The DRA Project relies on the support and involvement of our network of DRA Partners. Below are short descriptions of our DRA Partners and the work they are doing to eliminate health disparities. For more information on how you can join these organizations in reducing health disparities, please contact Craig Bettles at cbettles@altfutures.com.

Active Living by Design

Active Living by Design (ALbD) was launched in late 2001 as a national program of the Robert Wood Johnson Foundation (RWJF). Located in Chapel Hill and part of the North Carolina Institute for Public Health at the UNC School of Public Health, ALbD works with partnerships across the nation to increase routine physical activity and healthy eating through changes in community design.

In 2003, ALbD selected 25 diverse community partnerships from a pool of 966 applicants to receive $200,000 and technical assistance over five years. More recently, ALbD established Healthy Eating by Design (HEbD), a pilot program that provides 12 of these partnerships an additional $50,000 over 18 months to test approaches to increase access to healthy foods for children in low-income neighborhoods. The ALbD and HEbD community partnerships are located throughout the United States, and project areas range in size from small urban neighborhoods to large rural regions.

More information on ALbD as well as a map of the communities the program is active in is available here.

Bastyr University

Bastyr University, located north of Seattle, Washington, is one of the world's leading academic centers for advancing knowledge in the natural health sciences. A twenty-eight-year pioneer in natural medicine, Bastyr continues to be in the forefront of developing the model for 21st century medicine. Bastyr University has a long history of providing natural medical services to underserved populations in a manner that emphasizes prevention and health promotion within a Primary Care model. The Bastyr Center for Natural Health, the main clinical teaching facility sees a high percentage of patients at income-adjusted reduced fees. Naturopathic physicians and students also care for underserved patients such as homeless youth, the elderly and women in domestic violence shelters at over 15 affiliated sites. Bastyr researchers are also focusing on topics relevant to reducing health disparities such as School of Nutrition research on obesity and weight loss, and disease prevention lifestyle modification.

Additional information on Bastyr University can be found at www.bastyr.edu.

The Detroit Medical Center (DMC)

The Detroit Medical Center (DMC) is a 9-hospital, 2,000+ bed academic medical center whose precursor was founded during the Civil War. With its affiliate Wayne State University School of Medicine, the DMC has long been a leader in instigating change. The first successful heart pump was built by DMC physicians and General Motors engineers. AIDS drug AZT was first synthesized here.

Today, the DMC remains at the forefront of change, with every leading type of technology from a neutron beam cancer therapy machine to the largest fleet of robots of any hospital, including robots for physician “rounding,” psycho-social therapy, surgery, physical therapy, pharmacy, and labs.

DMC’s commitment to the future was further demonstrated through its appointment in 2004 of a “resident futurist,” its publication of Health Futures Digest, and its partnership with the Institute for Alternative Futures (IAF) in the Disparity-Reducing Advances (DRA) and Biomonitoring Futures Projects (BFP).

With a strong interest in telemedicine through its rounding robots, telecardiography program, and a home medical monitoring program, the DMC is committed to continuing the search for better ways for its patients to get better, and is proud to contribute its experience in these areas to the DRA and BFP.

Directors of Health Promotion and Education

The Directors of Health Promotion and Education is a non-profit organization dedicated to strengthen, promote and enhance the professional practice of health promotion and public health education nationally and within state health departments. DHPE represents 56 directors of health promotion and education units at the state and territorial health departments. DHPE also has approximately 280 associate members and members emeritus. Programmatically, DHPE members oversee a wide range of health education/health promotion-related programs including chronic disease prevention; injury prevention; HIV/AIDS; risk factor related programs such as tobacco use prevention, nutrition and physical activity; and school worksite health and community health promotion.

DHPE and the National Center for Chronic Disease Prevention and Health Promotion at the CDC jointly sponsor the National Conference on Health Education and Health Promotion in June of every year. The conference brings together health educators and other health professionals from state and local health departments, the Indian Health Service, other health organizations, and the academic community to strengthen health education/health promotion leadership and practice.

DHPE’s efforts in reducing health disparities are being clearly recognized through our DHPE/CDC Internship Program for Students of Minority-Serving Institutions. The goal of this program is to create a competent, diverse workforce suitable to meet and serve the cultural, social and health needs of racial and ethnic communities. The program’s intent is to enhance the capacity of academic programs serving minority students therefore increasing the pool of minority practitioners who in turn will go out into the field and serve these communities. The internship has already placed over 160 students at state and local health departments, health care delivery agencies, community based organizations, and other federal health agencies around the country for a first hand experience in the area of the health education and health promotion. For more information about DHPE, visit our website at www.dhpe.org.

The Hill Health Center

The Hill Health Center is a federally qualified community health center founded in 1968 in New Haven, CT. As Connecticut’s first community health center, we have 19 locations throughout the greater New Haven area, and employ approximately 450 staff. Our mission is to provide quality medical and behavioral health care to low income and medically underserved people. We have a sliding fee schedule for uninsured, and don’t turn away patients based on an inability to pay for care. In the past year, we provided 180,000 patient visits to people from more than 125 cities and towns throughout CT.

Medical Services include Internal Medicine, Pediatrics, Obstetrics and Gynecology, Ophthalmology, Dermatology, Podiatry, HIV/AIDS Care, and Neurology. We provide dental care at three sites. We operate 5 school-based health clinics where medical and behavioral health care is provided.

We provide mental health and substance abuse treatment at multiple sites, and have actively integrated our behavioral health care and medical care to assure patient needs are met. We operate two Child and Family Guidance clinics, a 29 bed in-patient detoxification facility, a partial hospital program serving 175 patients daily, along with adult psychiatric services.

Our pharmacy is licensed both as a retail pharmacy, and a Federal 340(B) pharmacy that allows purchase and sale of medications at substantially reduced prices. We also provide clinical laboratory services, nutrition services by registered dieticians, and provide health care services to homeless men, women, and children at shelters and soup kitchens.

We have made significant progress in addressing issues of health disparities in the areas of diabetes and asthma care. In 1999, we were among the first community health centers to participate in the Bureau of Primary Health Care’s Health Disparities Collaboratives. We have reduced the hemoglobin A1C percentage in our patient population to 7.1%, a substantial change from the 9.7% in 1999. Our asthma program has focused on pediatric asthma, and has been successful at reducing emergency room visits, school absenteeism, and was profiled in the Institute of Medicine’s text “40 Stellar Health Centers.”

Among our most current projects is collaboration with Yale New Haven Hospital that will bring mobile mammography services to all of our sites, and to underserved patients in the region. We also are beginning on-site bone density scanning to screen for and treat osteoporosis.

The Maryland Department of Health and Mental Hygiene

The mission of the Maryland Department of Health and Mental Hygiene (DHMH) is to protect, promote and improve the health and well-being of all Maryland citizens in a fiscally responsible way. DHMH envisions a state in which health care services are organized and delivered in a manner designed to eliminate health disparities among its ethnic and racial populations, thereby leading the way to a Healthy Maryland in the New Millennium. DHMH operates 15 programs to serve the 5 million residents of Maryland, of which 40% are ethnic minorities. Services provided include: HIV/AIDS, Chronic Diseases, Mental Health, Alcohol and Drug Abuse, and Maternal and Child Health. Directed by the Office of Minority Health and Health Disparities (MHHD), an internal assessment of DHMH is underway with the goal to change systems to provide greater focus on reducing minority health disparities.

MHHD was established in 2004 with the passing of House Bill 86 and Senate Bill 177 and is the leading Office at DHMH to address Health Disparities with the mission to focus on the elimination of health disparities. MHHD is preparing to publish the first Maryland Statewide Plan to Eliminate Health Disparities. Recommendations in this plan were collected from over 1000 sources throughout the state. The MMHD Workforce Diversity Initiative focuses on increasing the number of minority graduates from Maryland’s health professional schools and encourages health professionals to increase cultural competency. Funded by Maryland’s Cigarette Restitution Fund, the Minority Outreach and Technical Assistance (MOTA) program focuses on educating, enlightening and empowering ethnic minorities to impact cancer and tobacco health care decisions in their local jurisdictions. MOTA funds community-based, grass-roots, and faith-based organizations to provide outreach services statewide for racial and ethnic minorities and women.

The Medical Automation Research Center (MARC)

The Medical Automation Research Center (MARC) is located at The University of Virginia Health Sciences Center, Charlottesville, Virginia. The MARC is a basic research and innovations center that addresses issues that are at the forefront of medical care. The MARC employs a multidisciplanary team of engineers, biochemists, physicians, and clinical trial specialists which develop innovative solutions to customer needs. Recently, we have focused on developing a wellness paradigm for forecasting those who are most likely to develop a chronic disease, encouraging lifestyle modification to avoid or delay the onset, detecting the earliest point of onset, and then administering the most effective therapeutics. For example, we have developed a predictive test for hypertension and/or salt sensitivity that will determine if individuals have a genetic predisposition. We have also developed a suite of passive sensors that are deployed in a residence to measure one's state of wellness and blood pressure on a continuous basis. Following clinical trials of our system, we have demonstrated that we reduced the cost of care of elders by over 70%. We assist in the hosting of a non-profit international educational conference so that medical innovators may share their research and translational projects. You can learn more about these conferences here.

Prevention Institute

Prevention Institute is a national center dedicated to improving community health and well-being by building momentum for effective primary prevention. Primary prevention is defined as taking action to build resilience and prevent problems before they occur. Prevention Institute works with government agencies, private foundations, coalitions, and community organizations to establish effective prevention strategies and approaches. Prevention Institute also develops tools and other resource materials in order to advance primary prevention practice and policies. The Institute’s work is characterized by a strong commitment to community participation and promotion of equitable health outcomes among all social and economic groups.

Prevention Institute's approach to reducing health disparities focuses on advancing a deeper understanding of how fundamental causes of disparity (e.g., economics and oppression) shape community environments. These community environments in turn shape behaviors such as eating and activity patterns, tobacco and alcohol use, and violence. Improving healthcare and medical treatment is a necessary component of addressing health disparities. In addition, it is also critical to take action before the onset of illness and injury and to look beyond the individual to factors in the environment that influence the health of populations. Improving community environments represents a tremendous opportunity for promoting community wellbeing, preventing injury and illness, and reducing disparities. Accomplishing this requires a multi-faceted strategy that addresses multiple factors and works along a Spectrum of Prevention, including strengthening knowledge and individual skills and promoting community education as well as changing organizational practices and influencing policy and legislation.

Prevention Institute has worked on a number of projects directly addressing health disparities. You can read descriptions of these project here (link to PI HD Approach PDF). To better understand health disparities and how to reduce them, Prevention Institute conducted a scan of the literature and delineated 13 community factors that either directly influence health outcomes (e.g., air and water quality) or directly influence behaviors that in turn affect health outcomes (e.g., the availability of healthy food affects nutrition). You can read about these 13 community factors in the Prevention Institute’s report on community focused approaches to prevention. The report can be found here.

University of Texas Medical Branch

The University of Texas Medical Branch (UTMB) in Galveston, a sponsor of the Disparity Reducing Advances Project (DRA), has an historical commitment to innovation, public service, and the community. UTMB, which includes seven hospitals and four schools, is the oldest medical institution in Texas. UTMB has had a long history of providing health care to the underserved and underrepresented populations in Texas, and is a leader in access to quality health care for all.

One example of UTMB’s commitment to providing quality health care for all is its Center to Eliminate Health Disparities. The Center seeks to improve access to care by supporting research into the basic causes of health inequities in society, developing new models for understanding and eliminating health disparities, and promoting policy change to effectuate health reform. In addition to its support for the DRA, the Center is developing a 3-Share health benefits plan for Galveston County and has established a telehealth network to reduce disparities in three Texas counties (Galveston, Smith, and Cameron counties).

UTMB is also improving health through innovation by using telemedicine. Since 1995, clinicians and researchers at UTMB have been testing, refining, and utilizing telemedicine and telehealth technologies to improve and develop telemedicine- solving the problems of access to quality medical care. In 2004, UTMB’s Electronic Health Network was created to centralize UTMB’s skills, competencies, and technical resources into one entity. UTMB’s telemedicine program has been recognized as one of the top telemedicine programs in the United States and has been inducted into the Smithsonian Permanent Research Collection for Innovation in Information Technology. UTMB’s services comprise the largest operational telemedicine operation in the world, with over 300 locations and over 60,000 patient encounters annually.

Additionally, UTMB’s Office of Community Outreach supports the institution’s dedication to advancing the health of all Texans by bringing the educational and health care resources of the university directly into our communities. On any given day, in both rural and metropolitan areas, members of our outreach team can be found working diligently to make a real and positive difference in meeting the health needs of Texas.

These three UTMB entities work together frequently on projects designed to make quality health care more accessible and providing a means to eliminate health disparities.

For more information or to join the DRA Project contact Craig Bettles, cbettles@altfutures.com, 703-684-5880.