Documenting the Disparities
"Disparities in the health care delivered to racial and ethnic minorities are real and are associated with worse outcomes in many cases, which is unacceptable. The real challenge lies not in debating whether disparities exist, because the evidence is overwhelming, but in developing and implementing strategies to reduce and eliminate them."
-- Alan Nelson, retired physician, former president of the American Medical Association and chair of the committee that wrote the Institute of Medicine report, Unequal Treatment: Confronting Racial and Disparities in Health Care
http://www4.nas.edu/onpi/webextra.ns...2?OpenDocument
Racial and ethnic disparities are, with few exceptions, remarkably consistent across a range of illnesses and health care services. In some cases, differences in treating heart disease, cancer and HIV infection partly contribute to higher death rates for minorities. Although socioeconomic factors such as lack of health care facilities in minority communities or inability to afford high co-payments play a large role, racial and ethnic disparities in health care persist regardless of income or insurance, says the report. Below are just a few examples from hundreds of studies conducted during the past decade on minority disparities in health care.
Cardiovascular Disease
Racial and ethnic disparities are most evident in cardiovascular care. For example, minorities are less likely to be given appropriate cardiac medications or to undergo bypass surgery.
Cancer
Several studies show significant racial differences in who receives appropriate cancer diagnostic tests and treatments.
Stroke
Although African-Americans suffer strokes as much as 35 percent higher than whites do, several studies have found that they are less likely to receive major diagnostic and therapeutic interventions.
Kidney Dialysis, Transplants
Minorities are less likely to be placed on waiting lists for kidney transplants or to receive kidney dialysis or transplants.
HIV/AIDS
Minorities with HIV infection are less likely to receive antiretroviral therapy and other state-of-the-art treatments, which could forestall the onset of AIDS.
Asthma
Asthmatic African-Americans are less likely to receive appropriate medications to manage chronic symptoms.
Diabetes
Although minorities have a much higher rate of death and illness from diabetes, the disease is poorly managed among minority patients, says the report. In a study of nearly 1,400 Medicare patients, diabetic African-Americans were found less likely to receive key diagnostic tests.
Minorities are also more likely to receive certain less-desirable procedures, such as lower limb amputations for diabetes and other conditions.
Maternal and Child Health
Despite several federal and state initiatives to promote healthcare access to pregnant women and their children, racial and ethnic disparities persist in maternal and child healthcare. For example, minority women are more likely to undergo cesarean deliveries. And minority children are less likely to receive prescription medications.
Mental Health
In psychiatric care, African-Americans are more likely to be diagnosed as psychotic, but are less likely to be given anti-psychotic medications. They are more likely to be hospitalized involuntarily, to be regarded as potentially violent, and to be placed in restraints. A recent report from the U.S. Surgeon General illuminates the striking disparities in access and availability of mental health services for minorities, and calls for action to improve the quality of mental health care available to racial and ethnic minority populations.
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