title: Advancing health disparities research within the health care system: a conceptual framework.
abstract: We provide a framework for health services-related researchers, practitioners, and policy makers to guide future health disparities research in areas ranging from detecting differences in health and health care to understanding the determinants that underlie disparities to ultimately designing interventions that reduce and eliminate these disparities. To do this, we identified potential selection biases and definitions of vulnerable groups when detecting disparities. The key factors to understanding disparities were multilevel determinants of health disparities, including individual beliefs and preferences, effective patient-provider communication; and the organizational culture of the health care system. We encourage interventions that yield generalizable data on their effectiveness and that promote further engagement of communities, providers, and policymakers to ultimately enhance the application and the impact of health disparities research.
authors.affiliation: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pa 15240, USA. amy.kilbourne@va.gov
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Galen
authors.initials: G
authors.lastname: Switzer
authors.forename: Kelly
authors.initials: K
authors.lastname: Hyman
authors.forename: Megan
authors.initials: M
authors.lastname: Crowley-Matoka
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fine
mesh_terms: D001294:Attitude to Health; D003299:Cooperative Behavior; D005006:Ethnicity / Q000235:genetics; D006291:Health Policy; D006292:Health Priorities; D006297:Health Services Accessibility / Q000941:ethics; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D015279:Organizational Culture; D011203:Poverty; D011287:Prejudice; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D015983:Selection Bias; D012935:Social Justice; D012959:Socioeconomic Factors; D014481:United States; D035862:Vulnerable Populations / Q000145:classification / Q000208:ethnology