Objective To review systematically the role of e-mails in patient–provider communication in terms of e-mail content, and perspectives of providers and patients on e-mail communication in health care. Methods A systematic review of studies on e-mail communication between patients and health providers in regular health care published from 2000 to 2008. Results A total of 24 studies were included in the review. Among these studies, 21 studies examined e-mail communication between patients and providers, and three studies examined the e-mail communication between parents of patients in pediatric primary care and pediatricians. In the content analyses of e-mail messages, topics well represented were medical information exchange, medical condition or update, medication information, and subspecialty evaluation. A number of personal and institutional features were associated with the likelihood of e-mail use between patients and providers. While benefits of e-mails in enhancing communication were recognized by both patients and providers, concerns about confidentiality and security were also expressed. Conclusion The e-mail is transforming the relationship between patients and providers. The rigorous exploration of pros and cons of electronic interaction in health care settings will help make e-mail communication a more powerful, mutually beneficial health care provision tool. Practice implications It is important to develop an electronic communication system for the clinical practice that can address a range of concerns. More efforts need to be made to educate patients and providers to appropriately and effectively use e-mail for communication.

For the past 20 years, the percentage of the American population consisting of nonwhite minorities has been steadily increasing. By 2050, these nonwhite minorities, taken together, are expected to become the majority. Meanwhile, despite almost 50 years of efforts to increase the representation of minorities in the healthcare professions, such representation remains grossly deficient. Among the underrepresented minorities are African and Hispanic Americans; Native Americans, Alaskans, and Pacific Islanders (including Hawaiians); and certain Asians (including Hmong, Vietnamese, and Cambodians). The underrepresentation of underrepresented minorities in the healthcare professions has a profoundly negative effect on public health, including serious racial and ethnic health disparities. These can be reduced only by increased recruitment and development of both underrepresented minority medical students and underrepresented minority medical school administrators and faculty. Underrepresented minority faculty development is deterred by barriers resulting from years of systematic segregation, discrimination, tradition, culture, and elitism in academic medicine. If these barriers can be overcome, the rewards will be great: improvements in public health, an expansion of the contemporary medical research agenda, and improvements in the teaching of both underrepresented minority and non-underrepresented minority students.

Although nearly all segments of the Black population experienced widened post-HAART disparities, disparities were not inevitable and tended to reflect pre-HAART levels. Public health policymakers should consider the hypothesis of unequal diffusion of the HAART innovation, with place effects rendering some communities more vulnerable than others to this potential problem.

The survey confirms that pediatricians are knowledgeable about fetal alcohol syndrome but do not feel adequately trained to integrate the management of this diagnosis or prevention efforts into everyday practice. Furthermore, the respondents were not active in routine anticipatory guidance with adolescents for prevention of alcohol-affected pregnancies. The development, dissemination, and implementation of best practice tools for prevention, diagnosis, and referral of fetal alcohol syndrome that are specific for general and subspecialist pediatricians are recommended.

An influenza pandemic would have a disproportionately adverse impact on minority populations, the poor, the uninsured, and those living in underserved communities. Primary care practices serving the underserved would face special challenges in an influenza pandemic. Although not a formalized system, components of the primary care safety net include federally qualified health centers, public hospital clinics, volunteer or free clinics, and some local public health units. In the event of an influenza pandemic, the primary care safety net is needed to treat vulnerable populations and to provide health care surge capacity to prevent the overwhelming of hospital emergency departments. We examined the strength, capacity, and preparedness of key components of the primary care safety net in responding to pandemic influenza.

Despite efforts to eliminate inequality in health and health care, disparities in health care access and utilization persist in the United States. The purpose of this study was to compare the access to care and use of health care services of US-born and foreign-born Asian Americans. We used aggregated data from the National Health Interview Survey (NHIS) from 2003 to 2005, including 2,500 participants who identified themselves as Asian. Associations between country of birth and reported access and utilization of care in the previous 12 months were examined. After controlling for covariates, being foreign-born was negatively related to indicators of access to care, including health insurance (OR = 0.29, 95%CI = 0.18–0.48), routine care access (OR = 0.52, 95%CI = 0.36–0.75), and sick care access [OR = 0.67, 95%CI = 0.47–0.96)]. Being foreign-born was also negatively related to all indicators of health care utilization (office visit: OR = 0.58, 95%CI = 0.41–0.81; seen/talked to a general doctor: OR = 0.69, 95%CI = 0.52–0.90; seen/talked to a specialist: OR = 0.42, 95%CI = 0.28–0.63) but ER visit (OR = 0.84, 95%CI = 0.59–1.20). There are substantial differences by country of birth in health care access and utilization among Asian Americans. Our findings emphasize the need for developing culturally sensitive health services and intervention programs for Asian communities.

This article describes the ingredients of successful programs for the development of minority faculty in academic medicine. Although stung by recent cuts in federal funding, minority faculty development programs now stand as models for medical schools that are eager to join the 140-year-old quest for diversity in academic medicine. In this article, the ingredients of these successful faculty development programs are discussed by experts in minority faculty development and illustrated by institutional examples. Included are descriptions of program goals and content, mentoring and coaching, selecting participants, providing a conducive environment, managing the program, and sustaining support. This article is a companion to another article, "Successful Programs in Minority Faculty Development: Overview," in this issue of the Mount Sinai Journal of Medicine.

Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve.