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How Can Practice-based Research Contribute to the Elimination of Health Disparities?

National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA (GR)
Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (LAC)

Correspondence: Corresponding author: George Rust, MD, MPH, National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310 (E-mail: GRust{at}msm.edu)

Racial, ethnic, and socioeconomic disparities in health care and health outcomes are well documented. Disparities research is evolving from documenting these disparities, to understanding their causes and mechanisms, and finally to conducting interventional research to reduce or eliminate disparities. Unfortunately, few studies to date have demonstrated substantial reductions in health outcomes disparities.

Traditional experimental models of research that test a single intervention held constant throughout the study period may not have the power to impact complex clusters of comorbid health disparities in patients who receive care in underresourced primary care safety net practice settings. New models of research will be required to test dynamic, multidimensional interventions that triangulate on patients, providers, and communities and are continuously improved with every radar-sweep of feedback from rapid-cycle measurement of population health outcomes on a community-wide basis. In this article, we review 12 promising strategies that could substantially increase the impact of research on eliminating health disparities in America.

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