Participants in the National Health Training Alliance constitute a multicultural collaboration on many levels. Each participant represents a different racial and ethnic constituency and each has different content and outreach strategies that are believed to be culturally appropriate for the targeted constituencies.

• Members of the National Association of Latino Elected and Appointed Officials (NALEO) understand the unique public health and chronic disease disparities that burden Latino and Hispanic populations. As a consequence, they have elected to emphasize education and training activities that focus on prevention and effective management of conditions such as diabetes, hepatitis, and HIV/AIDS.
  

• The National Medical Association is the oldest professional association for black physicians in the country, and its members understand the unusual barriers its constituency faces to practicing and reducing health disparities. Its prioritized policy and related training focuses on Medicaid and Medicare Part D issues.
  

• The Joint Center Health Policy Institute (HPI) has made a strategic decision to help its constituent communities identify and develop interventions for addressing the social determinants (educational, economical, behavioral, and environmental) that influence health outcomes. This strategy includes, of course, access to quality care.
  

• FamiliesUSA, Inc., a national nonprofit, non-partisan organization dedicated to the achievement of high-quality, affordable health care for all Americans, has developed its training and education materials on public programs, Medicare, Medicaid and SCHIP. www.familiesusa.org

Are these efforts complementary? How is the whole greater than the sum of its parts? It is important to view the challenge of addressing health disparities through a lens that reveals the complexity of the challenge and, at the same time, offers opportunities for progress. This unique multicultural collaboration accomplishes both. The array of complexities, variations within ethnic groups' experiences of health disparities, variations within service providers and resources, and variations in translation of policy into practice are evidenced in the outputs of this first year.

But the culturally specific opportunities for intervention and related sharing and cross cultural learning are also clear. The partnership is creating a space for building trust, and promoting cross cultural interaction and communication. Valuable lessons are being learned that can be leveraged for more effective coalition efforts in the future. The four distinct areas of focus address the continuum of health disparities challenges: social determinants, prevention, and disease management, access and quality issues. But most importantly, these dimensions are addressed within diverse cultures that bear a disproportionate burden of illness.