Evette Joy Ludman, Ph.D., of Seattle-based Group Health Cooperative, is an expert in the area of self-care of chronic diseases, and agreed that income level and patient education play a major role in how well minority patients manage their condition.

"Low income, low English proficiency and nonparticipation in self-management education are factors often associated with poorer self-care in people living with many types of chronic conditions," Ludman said. "Creative solutions are being researched and implemented, however. Some of the most intriguing I've seen combine outreach and peer support by community members, such as the 'promotora' model in Spanish speaking communities."

A promotora is an outreach worker in a Hispanic community who is responsible for raising awareness of health and educational issues.

Ethnicity & Disease is a quarterly medical journal studying the ethnic patterns of disease. For more information, contact ethndisishib or visit ishib/ED_index.asp

Levine DA, et al. Disparities in self-monitoring of blood glucose among low-income ethnic minority populations with diabetes, United States. Ethnicity & Disease 19(2), 2009.

By Glenda Fauntleroy, Health Behavior News Service

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