Karen Bouye - Academia.edu (original) (raw)

Papers by Karen Bouye

Research paper thumbnail of Pandemic Influenza Preparedness and Response Among Public-Housing Residents, Single-Parent Families, and Low-Income Populations

American Journal of Public Health, Oct 1, 2009

Research paper thumbnail of Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions

Journal of Public Health Management and Practice, 2016

T he public health infrastructure required for achieving health equity is multidimensional and co... more T he public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

Research paper thumbnail of Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015

International Journal of Environmental Research and Public Health, 2019

The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-b... more The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to ...

Research paper thumbnail of Measurement of Health Disparities, Health Inequities, and Social Determinants of Health to Support the Advancement of Health Equity

Journal of Public Health Management and Practice, 2016

Reduction of health disparities and advancement of health equity in the United States require hig... more Reduction of health disparities and advancement of health equity in the United States require highquality data indicative of where the nation stands vis-à-vis health equity, as well as proper analytic tools to facilitate accurate interpretation of these data. This article opens with an overview of health equity and social determinants of health. It then proposes a set of recommended practices in measurement of health disparities, health inequities, and social determinants of health at the national level to support the advancement of health equity, highlighting that (1) differences in health and its determinants that are associated with social position are important to assess; (2) social and structural determinants of health should be assessed and multiple levels of measurement should be considered; (3) the rationale for methodological choices made and measures chosen should be made explicit; (4) groups to be compared should be simultaneously classified by multiple social statuses; and (5) stakeholders and their communication needs can often be considered in the selection of analytic methods. Although much is understood about the role of

Research paper thumbnail of Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions

Journal of public health management and practice : JPHMP

The public health infrastructure required for achieving health equity is multidimensional and com... more The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are n...

Research paper thumbnail of www.mdpi.com/journal/ijerph Article Difference in Health Inequity between Two Population Groups due to a Social Determinant of Health

Abstract: The World Health Organization defines social determinants of health as “complex, integr... more Abstract: The World Health Organization defines social determinants of health as “complex, integrated, and overlapping social structures and economic systems ” that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference...

Research paper thumbnail of Climate Change and Human Health in Populations of Concern: Chapter 9 of USGCRP Report

Research paper thumbnail of Increasing Diversity in the Health Professions: Reflections on Student Pipeline Programs

Journal of healthcare, science and the humanities, 2016

Despite major advances and technological improvements in public health and medicine, health dispa... more Despite major advances and technological improvements in public health and medicine, health disparities persist by race and ethnicity, income and educational attainment, and in some cases are increasing (Jackson & Garcia, 2014). These health disparities among these populations have even worsened or remained about the same since the landmark 1985 Report of the Secretary's Task Force on Black & Minority Health released by then Secretary Margaret M. Heckler. Ensuring diverse public health and healthcare workforces to provide services to diverse populations, in combination with other strategies, can increase access to and quality of healthcare for vulnerable populations and decrease healthcare disparities. One mechanism for achieving a diverse public health and healthcare workforce is to establish, promote, and conduct student training programs in public health. The Office of Minority Health and Health Equity, Centers for Disease Control and Prevention (CDC), has partnered with inst...

Research paper thumbnail of Addressing Social Determinants of Health and Health Equity among Rural Communities

Research paper thumbnail of Ch. 9: Populations of Concern

Research paper thumbnail of Strategies for reducing health disparities — selected CDC-sponsored interventions, United States, 2016

The Office of Minority Health and Health Equity (OMHHE) published a related MMWR serial report, t... more The Office of Minority Health and Health Equity (OMHHE) published a related MMWR serial report, the “Strategies for Reducing Health Disparities — Selected CDC-Sponsored Interventions, United States, 2014”. This report includes selected interventions that reflect effective public health actions supported by CDC that are proven effective or show promise for reducing health disparities at the local or national levels.

Research paper thumbnail of Social Determinants of Health: Implications for Minority Health, Women’s Health, and for Initiatives to Advance Health Equity in Rural Areas

Research paper thumbnail of Ch. 9: Populations of Concern. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment

Research paper thumbnail of The resource mothers program: how community health workers can reduce low-birth weight among African-American clients in WIC programs

Research paper thumbnail of Addressing Health Equity in Public Health Practice: Frameworks, Promising Strategies, and Measurement Considerations

Annual Review of Public Health

This review describes the context of health equity and options for integrating equity into public... more This review describes the context of health equity and options for integrating equity into public health practice. We first discuss how the conceptualization of health equity and how equity considerations in US public health practice have been shaped by multidisciplinary engagements. We then discuss specific ways to address equity in core public health functions, provide examples of relevant frameworks and promising strategies, and discuss conceptual and measurement issues relevant to assessing progress in moving toward health equity. Challenges and opportunities and their implications for future directions are identified. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Research paper thumbnail of Public Health Agency Responses and Opportunities to Protect Against Health Impacts of Climate Change Among US Populations with Multiple Vulnerabilities

Journal of Racial and Ethnic Health Disparities

Research paper thumbnail of Racial/Ethnic Health Disparities Among Rural Adults - United States, 2012-2015

Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002), Nov 17, 2017

Rural communities often have worse health outcomes, have less access to care, and are less divers... more Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States. 2012-2015. Self-reported data from the 2012-2015 Behavioral Risk Factor Surveillance System were pooled to evaluate racial/ethnic disparities in health, access to care, and health-related behaviors among rural residents in all 50 states and the District of Columbia. Using the National Center for Health Statistics 2013 Urban-Rural Classification Scheme for Counties to assess rurality, this analysis focused on adults living in noncore (rural) counties. Racial/ethnic minorities who lived in rural areas were younger (more often in the youngest age group) than non-Hispanic wh...

Research paper thumbnail of Increasing Diversity in the Health Professions: Reflections on Student Pipeline Programs

Journal of healthcare, science and the humanities, 2016

Despite major advances and technological improvements in public health and medicine, health dispa... more Despite major advances and technological improvements in public health and medicine, health disparities persist by race and ethnicity, income and educational attainment, and in some cases are increasing (Jackson & Garcia, 2014). These health disparities among these populations have even worsened or remained about the same since the landmark 1985 Report of the Secretary's Task Force on Black & Minority Health released by then Secretary Margaret M. Heckler. Ensuring diverse public health and healthcare workforces to provide services to diverse populations, in combination with other strategies, can increase access to and quality of healthcare for vulnerable populations and decrease healthcare disparities. One mechanism for achieving a diverse public health and healthcare workforce is to establish, promote, and conduct student training programs in public health. The Office of Minority Health and Health Equity, Centers for Disease Control and Prevention (CDC), has partnered with inst...

Research paper thumbnail of Background and rationale

Mmwr Surveillance Summaries Morbidity and Mortality Weekly Report Surveillance Summaries Cdc, Apr 18, 2014

Research paper thumbnail of Toward Achieving Health Equity: Emerging Evidence and Program Practice

Journal of public health management and practice : JPHMP

Health equity, in the context of public health in the United States, can be characterized as acti... more Health equity, in the context of public health in the United States, can be characterized as action to ensure all population groups living within a targeted jurisdiction have access to the resources that promote and protect health. There appear to be several elements in program design that enhance health equity. These design elements include consideration of sociodemographic characteristics, understanding the evidence base for reducing health disparities, leveraging multisectoral collaboration, using clustered interventions, engaging communities, and conducting rigorous planning and evaluation. This article describes selected examples of public health programs the Centers for Disease Control and Prevention (CDC) has supported related to these design elements. In addition, it describes an initiative to ensure that CDC extramural grant programs incorporate program strategies to advance health equity, and examples of national reports published by the CDC related to health disparities, ...

Research paper thumbnail of Pandemic Influenza Preparedness and Response Among Public-Housing Residents, Single-Parent Families, and Low-Income Populations

American Journal of Public Health, Oct 1, 2009

Research paper thumbnail of Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions

Journal of Public Health Management and Practice, 2016

T he public health infrastructure required for achieving health equity is multidimensional and co... more T he public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

Research paper thumbnail of Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015

International Journal of Environmental Research and Public Health, 2019

The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-b... more The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to ...

Research paper thumbnail of Measurement of Health Disparities, Health Inequities, and Social Determinants of Health to Support the Advancement of Health Equity

Journal of Public Health Management and Practice, 2016

Reduction of health disparities and advancement of health equity in the United States require hig... more Reduction of health disparities and advancement of health equity in the United States require highquality data indicative of where the nation stands vis-à-vis health equity, as well as proper analytic tools to facilitate accurate interpretation of these data. This article opens with an overview of health equity and social determinants of health. It then proposes a set of recommended practices in measurement of health disparities, health inequities, and social determinants of health at the national level to support the advancement of health equity, highlighting that (1) differences in health and its determinants that are associated with social position are important to assess; (2) social and structural determinants of health should be assessed and multiple levels of measurement should be considered; (3) the rationale for methodological choices made and measures chosen should be made explicit; (4) groups to be compared should be simultaneously classified by multiple social statuses; and (5) stakeholders and their communication needs can often be considered in the selection of analytic methods. Although much is understood about the role of

Research paper thumbnail of Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions

Journal of public health management and practice : JPHMP

The public health infrastructure required for achieving health equity is multidimensional and com... more The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are n...

Research paper thumbnail of www.mdpi.com/journal/ijerph Article Difference in Health Inequity between Two Population Groups due to a Social Determinant of Health

Abstract: The World Health Organization defines social determinants of health as “complex, integr... more Abstract: The World Health Organization defines social determinants of health as “complex, integrated, and overlapping social structures and economic systems ” that are responsible for most health inequities. Similar to the individual-level risk factors such as behavioral and biological risk factors that influence disease, we consider social determinants of health such as the distribution of income, wealth, influence and power as risk factors for risk of disease. We operationally define health inequity in a disease within a population due to a risk factor that is unfair and avoidable as the difference between the disease outcome with and without the risk factor in the population. We derive expressions for difference in health inequity between two populations due to a risk factor that is unfair and avoidable for a given disease. The difference in heath inequity between two population groups due to a risk factor increases with increasing difference in relative risks and the difference...

Research paper thumbnail of Climate Change and Human Health in Populations of Concern: Chapter 9 of USGCRP Report

Research paper thumbnail of Increasing Diversity in the Health Professions: Reflections on Student Pipeline Programs

Journal of healthcare, science and the humanities, 2016

Despite major advances and technological improvements in public health and medicine, health dispa... more Despite major advances and technological improvements in public health and medicine, health disparities persist by race and ethnicity, income and educational attainment, and in some cases are increasing (Jackson & Garcia, 2014). These health disparities among these populations have even worsened or remained about the same since the landmark 1985 Report of the Secretary's Task Force on Black & Minority Health released by then Secretary Margaret M. Heckler. Ensuring diverse public health and healthcare workforces to provide services to diverse populations, in combination with other strategies, can increase access to and quality of healthcare for vulnerable populations and decrease healthcare disparities. One mechanism for achieving a diverse public health and healthcare workforce is to establish, promote, and conduct student training programs in public health. The Office of Minority Health and Health Equity, Centers for Disease Control and Prevention (CDC), has partnered with inst...

Research paper thumbnail of Addressing Social Determinants of Health and Health Equity among Rural Communities

Research paper thumbnail of Ch. 9: Populations of Concern

Research paper thumbnail of Strategies for reducing health disparities — selected CDC-sponsored interventions, United States, 2016

The Office of Minority Health and Health Equity (OMHHE) published a related MMWR serial report, t... more The Office of Minority Health and Health Equity (OMHHE) published a related MMWR serial report, the “Strategies for Reducing Health Disparities — Selected CDC-Sponsored Interventions, United States, 2014”. This report includes selected interventions that reflect effective public health actions supported by CDC that are proven effective or show promise for reducing health disparities at the local or national levels.

Research paper thumbnail of Social Determinants of Health: Implications for Minority Health, Women’s Health, and for Initiatives to Advance Health Equity in Rural Areas

Research paper thumbnail of Ch. 9: Populations of Concern. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment

Research paper thumbnail of The resource mothers program: how community health workers can reduce low-birth weight among African-American clients in WIC programs

Research paper thumbnail of Addressing Health Equity in Public Health Practice: Frameworks, Promising Strategies, and Measurement Considerations

Annual Review of Public Health

This review describes the context of health equity and options for integrating equity into public... more This review describes the context of health equity and options for integrating equity into public health practice. We first discuss how the conceptualization of health equity and how equity considerations in US public health practice have been shaped by multidisciplinary engagements. We then discuss specific ways to address equity in core public health functions, provide examples of relevant frameworks and promising strategies, and discuss conceptual and measurement issues relevant to assessing progress in moving toward health equity. Challenges and opportunities and their implications for future directions are identified. Expected final online publication date for the Annual Review of Public Health, Volume 41 is April 1, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Research paper thumbnail of Public Health Agency Responses and Opportunities to Protect Against Health Impacts of Climate Change Among US Populations with Multiple Vulnerabilities

Journal of Racial and Ethnic Health Disparities

Research paper thumbnail of Racial/Ethnic Health Disparities Among Rural Adults - United States, 2012-2015

Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002), Nov 17, 2017

Rural communities often have worse health outcomes, have less access to care, and are less divers... more Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States. 2012-2015. Self-reported data from the 2012-2015 Behavioral Risk Factor Surveillance System were pooled to evaluate racial/ethnic disparities in health, access to care, and health-related behaviors among rural residents in all 50 states and the District of Columbia. Using the National Center for Health Statistics 2013 Urban-Rural Classification Scheme for Counties to assess rurality, this analysis focused on adults living in noncore (rural) counties. Racial/ethnic minorities who lived in rural areas were younger (more often in the youngest age group) than non-Hispanic wh...

Research paper thumbnail of Increasing Diversity in the Health Professions: Reflections on Student Pipeline Programs

Journal of healthcare, science and the humanities, 2016

Despite major advances and technological improvements in public health and medicine, health dispa... more Despite major advances and technological improvements in public health and medicine, health disparities persist by race and ethnicity, income and educational attainment, and in some cases are increasing (Jackson & Garcia, 2014). These health disparities among these populations have even worsened or remained about the same since the landmark 1985 Report of the Secretary's Task Force on Black & Minority Health released by then Secretary Margaret M. Heckler. Ensuring diverse public health and healthcare workforces to provide services to diverse populations, in combination with other strategies, can increase access to and quality of healthcare for vulnerable populations and decrease healthcare disparities. One mechanism for achieving a diverse public health and healthcare workforce is to establish, promote, and conduct student training programs in public health. The Office of Minority Health and Health Equity, Centers for Disease Control and Prevention (CDC), has partnered with inst...

Research paper thumbnail of Background and rationale

Mmwr Surveillance Summaries Morbidity and Mortality Weekly Report Surveillance Summaries Cdc, Apr 18, 2014

Research paper thumbnail of Toward Achieving Health Equity: Emerging Evidence and Program Practice

Journal of public health management and practice : JPHMP

Health equity, in the context of public health in the United States, can be characterized as acti... more Health equity, in the context of public health in the United States, can be characterized as action to ensure all population groups living within a targeted jurisdiction have access to the resources that promote and protect health. There appear to be several elements in program design that enhance health equity. These design elements include consideration of sociodemographic characteristics, understanding the evidence base for reducing health disparities, leveraging multisectoral collaboration, using clustered interventions, engaging communities, and conducting rigorous planning and evaluation. This article describes selected examples of public health programs the Centers for Disease Control and Prevention (CDC) has supported related to these design elements. In addition, it describes an initiative to ensure that CDC extramural grant programs incorporate program strategies to advance health equity, and examples of national reports published by the CDC related to health disparities, ...