A matter of trust: Commitment to act for health equity.

We believe these recommendations constitute "minimum requirements" for health care organizations to move toward greater health equity. As health systems, standards-setting organizations, national and private purchaser organizations, and thought leaders, we represent organizations in the health care ecosystem that can both advise on strategies for adopting the recommendations and have the power and leverage to cause their implementation. We commit individually and collectively to use our leverage to propel their implementation at our own institutions and across the county. We very much hope others will join us.

Integrated Measures of Health Literacy, Language Access, and Cultural Competency Would Improve Health Care Quality and Value.

Improving health care quality and value requires increased attention to patient and family-centeredness as well as care equity. Although health literacy, language access, and cultural competency have been perceived as separate constructs. each represents a dimension of patient and family-centeredness and care equity. Developing and using integrated measures of health literacy, language access, and cultural competency could provide a viable strategy to improve patient and family-centeredness and equity in health care. While there are challenges to the development and use of integrated measures, some responsive strategies include: using more patient, family and caregiver-reported information; utilizing patient demographic data from electronic health records; and incorporating the latter elements within measures of patient experience. Integrated quality measures also create opportunities for collaborative and interdisciplinary research, and for health care delivery innovation.

The Dental Pipeline program's impact on access disparities and student diversity.

BACKGROUND: The Robert Wood Johnson Foundation, Princeton, N.J., the W.K. Kellogg Foundation, Battle Creek, Mich., and The California Endowment, Los Angeles, collaborated in funding a five-year (2002-2007) national demonstration program (Pipeline, Profession & Practice: Community-Based Dental Education [Dental Pipeline]) to reduce dental care access disparities. Fifteen dental schools were selected to participate in the Dental Pipeline program. The goals were to have senior students spend more time in community sites providing care to underserved patients; to prepare students to treat diverse, low-income patients; and to increase enrollment of underrepresented minority (URM) students. METHODS: A national program office at Columbia University in New York City administered the Dental Pipeline program. The participating dental schools developed networks of community clinics and practices for student rotations, established courses in cultural competency and public health and implemented new programs to recruit URM students. RESULTS: The average time senior students spent in community clinics and practices increased from 10 to 50 days; all schools developed courses in cultural competency and public health; and enrollment of UMR students increased 54.4 percent (excluding two of the schools) versus 16 percent in non-Dental Pipeline schools. CONCLUSIONS: On average, the participating dental schools were successful in meeting program goals.