Andy J Karter, PhD
   CDTR Associate Director: Health Disparities Core Kaiser Permanente

Health Disparities Core

The Health Disparities Core is dedicated to fostering the ongoing evaluation of social differences in the outcomes of translation, the development of practical methodologies for monitoring changes in health status across population subgroups within practice settings, and the provision of expertise, guidance and mentorship to junior investigators interested in this special subtype of translation research. This work takes place in both fully insured populations (managed care settings included in this application) as well as in the vulnerable patients cared for by safety net providers (represented by the California Diabetes Program). A comprehensive evaluation of the translation process and its potential impact on disparities would be incomplete without understanding both settings.

The Diabetes Health Disparities Research Core creates capacity to assess the effects of translational interventions across social groups and stimulate the following research activities:

  1. Increase awareness about the importance of testing the uniform benefit assumption with every new translation effort
  2. Identify quality improvement approaches or policies that establish surveillance, encourage uniform benefit or strive specifically for reductions in disparities in key population subgroups
  3. Develop surveillance approaches and statistical metrics that can be implemented in health care settings and state health departments to track whether implementation of an intervention or policy benefits all groups equally (by health literacy, language proficiency, education, income and race/ethnicity).
  4. Examine whether the benefits (e.g., reach or absolute and relative effect size) of translational
    interventions are uniform across social groups, or reduce or increase disparities?
  5. Identify mediators, i.e., intervention characteristics or barriers, particularly modifiable ones, that may explain differential success and/or relative changes in disparities
  6. Evaluate modifications to the intervention implementation so as to achieve uniform benefits or to reduce disparities
  7. Evaluate longitudinally whether initial subgroup effect differences subsequent to a translation process change (improves/worsens) over time


Andrew J. Karter, Health Disparities Core Lead, KPNC

Alyce Adams, KPNC

Jay Desai, HealthPartners

Alka Kanaya, UCSF

Dean Schillinger, UCSF

Julie Schmittdiel, KPNC