Note from the Editor

The papers here cover a broad range of topics, health care targets, and methodologies. Still, they share a common motivation, that of intervention. Each paper addresses this concern differently. Some, like Crenshaw and colleagues, address knowledge gaps and provide valuable baseline data for underserved areas, identifying effective health care targets for future intervention. Others chart some of the ramifications of linguistic diversity among patients. Zhang and colleagues, for example, examine the effects of limited English proficiency on medication-related self-efficacy among patients, while Scales discusses how cultural and personal communication styles, regardless of any language barrier, affect clinician-patient communication. Further papers outline strategies employed to address those disparities, suggesting alternative approaches that might be profitably added to our existing efforts. For instance, Cottrell and colleagues propose a conceptual framework to demonstrate how health information technologies might be used to bring data regarding social determinants of health to bear in primary care settings, suggesting a pathway for future research. Deerin and colleagues investigate the effectiveness of a testing paradigm which makes use of HIV surveillance data to aid in targeted, community-based hepatitis C virus testing, and Carroll and colleagues present a practical approach to hypertension counseling that aims to engage patients in partnership while still addressing the clinician's pragmatic needs. All these papers concern themselves with the question of how best to shape and conduct our larger interventions, be it by identifying particular vulnerabilities or expounding on the relative successes and imperfections of various programs and approaches.

The barriers and vicissitudes that impede health equity are many, often recalcitrant, and demanding of our utmost efforts and attention. It seems almost trite to say so, but it bears repeating, if only as a sort of mantric reminder. With the admonition, comes its tonic corollary: a problem precisely understood is a problem halfway solved. Each intervention entails its own exigencies. Thus, the importance of our commitment to delineate, in exacting detail as our authors here do, each instance of inequity as well as the attendant opportunities for improvement. Doing so generates a better grammar, as it were, to express the issues we face, make judgments, pursue alternative questions, and make exchanges in the ongoing conversation about health more fruitful. The task is to discover and then chart the path, to outline those policy initiatives and strategies for intervention that adequately address the unique pressures of each instance of health inequity. Humbly, and with deference to our authors, we feel the present issue meaningfully contributes to this goal.