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Racial and Ethnic Health Disparities

Henry Kaiser and Sidney Garfield, MD, the founders of Kaiser Permanente, first met more than 65 years ago to discuss ways to eliminate inequalities of health care. Kaiser Permanente’s practical commitment to reducing disparities of care has continued, grown, and expanded over the years. We support that work with a range of programs, projects, and partnerships. Here are a few examples:

National Diversity Program

Our National Diversity Program is organized to focus on important aspects of diversity both internally and external to Kaiser Permanente. The Institute for Culturally Competent Care (ICCC) develops tools, training, and educational resources for physicians and other staff to influence health care outcomes through cultural sensitivity. National Linguistic & Cultural Programs serves as the central resource for developing linguistic and cultural training tools, education, research, and other resources.

Building a Work Force of Qualified Health Care Interpreters

Kaiser Permanente recognizes that qualified health care interpreters provide the critical linkage between clinicians and patients that influences care access, quality of care, and patient safety when those communicating do not share a common language and/or culture. Our Health Care Interpreter (HCI) Certificate Program fosters culturally competent care in diverse communities by increasing the community's own capacity to provide high-quality health care interpretation. Click here for more on the program.

Culturally Competent Care

Kaiser Permanente serves some of the most culturally diverse communities in the world. Our members speak more than 80 different languages, each representing a culture with unique beliefs, attitudes, and behavior. Kaiser Permanente’s Institute for Culturally Competent Care (ICCC) has established Kaiser Permanente as a model for the nation's health care industry. Our cultural competency system ensures that members' cultural needs are considered and respected at every point of contact between the member and the organization. The Institute has helped establish Centers of Excellence in our facilities and conducts and promotes research. We engage in public advocacy in an effort to address health issues that are specific to racial, ethnic, and socioeconomic groups.

Centers of Excellence in Culturally Competent Care
Examples of our work:

African American Population (West Los Angeles, CA)

Sickle cell anemia: 22 percent decrease in hospital stays in one year; 93 percent of patients able to eliminate use of Demerol for pain management

Prostate cancer: Earlier and more frequent screening for African American males, who have the highest incidence and mortality rates of prostate cancer in the world

Congestive heart failure: Cultural group appointments including family members; health education tailored to beliefs/diet

Armenian Population (Glendale, CA)

Intense focus on high cholesterol, diabetes, cardiovascular disease, obesity, smoking, and alcohol use (this population has higher rates than the general U.S. population)

Bilingual providers and cross-cultural training for all providers

Latino Population (Denver, CO)

Intense focus on primary care and prevention, and

Spanish-speaking physicians, nurse practitioners, call center

Diabetes program tailored to cultural values

“Family room” – the enlarged exam room to accommodate members of the extended family who accompany the patient

Health Promotion for African Americans (Ohio)

Identifying ways to help reduce the risk of a cardiac event (heart attack, admission for ischemic heart disease, or cardiac death) in the African American population

New weight management program for African American women

Providers’ Handbooks: African American; Latino; Asian and Pacific Island American; Individuals with Disabilities; Lesbian, Gay, Bisexual and Transgender

Culturally-competent care pocket cards can be carried by clinicians in their lab coat pockets as an easy reference to:

Assess patient’s language preference, expectations, prior treatment, set plan of treatment;

Help understand family issues, religious beliefs and customs, folk medicine, dietary practices, pain, fatalism, end-of-life decisions.

Disparities Research

A few examples of our current research projects:

African Americans and Breast Cancer: What Works?
Cancer Screening, Managed Care, and the Underserved
Cross Cultural Communication in Colorectal Screening
Educational Disparities in Diabetes Complications
Ethnic Disparities in Childhood Stroke
Ethnic Disparities in Perinatal Outcomes
Patient-Clinician Factors Influencing Racial/Ethnic Variation in the Treatment of Coronary Disease: The REMOVE CHD Study
Differences in Alcohol and Drug Treatment Outcomes for Various Cultural Groups

AHRQ Initiative

Partners: Agency for Healthcare Research and Quality (AHRQ); Robert Wood Johnson Foundation; Institute for Healthcare Improvement (IHI); RAND Corporation, Kaiser Permanente and nine other health plans.

This three-year initiative was launched in 2005 to reduce racial and ethnic inequities in health care service delivery. It is testing ways to improve collection and analysis of data on race and ethnicities, match those data to quality measures, develop quality improvement interventions that close the gaps in care, and produce results that can be replicated by all health organizations

The Family Health Project

In 2005 we developed a videotape and guidebook aimed at improving prevention and wellness for families of African American descent in partnership with the American Academy of Family Physicians and the Institute of Church Administration and Management. The Guide, available below for you to download, is the first of a series Kaiser Permanente will be developing aimed at promoting wellness among the diverse populations in our communities. We invite you check back periodically for new guides in the series.

Caring for Your Family’s Health: A Guide for African Americans
Eat nutritious foods. Exercise. Know your family history and "numbers." See a doctor routinely. This is the Rx at the heart of Kaiser Permanente’s African American Family Health Project supporting black Americans to boost their chances of maintaining or improving their health. Developed in collaboration with the American Academy of Family Physicians and the Institute of Church Administration and Management, “Caring for Your Family’s Health: A Guide for African Americans,” is full of helpful information, charts, and space for each person to jot down details of their own and their family members' medical histories. We'll soon be launching similar, concentrated efforts for Asians and Pacific Islanders, followed by Latinos.
(39 pages) (1.41M pdf , download)
A brief preview video for the guide (1.5 min)