After the small-group discussions, each group reported back to the larger group. Will Crimi summarized the themes outlined by the small groups, as described below.

Working Across Racial and Ethnic Groups

Several participants noted the difficulties in bringing together groups that have their own interests to work together. One person suggested finding a common goal to bring groups together, for example, focusing on reducing poverty or supporting immigrant rights. Certainly, one area of common ground is the issue of health equity.

Another approach to encourage working across groups is to highlight the idea that health disparities are a shared problem and a multicultural issue. Therefore, finding the solution requires all groups to take responsibility together so that no one suffers. Health disparities, one participant said, need to be framed as a community problem rather than an individual problem. In this way, more people within a community will have ownership of the problem.

One participant suggested that it is easier to effect change by using the infrastructure already present in the community rather than starting from scratch. For example, working with the media and working with local fast-food outlets within the community can create an environment conducive to behavior change.

The Importance of Framing

A second theme that emerged from the small-group discussions was the importance of reframing the issue of health disparities so that the message appeals to a broader constituency. Several groups discussed the role of the media in framing issues; and the topic of how to take advantage of new forms of media, such as blogging, was raised. One participant, echoing Lori Dorfman’s comments, suggested that it is essential to encourage the media to pay attention to the context as well as the individual.

Roundtable member Sam So, in describing his work in the Asian American community in Northern California, noted the importance of framing hepatitis B and liver cancer as community problems rather than as health disparities. Dr. So also worked with the media to promote health messages to the community.

Systemic Issues

A third theme that emerged from the discussions is that health disparities will never be reduced until broad systemic issues are addressed. One



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