Perot, Ruth T.

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DePaul Journal of Health Care Law Volume 10 Issue 1 Fall 2006 Article 9 October 2015 The Future of Health in Communities of Color Out of Many, One a Multicultural Action Plan to Achieve Health Parity Ruth T. Perot Follow this and additional works at: https://via.library.depaul.edu/jhcl Recommended Citation Ruth T. Perot, The Future of Health in Communities of Color Out of Many, One a Multicultural Action Plan to Achieve Health Parity, 10 DePaul J. Health Care L. 107 (2006) Available at: https://via.library.depaul.edu/jhcl/vol10/iss1/9 This Article is brought to you for free and open access by the College of Law at Via Sapientiae. It has been accepted for inclusion in DePaul Journal of Health Care Law by an authorized editor of Via Sapientiae. For more information, please contact digitalservices@depaul.edu. THE FUTURE OF HEALTH IN COMMUNITIES OF COLOROUT OF MANY, ONEA MULTICULTURAL ACTION PLAN TO ACHIEVE HEALTHPARITYRuth T PerotI. INTRODUCTION*Winds of change are stirring and racial and ethnic health disparities havebegun to appear on radar screens where policy decisions are made. For thefirst time ever, government and community leaders have set a date - 2010- to reach a goal of parity in health. 1/ The landmark study issued in 2002by the Institute of Medicine, Unequal Treatment/Confronting Racial andEthnic Disparities in Health Care, 2/ presents a comparable call for urgentaction. Reports released recently by the Agency for Healthcare Researchand Quality 3/echo similar messages. Racial and ethnic disparities inhealth persist, their existence is beyond dispute, and they warrant multi-faceted corrective efforts.African Americans, American Indians and Alaska Natives, AsianAmericans, Hispanic/Latino Americans and Native Hawaiians and otherPacific Islanders know their communities - their struggles, hopes, anddreams. Gaps in health status between themselves and the total populationhave continued for decades, if not for hundreds of years. Representativesof these communities strongly endorse the Institute of Medicine's findingthat negative health outcomes associated with these disparities areunacceptable. These representatives know first-hand that living with thestatus quo means dying from preventable causes too soon. For them,inaction must not be an option.People of color are attaining majority status in states andcommunities across the nation, and according to the U.S. census, nowcomprise a third of the U.S. population. New faces and cultures areappearing in communities where they have never been before. Recognitionis growing, moreover, that providing quality care means responding toracial and ethnic diversity with sensitivity and competence. Further, ascost-effectiveness becomes the watchword, funders are signaling theirpreference for working coalitions, partnerships, and networks to maximizeefforts to tackle common goals.Underserved racial and ethnic minority groups have responded tothese changing realities. They are organizing in neighborhoods, city-wide,across counties, state-wide, and nationally. Tackling health disparities andDEPAUL JOURNAL OF HEALTH CARE LAWexpanding access to health care have become common targets foradvocacy. People of color are voicing increased demands for services thatmeet their cultural and language needs. In addition, leaders fromcommunities of color have increasingly embraced collaboration. Somehave focused on harmonizing different voices within their communities.Others have joined broad-based coalitions led by non-minority agencies.Still, other people of color have assumed leadership of communitynetworks, in which multiple racial and ethnic groups play a role.People from diverse communities of color are also turning to eachother as they focus on shared challenges and the need to mobilize forchange. The result is coalitions among communities of color (CACCs.)These coalitions are multicultural, multi-racial, and multi-ethnic. Thesenetworks may also be described as racial and ethnic minority coalitions. Inthese coalitions, persons from diverse groups experiencing disparitiesprovide leadership. These leaders also predominate among coalitionparticipants. Although representatives from non-racial and ethnicminority groups and individuals may be involved, it is clear that they areinvited to participate in the CACC in a supportive, rather than a leadershiprole.Builders of these coalitions have to know the basics. Coalitions ofall kinds operate best if certain rules are observed. Demonstrating one'sability to respect and honor other cultures is a "must" in coalition activitiesof all kinds. Certain communications and group management principlesapply no matter who is involved.At the same time, CACCs are different from other coalitions formany reasons, so experiences with other non-CACC networks do notnecessarily transfer. One clear distinction, for example, is this: membersof racial and ethnic minority groups share a bond that is linked to theirproud histories and common experiences in the U.S. This sharing hasgiven rise to assets for relationship- and coalition-building that are notalways valued or even recognized in other kinds of networks. Suchcoalitions also commonly seek to hasten the day when health parity, equityand wellness become realities in every community.II. OUT OF MANY, ONEThis presentation describes the coalition-building journey of Out ofMany, One (OMO,) a national multi-ethnic/racial network that iscommitted to the attainment of health parity, equity and justice for all whoreside in the U.S. and territories. OMO was created by the five principalcommunities of color that have experienced disparities. This movement[VOL. 10.1: 107THE FUTURE OF HEALTH IN COMMUNITIES OF COLORbegan in 1999, when Summit Health Institute for Research and Education,Inc. (SHIRE) received a grant from the Office of Minority Health (OMH),U.S. Department of Health and Human Services, to plan and convene anational multicultural conference to advance a Campaign to EliminateRacial and Ethnic Disparities (CERED). Planning was initiated by acoalition comprising the Asian and Pacific Islander American HealthForum, the Latino Council on Alcohol and Tobacco, the National IndianCouncil on Aging, Papa Ola Lokahi, and SHIRE. These organizationsrepresent the five primary underserved and uninsured racial and ethnicminorities, which are also identified by the Office of Management andBudget as targeted minority groups in government data gathering andreporting initiatives.In November 2000, history was made when these fiveorganizations were joined by 75 other organizations, 15 each from NativeHawaiian/other Pacific Islander, Latino/Hispanic, Asian, AmericanIndian/Alaska Native, and African American communities, in a nationalmulticultural working summit. Their task, to create a united health parityagenda, was accomplished in less than two days. Intense andunprecedented multicultural participation and collaboration resulted in thedevelopment of a ground-breaking document, A Multicultural Action Planto Achieve Health Parity. This plan was published in its final form byJanuary 31, 2001 and it provides strategic directions for achieving healthparity and equal access for communities of color within the next decade(See www.outofmanyl.org).Even more significant, organizations participating in the planningand creative process decided to continue to work together on an ongoingbasis under the umbrella of Out of Many, One. OMO emerged and hasthrived for five years with the invaluable support and leadership of HardySpoehr, the Papa Ola Lokahi staff in Hawaii, and many otherorganizations. Through our collective efforts, OMO has becomeestablished as an advocacy presence in public and private venues and atnational and community levels.OMO's principal goal is to help empower racial and ethniccommunities, individually and collectively; to provide leadership to thoseworking toward parity and equity in health; and to promote the attainmentof optimal health in all communities. OMO's effective functioning as amultiethnic/racial coalition has also provided guidance for the publicationof a handbook on coalition-building, scheduled to be released by theOffice of Minority Health in early summer 2005.2006]DEPAUL JOURNAL OF HEALTH CARE LAWIII. HIGHLIGHTS OF THE OMO MULTICULTURAL ACTIONPLANOMO's Multicultural Action Plan to Achieve Health Parity makesseveral important contributions to those who would seek to reshape thefuture of health in communities of color.First, the plan articulates a compelling vision:We believe that the attainment of the highest level of healthand quality of life is a basic human and civil right. Weembrace a vision of healthy communities that. respectsdiverse cultural and spiritual values and empowers allpeople - individuals and families - in a loving, holistic,healing and compassionate manner. We are committed todevelop diverse leadership to build healthy environmentsand a prosperous, just and humane society.....Second, the plan places emphasis on health parity, a positive concept,which establishes that the parity sought is that consistent with the bestlevel of health achieved by any group.Third, the plan reflects its creators' honest appraisal of the assets andbarriers to working together that must be acknowledged whenrepresentatives from different racial and ethnic groups come to the table.Examples of assets include:" Our shared historical bond of commitment to achievesocial, racial, economic, environmental justice;* Our diverse cultural richness of families and communities,spiritual vision, traditions and values;" Our rapidly growing populations, becoming an emergingmajority as a whole; and" The existence of successful, collaborative, respectful,multicultural networks.Examples of barriers include:* Lack of access to benefits, infrastructure, capacity;* Lack of funds and resources;* Competition for funds;* Limited number of political advocates; and[VOL. 10. 1: 107THE FUTURE OF HEALTH IN COMMUNITIES OF COLOR* Colonial mentality, internalized/lateralized oppressionamong ourselves.Finally, the Multicultural Action Plan sets forth a platform with sixmajor goals: 1) achieve universal health care, 2) establish comprehensivehealth systems, 3) improve cultural, institutional, and educationaldevelopment, 4) improve research and data, 5) achieve empowerment, and6) develop community leadership. Each goal is accompanied by specificobjectives that have been revisited on a periodic basis as guidance forOMO's strategic planning process.A review of specific objectives associated with these goals revealsseveral key points. First, it is clear that OMO is prepared to think and actglobally as well as locally. While many of the proposed objectives arecommunity-specific, many call for broad advocacy efforts that impact dataand allocation issues and systems of care at the national level. Second,there is a clear emphasis on individual and community self-determination,in such areas as community leadership, consumer rights, and patient care.Third, the collection, reporting, and dissemination of data by ethnicity,race, primary language, and other indicators are seen as essentialrequirements if health parity is to be attained. Fourth, there is greatrespect for complementary cultural healing practices and other approachesthat recognize the importance of broader, more holistic views ofcommunities of color.IV. CONCLUSIONI have shared the highlights of a journey of discovery that haswidened horizons and deepened relationships among people of color inextraordinary ways. As important, the groundwork has been laid for thecreation of a national partnership in which Native Hawaiians, along withother communities of color, are playing a significant leadership role. Outof Many, One will continue its efforts to brighten the future of health inpeople of color communities -- by thinking strategically, actingeffectively, and working collaboratively and harmoniously. We invite yourinvolvement and support as we work to attain the vision of a just andhealthy nation and world.2006]DEPAUL JOURNAL OF HEALTH CARE LAWREFERENCES1. Healthy People 2010 is a comprehensive set of disease preventionand health promotion objectives for the nation to achieve over thefirst decade of the new century. Created by scientists both insideand outside the federal government, this initiative identifies a widerange of public health priorities and measurable objectives. Itsoverarching goals are: 1) increase quality and years of healthy life;and 2) eliminate health disparities. This program is administeredby the Office of Disease Prevention and Health Promotion, U.S.Department of Health and Human Services.2. Brian D. Smedley, Adrienne Y. Stith and Alan R. Nelson, Editors,Institute of Medicine of the National Academies. UnequalTreatment/Confronting Racial and Ethnic Disparities in HealthCare. The National Academies Press, Washington, DC.2002/2003.3. Agency for Healthcare Research and Quality. National HealthcareDisparities Report, July 2003 and December 2004.4. Summit Health Institute for Research and Education, Inc. with Outof Many, One. Building Coalitions among Communities of Color/AMulticultural Approach. Office of Minority Health, U.S.Department of Health and Human Services. CooperativeAgreement #US2MP98011-05.* The Introduction was adapted from Building Coalitions amongCommunities of Color/A Multicultural Approach, authored by SummitHealth Institute for Research and Education, Inc. in collaboration with Outof Many, One, Cooperative Agreement #US2MP98011-05, Office ofMinority Health, U.S. Department of Health and Human Services.[VOL. 10. 1: 107

The Future of Health in Communities of Color Out of Many, One a Multicultural Action Plan to Achieve Health Parity

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The Future of Health in Communities of Color Out of Many, One a Multicultural Action Plan to Achieve Health Parity

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