Archive | Cultural Competence

Now available on iBooks!

“What Pharmacists Need to Know About Racial and Ethnic Health Disparities”, available on iBooks

Available on iBooks - What Pharmacists Need to Know About Racial and Ethnic Health Disparities






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A text for use in public health, health disparities, health services research, and related courses

for pharmacy students in their second, third, and fourth years of training. Discusses the concepts of race and ethnicity and the constructs used to classify and categorize them and provides an overview of the data collected regarding disparities in mortality, morbidity, provision of health care, and other health indicators and epidemiologic studies of mechanisms and pathways. Addresses racial and ethnic health disparities that can occur in real-world pharmacy care, such as differences in disease conditions, response to medication, access to care, health literacy, and understanding of health and medications.

As reviewed in the American Journal of Pharmaceutical Education

Print version available on

Ch 4 Mechanisms of health disparities

Infographics are a great way to begin a discussion about mechanisms of health disparities.

Infographic mechanisms of health disparities

Conceptual model: Mechanisms of health disparities

This infographic illustrates multiple potential pathways leading from race and ethnicity to disparities in health outcomes, mechanisms of health disparities. Chapter 4 of “What Pharmacists Need to Know About Racial and Ethnic Health Disparities” explores mechanisms and explanations and provides students with tools for understanding this complex topic.

The visual can provoke thought, raise questions, and educate, all at the same time. The infographic suggests pathways, but doesn’t cover them all. The student can take this infographic, generate hypotheses, and explore relationships.

For example, a student might begin with the association between race and ethnicity and socio-economic status, and then follow the pathways leading through occupation, income, education or neighborhood, which then lead through variables such environmental exposures, ability to understand health information or health insurance coverage, and then to health outcomes.

Another set of pathways might begin with the association between race and ethnicity and culture and religion (another broad area, in itself). One can follow the pathways through behaviors such as diet, reproductive practices, attitudes towards medication, education and occupation, and lead to differences in risk factors and health outcomes.

Chapter 4 also explores direct effects of race or ethnicity on health – and discusses the landmark study “The effect of race and sex on physicians’ recommendations for cardiac catheterization” that was published in the New England Journal of Medicine in 1999.

“What Pharmacists Need to Know About Racial and Ethnic Health Disparities” – a text tailored for pharmacy students.

Available on

Book Review

“What Pharmacists Need to Know About Racial and Ethnic Health Disparities”

Book review pharmacy health disparities

Great to see this thoughtful book review of “What Pharmacists Need to Know About Racial and Ethnic Health Disparities” in the American Journal of Pharmaceutical Education.

Dr. Christine Catney, of the University of Iowa College of Pharmacy reviewed the text, recommending the book.


She wrote,

Pharmacy educators who are developing materials and approaches for teaching health disparities and cultural competence topics will appreciate the author’s suggestions for assignments and learning activities. Examples of these ideas include examining census forms, preparing reports to illustrate and explain specific health disparities in detail, and generating examples from students’ pharmacy practice experiences. Several of these ideas, as well as examples provided within the text, could be transformed into small group activities for a flipped classroom approach.

Teaching about pharmacy health disparities

She also pointed out the need to cover other disparities that are affected by factors such as income, gender, age (under 18 years and 65 years and over), geographic location, sexual orientation, disability, and special or chronic care needs, and I couldn’t agree more.

There are so many issues in considering pharmacy health disparities, and the important thing is to begin the discussion. The classroom is the right place to generate lively discussion about pharmacy health disparities and the pharmacist’s role in addressing disparities. Learning about health disparities during professional training is a first step towards cultural competence and equips students to engage in these issues throughout their lives and careers.

Ch 3 Health disparities associated with race and ethnicity

Health disparities statistics

Chapter 3 of “What Pharmacists Need to Know About Race and Ethnicity” presents the data documenting disparities in mortality, morbidity, provision of health care, and other health indicators by race and ethnicity. The attached infographic highlights differences in life expectancy. Students are always startled to see the data and it always provokes questions and interest.

Health disparities statistics

Health disparities occur along the causal pathway from exposures and risk factors to all health outcomes.

The chapter explores disparities in life expectancy, mortality, incidence of disease, risk factors, and access to care, allowing students to explore the disparities along the pathways from causal factors to health outcomes. Students apply their skills in epidemiology, data analysis and statistics and gain a deeper understanding of how health disparities are manifested.

The figures and data are drawn from a range of government sources including the Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, and Health Resources and Services Administration. All provide extensive documentation and resources for further study, such as the CDC Health Disparities and Inequalities Report.

Ch 2 Classification of race and ethnicity in the United States

How are race and ethnicity defined in the US?

In Chapter 1 of “What Pharmacists Need to Know About Racial and Ethnic Health Disparities,  we spoke about race and ethnicity as social constructs. In Chapter 2 we pivot to describe the process used by the United States government uses to develop operational definitions of race and ethnicity to be used in carrying out government activities. It starts with the US census, where data are collected every 10 years to provide information about the US population. The definitions developed for the Census must be used by all federal agencies, as well as any other organization receiving federal funds. This covers pretty much everyone doing research on health disparities.

Classification of race and ethnicity is an unsatisfying process for a reason – it is a social construct and not based in science or biology.

Here’s the infographic.

Classification of race and ethnicity

Chapter 2 infographic