A review of U.S.-based studies of interventions targeting racial and ethnic disparities in adults with chronic conditions found that few studies evaluated the effectiveness of such interventions in reducing gaps in health disparities. The researchers suggest there is a critical need for targeted, long-term research focused on underrepresented racial and ethnic groups to effectively address health disparities.
The study is published in Annals of Internal Medicine.
Researchers from the University of Minnesota School of Public Health studied data from 174 unique studies of interventions targeting racial and ethnic disparities in adults with chronic conditions published between 2017 to 2024 to create an evidence map. The researchers aimed to identify interventions that have been studied and highlight gaps in knowledge and research needs.
The studies included in the evidence map met certain eligibility criteria, including specifically aiming to examine the potential reduction of a disparity; aiming to improve outcomes for specified racially/ethnically minoritized people; and taking place in a health care setting or showing strong links between a health care organization and community-based settings.
The results found that the largest category of interventions studied was self-management followed by patient navigation and prevention/lifestyle support. 57% of these studies included interventions that solely targeted patients. Only 3% of studies reported on equity of service between racially/ethnically minoritized people and other groups.
“This study sheds light on the urgent need for health care interventions that go beyond treating individual patients to address the systemic barriers that drive racial and ethnic health disparities,” says Toyin Lamina, SPH researcher and lead author. “By mapping the range of existing strategies, we’ve revealed critical gaps in research, particularly for underrepresented communities like American Indian and Alaska Native populations. This evidence map should serve as a catalyst for more inclusive, community-centered, and data-driven interventions that close the health equity gap for chronic conditions like diabetes and cancer, which have disproportionately affected people in these underserved communities.”
Studies primarily occurred in clinical settings, however, some studies occurred in community-based settings, like churches or libraries, where health care is more likely to reach certain populations who are disconnected from traditional clinical settings. 46% of studies examined multiple racial groups including African Americans/Blacks, Hispanics/Latinos and Asians, but only 1% of studies targeted American Indian/Alaska Native populations. Cancer, diabetes and hypertension are the most researched chronic conditions, however, other conditions like mental health, liver disease and COPD that disproportionately affect racial and ethnic minority populations were underrepresented in the studies.
The interventions studied for specific conditions were varied, with self-management more frequently targeted towards diabetes and patient navigation interventions primarily focused on cancer. The researchers hope that the evidence map created from this review of studies will inform health care system leaders, policymakers, researchers and funding bodies about the current state of intervention strategies, gaps in knowledge, and areas requiring further investigation in the treatment of chronic conditions among underrepresented racial and ethnic populations.
