Department of Health and Human Services Office of Minority Health and Health Disparities North Carolina January 2003 “From Disparity to Parity in Health” Eliminating Health Disparities Call to Action“From Disparity to Parity in Health” Eliminating Health Disparities Call to Action North Carolina Department of Health and Human Services Emmanuel Ngui, MS., Editor Office of Minority Health and Health Disparities This publication is in the public domain and may be reprinted without permission. Citation of the source is appreciated. Ngui, E. 2002. From Disparity to Parity in Health: Eliminating Health Disparities - Call to Action. Office of Minority Health and Health Disparities, North Carolina Department of Health and Human Services, Raleigh, NC.Call to Action, 2003: OMHHD, N.C. - DHHS iiCall to Action, 2003: OMHHD, N.C. - DHHS iii Message from Secretary Carmen Hooker OdomCall to Action, 2003: OMHHD, N.C. - DHHS ivCall to Action, 2003: OMHHD, N.C. - DHHS v Acknowledgements This plan was developed through the leadership of the North Carolina Office of Minority Health and Health Disparities (OMHHD) in collaboration with the Department of Health and Human Services Eliminating Health Disparities Steering Committee. We also offer our sincere appreciation to  Jennifer Treadway and Melissa Green and other members of the Office of Minority Health and Health Disparities Staff for all their support;  External reviewers who provided critical input and guidance;  All of the participants of the Eliminating Health Disparities Focus Groups sessions held in January 17-18, 2001;  All of the participants of the three health disparities forums held in Greenville, Greensboro and Asheville, NC. The printing of this document was supported in part by: 1. North Carolina Baby Love Plus and Minority Infant Mortality Reduction Program (MIMRP)1, North Carolina Department of Health and Human Services 2. Cancer Prevention and Control Branch, Division of Public Health, North Carolina Department of Health and Human Services 3. Office of Research, Demonstration, and Rural Health and Development, North Carolina Department of Health and Human Services 1 “Supported in part by project #1 H49 MC 00086 from the Healthy Start Initiative, Maternal and Child Health Bureau, Health Resources and Services Administrative, Department of Health and Human Services.”Call to Action, 2003: OMHHD, N.C. - DHHS vi Members of the DHHS Eliminating Health Disparities Steering Committee Department of Health and Human Services Barbara Pullen-Smith, Facilitator Director, Office of Minority Health and Health Disparities Becky Procter Health Educator Oral Health Section Emmanuel Ngui, Facilitator Research Associate Office of Minority Health and Health Disparities Marcia Roth Program Manager NC Office of Disability and Health Leah Devlin Acting State Health Director, DHHS Ira Palmer DEC Mary Bethel Human Services Planner / Evaluator Division of Aging Michael Sanderson Senior Advisor for Healthy Schools Healthy Schools Wanda N. Brooks Program Analyst Office of Economic Opportunity Michael Sells Public Health Prevention Specialist NC HIV/STD Prevention and Care Branch Leslie Brown Health Disparities Liaison Office of Minority Health and Health Disparities Georgia Steele Asst. Dir. for Program Operations and Support Services NC Division of Vocational Rehabilitation Carmen Green Regional Manager Division of Deaf & Hard of Hearing Wilson Regional Resource Center Sandra Tatum Division of Facility Services Cheryl D. Holland Curriculum Intervention Specialist Office of Education Service Sharnese Ransome Special Assist to the Director Division of Social Services Bob Kurtz, PhD. Acting Section Chief for Advocacy Client Right and Quality Improvement Division of Mental Health Gé Brogden, Senior Planner, NC Office of Planning Yvette McMiller Primary Care Assistant Associate Office of Rural Health Wanda Woods Former Staff Office of Minority Health and Health Disparities Tara Owens Program Manager Women’s & Children’s Health Section Division of Public Health Brenda Crowder-Gaines Former Staff HIV/STD Prevention and Care Branch George Packenham Assistant Director of Medical Policy Division of Medical Assistance Kathy Tobin Former Staff NC Office of Planning Other Departments Linda Hinnant Former Staff, Division of Environmental Health Dept. of Environment and Natural Resources Dorothea Brock Coordinated School Health Programs Department of Public InstructionCall to Action, 2003: OMHHD, N.C. - DHHS vii Table of Contents Message from Secretary Carmen Hooker Odom __________________________________________ iii Acknowledgements __________________________________________________________________ v Members of the DHHS Eliminating Health Disparities______________________________________vi Steering Committee _________________________________________________________________vi Table of Contents __________________________________________________________________ vii Executive Summary _________________________________________________________________ 2 Purpose and Vision _________________________________________________________________ 6 North Carolina Demographics_________________________________________________________ 8 Overview: Health Disparities__________________________________________________________ 9 Key Areas of Disparities in Health Status _______________________________________________ 10 Determinants of Health _____________________________________________________________ 20 DHHS Disparities Program Assessment ________________________________________________ 24 Overview of Key Challenges ______________________________________________________ 24 Current Gaps in Eliminating Health Disparities __________________________________________ 27 Implementation Plans_______________________________________________________________ 29 Division of Public Health _________________________________________________________ 30 Division of Medical Assistance ____________________________________________________ 72 Division of Mental Health, Developmental Disabilities and Substance Abuse Services ______ 76 Division of Facility Services _______________________________________________________ 82 Division of Social Services ________________________________________________________ 92 Division of Services for the Blind _________________________________________________ 100 Division of