2003.
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