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This graph is titled "A Strategic Framework for Improving Racial/Ethnic Minority Health & Eliminating Racial/Ethnic Health Disparities." The graph depicts a progression of five steps aligned in a row from left to right, with each step identified in a logical progression necessary to effectively address racial/ethnic minority health problems. The first step is entitled "Long-Term Problems", which reflects the need to identify such problems before proceeding to the second step, entitled "Contributing Factors", which must then be identified. The third step is called "Strategies and Practices", which indicates that effective strategies and practices are then needed to address the contributing factors. The fourth step is entitled "Outcomes and Impacts", which represent the results intended from the strategies and practices. And the last step represents "Long-Term Objectives and Goals", which will be realized if the outcomes and impacts are achieved. Additional information is provided for each step, as follows:

1. Long-Term Problems.
   1. Racial/Ethnic Minority Health Status Issues (i.e., preventable morbidity & premature mortality)
   2. Racial/Ethnic Health Disparitiess
   3. Need for a Systems Approach
2. Contributing Factors. There are three levels identified for Contributing Factors:  Individual Level, Environmental/Community Level, & Systems Level.
   1. Individual Level. Under Individual Level, there are 5 items listed which include:
      1. Knowledge
      2. Attitudes
      3. Skills
      4. Behaviors
      5. Biological/Genetic Risks
   2. Environmental/ Community Level. Under Environmental/ Community Level , there are six items listed, which include:
      1. Physical Environment
      2. Social Environment
      3. Community Values
      4. Community Assets
      5. Community Involvement
      6. Economic Barriers
   3. Systems Level. Under Individual Level, there are five items listed, which include:
      1. Components and Resources
      2. Coordination and Collaboration
      3. Leadership and Commitment
      4. User-Centered Design
      5. Science and Knowledge
3. Strategies and Practices. There are 3 levels identified for Strategies and Practices :  Individual Level, Environmental/Community Level, & Systems Level.
   1. Individual Level. Under Individual Level, there are five items listed, which include:
      1. Efforts to Increase Knowledge
      2. Efforts to Promote Attitudes Conducive to Good Health
      3. Efforts to Build Skills
      4. Efforts to Promote Healthy Behaviors
      5. Efforts to Address Biological or Genetic Risks
   2. Environmental/Community Level. Under Environmental/Community Level, there are three items listed, which include:
      1. Efforts to Promote a Healthy Physical Environment
      2. Efforts Aimed at the Social Environment
      3. Efforts to Address Economic Barriers
   3. Systems Level. Under Systems Level, there are five items listed, which include:
      1. Efforts to Strengthen Components and Resources
      2. Efforts to Promote Coordination and Collaboration
      3. Efforts to Foster Leadership and Commitment
      4. Efforts to Promote User-Centered Design to Address Racial/Ethnic Minority Needs Through:
         1. Racial/Ethnic Minority Participation
         2. Health Care Access/Coverage
         3. Culturally and Linguistically Appropriate Service
         4. Workforce Diversity
         5. Racial/Ethnic Data Collection
      5. Efforts to Improve Science and Knowledge
4. Outcomes and Impacts. There are three levels identified for Outcomes and Impacts:  Individual Level, Environmental/Community Level, & Systems Level.
   1. Individual Level. Examples of outcomes and impacts listed under Individual Level are:
      1. Increased awareness/knowledge about disease prevention or risk reduction
      2. Increased health care provider skills in providing culturally & linguistically appropriate services
      3. Increased patient adherence to prescribed treatment regimens
      4. Reduced morbidity & mortality
   2. Environmental/Community Level: Examples of outcomes and impacts listed under Environmental/Community Level are:
      1. Decreased exposure to risks in the physical environment
      2. Increased public awareness about racial/ethnic health disparities
      3. Increased health care access & appropriate utilization
      4. Increased plans & policies that promote health & well-being at the local, state, & national levels
      5. Reduced morbidity & mortality
   3. Systems Level. Examples of outcomes and impacts listed under Systems Level are:
      1. Increased inputs & other resources for racial/ ethnic minority health-/health disparities-related priorities
      2. Increased partnerships & collaborations for greater effectiveness & efficiency
      3. Increased strategic planning, with goals & objectives, evaluation, & performance monitoring
      4. Increased system design characteristics to minimize barriers for minority users
      5. Increased knowledge development/science base about "what works"
5. Long-Term Objectives and Goals.
   1. Increased quality and years of healthy life for racial/ethnic minorities
   2. Reduced and, ultimately, eliminated racial/ethnic health disparities
   3. Systems approach to racial/ethnic minority health improvement and health disparities reduction

Office of Minority Health