Coalition of Universities Collaborate to End Health Disparities

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Eradicating health disparities for minority populations in urban areas has been a persistent struggle for healthcare researchers and organizations at both the local and national levels. While numerous causes have been identified as contributing to ongoing inequities — such as a lack of community providers and resources — these factors have been difficult to change. 

[Above: Students in the Urban Health Fellows program with Dr. Vida Lock, dean of the Cleveland State University School of Nursing]

This was the challenge for the steering committee of the Urban Universities for HEALTH learning collaborative. Launched in 2013, the collaborative is a joint effort by the Coalition of Urban Serving Universities (USU), Association of Public and Land-Grant Universities (APLU), the NIH National Institute on Minority Health and Health Disparities (NIMHD), and the Association of American Medical Colleges (AAMC). 

The goal of the collaborative is to create a nationwide network of five urban colleges and universities that can serve as “demonstration sites” for testing new strategies designed to improve health outcomes for local underserved communities, says Julia Michaels, the program’s project manager.  

“In the long term, we hope to see an impact in the number of graduates working in underserved urban communities, a more diverse workforce overall, and a dramatic reduction in health disparities,” says Michaels. 

Cleveland State University, Northeast Ohio Medical University (NEOMED), State University of New York Center for Workforce Studies, University of Cincinnati, University of Missouri-Kansas City, and the University of New Mexico were chosen as the five project demonstration sites. At these institutions, university leadership and faculty work alongside advisors from NIMHD to test strategies and share results for improving community outreach, increasing recruitment of local minority students to health professions, and supporting local providers.

In order to ensure the scalability and sustainability of these efforts, the collaborative recognizes that it is not enough merely to train students to meet the demand for urban healthcare workers. Students need to have a vested interest in working in the local community and reflect that community through racial and cultural identity. The project also reveals that ongoing educational support is needed for healthcare professionals from a robust resource to ensure high quality service for the long-term. 

Malika Fair
Malika Fair

This three-pronged approach takes the unique circumstances of each urban community into consideration to empower universities to analyze and optimize practices for recruiting students for medical programs, says Michaels. For example, SUNY Downstate Medical University is located in an ethnically diverse area where community members speak more than 95 different languages. It is important for the center to assess the linguistic support needed to recruit potential students and to learn what barriers related to language created obstacles for patient care. In addition, the University of Cincinnati “observed that the local population had a higher concentration of [African American] men than was reflected in student enrollment, [so] they rolled out a social media campaign to promote the school’s programs on Facebook and Twitter,” says Malika Fair, MD, senior director of health equity partnerships and programs at the AAMC. 

The five universities also have to use a number of local outreach strategies to educate high school students about opportunities for health education in the dental, medical and mental health industries, says Michaels. They collaborate with local community organizations to advertise courses, engage social media channels to promote jobs and curricula, and partner with community-based healthcare providers (e.g., federally qualified health centers) to provide students with clinical experiences. Another key part of this approach, implemented concurrently, is the development of strategies for recruiting and maintaining an equally diverse array of educators to work at the universities to train and develop these students, she says. 

The collaborative was able to create multiple tools and resources from the effort that are available to any medical school and can be easily accessed online. Educational webinars on a variety of social and economic factors as they affect healthcare and case studies were developed by each university that participated in the program, detailing the overall experience. “One of the key accomplishments was the development of … interactive dashboards which allowed institutions to showcase their data visually to community stakeholders, education leaders, and community members,” says Fair.

For example, Cleveland State University’s dashboard was designed to help students create an academic plan to prepare them for success on the collegiate level. NEOMED used their dashboard to organize and analyze student, employee, and admissions data to show how strategies were affecting their organizational goals. They also created a comprehensive Metrics Toolkit.

The Metrics Toolkit is an interactive resource designed to help university leaders plan, set goals, and track their progress through a program and beyond. It provides a metrics generator, complete list of workforce strategies, metrics and indicators developed from the findings of the collaborative, and an extensive evidence base compiled from research studies to support these health workforce strategies. Examples of strategic recommendations include the following:

● Facilitate entry into health and STEM careers through pipeline programs.

● Provide access to financial resources for students in health professions programs.

● Foster an inclusive climate to support student success.

It will take several years to see the full results of the program, but committee members are pleased with early results, and they anticipate continued success with the program implementation across the participatory institutions, says Michaels. 

Students in a health professions pipeline program present their work on community-based projects during an Urban Universities for HEALTH meeting at Cleveland State University in 2014.
Students in a health professions pipeline program present their work on community-based projects during an Urban Universities for HEALTH meeting at Cleveland State University in 2014.

“We hope that more schools will adopt some of the evidence-based strategies such as using a holistic review process in admissions, creating pipeline programs, and integrating cultural competence and (minority) population health into the curriculum,” she says.

The collaborative will continue to follow up with each university as well as a network of educational support organizations to monitor and track ongoing findings as new schools access and implement the tools. The long-term vision is to engage university presidents nationally and expand the program to urban health institutions around the country.

Joshlyn Polk is a contributing writer for INSIGHT Into Diversity. To learn more about the initiative, visit the Urban Universities for HEALTH website at urbanuniversitiesforhealth.org. This article ran in our May 2018 issue.