Substandard health care for minorities?

fergus51 · Mar 24, 2002

Do you really think it's all bunk Peeps? It seems to be from a reliable source to me (The Institute of Medicine prepared the report for congress right?) I don't know why the Institute of Medicine would be making it up. I think the majority of the disparity comes from indivual practitioners and situations, but it does seem that coorporations do treat minorities differently:

--Among 15,578 people who sought care in an urban emergency room, blacks were 1.5 times more likely to be denied authorization by their managed-care providers.

The report said the differences exist even when insurance, income, age and the severity of the disease are the same for both groups.

fergus51 · Mar 24, 2002

I've attached a Health Canada link. Health Canada now takes the view that health is determined by a variety of social factors (the social determinants of health) which include:

Income and Social Status Social Support Networks Education Employment/Working Conditions Social Environments Physical Environments Personal Health Practices and Coping Skills

Healthy Child Development Biology and Genetic Endowment

Health Services Gender and Culture.

Culture is where we are concerned with minorities. In Canada the most studied minority group has to be our aboriginal population and their health status as a group is apalling. Pick any disease and chances are it's higher among them than the general population despite the fact that they are garanteed free health care. So access is not the absolute solution.

http://www.hc-sc.gc.ca/hppb/phdd/determinants/e_determinants.html#income

It has some good hard stats if you want them Peeps. Though I know Canada and the US are not the same.

donmurray · Mar 24, 2002

Does the term "Institutional Racism" translate? Where the system functions in such a way as to discriminate against minorities.

wrightgd · Mar 25, 2002

I think the point about skewed data is on target... The data for reports such as these are often derived from pre-determined fact finding missions which intentionally lead toward the desired results, or intentionally ignore other pertinent factors such as the cultural preferences that some others here have mentioned.

The short of the matter is that if all citizens are afforded equal opportunity to competent care, then there is no one to blame, except the patient, for not seeking the medical attention that he/she needs. It seems to me that this report misses it's mark. The authors of this report attempt to convince us that there is rampant racism in American healthcare. Anyone who utilizes healthcare in America, knows that this issue goes farther than race, gender, and ethnicity... This is not a diversity issue. It is, and always be a MONEY issue.

George

Q. · Mar 25, 2002

Here, here George! :)

fergus51 · Mar 25, 2002

I don't see why blame has anything to do with it. I don't consider myself to blame for minorities poor health care. I don't think that's the point. I think the point is that if we want to improve the health of the population as a whole, it has to be done by adressing the health challenges of subpopulations that need it the most (whether that subpopulation is defined by race, socio-economic status or whatver).

SharonH, RN · Mar 26, 2002

To George, Brad and Suzy: Too bad you choose to ignore the data. If I gave you a story about what I have observed, seen, and experienced, you'd say show me the hard data. You get the data and you prefer to believe that the data's skewed. If you haven't experiencecd it, then how do you know? There is racism in healthcare and I'm sorry if that makes you uncomfortable to acknowledge(or in Brad's case, angry) but it's true.

Q. · Mar 26, 2002

I've also learned that hard data can be made to say anything the author wishes. I just try to read with a discriminating eye.

wrightgd · Mar 26, 2002

Sharon,

I don't mean to imply that there is not racism in healthcare... Of course there is... It's everywhere. My point is that the data is scientifically unsound. There are so many other factors which influence the treatment of all individuals seeking healthcare.

The biggest point I am trying to make is this... Let's assume that the data is 100% accurate and encompasses all possible variables... The bottom line is still that America's healthcare system is off base... It is designed and operated as a business, and not to take care of the public's health needs. That is my point...

But still, you're right... I don't necessarily agree that this report is accurate... Waaaaayyyyy too many variables that just can't be documented...

Thanks for the debate...

George

eldernurse · Mar 26, 2002

I still say we all live together in this country. We all have socio-economic situations, be it race or money. Each one of us is responsible for our own health. If you come to the ER with whatever and the nurse and the doctor give you follow up info and stress that the follow up is important, it is still the individual's responsibility to seek out the available help.

I do not feel it is our duty to hold their hand, make the follow up appointment and make sure they go to it.

I treat everyone (and I mean EVERYONE) the same when they come to the ER. I don't care if you are Susie prostitute with lady partsl discharge or the president's mother with chest pain. Each patient I care for is important. Each of them need the proper follow up care after the ER visit. Those needs are addressed. I resent a study that implies that health care is not out there for everyone.

semstr · Mar 26, 2002

Well, I agree with a lot of statements here.

But doesn't money(aka not having money) goes hand in hand with racisme most of the time?

Take care, Renee

Stargazer · Mar 26, 2002

I resent a study that implies that health care is not out there for everyone.

eldernurse, how you, individually, treat patients is not really the point of studies like this. The point of research like this is to study systems: are there mechanisms in place to educate minorities about the value of primary care; are poorer counties underserved by sufficient hospitals/primary care centers, etc.

Whether or not you "resent" it is neither here nor there--the numbers are there. Now, you can argue, as some of the other posters have done, that the study itself has design flaws, and that may be so. Most studies aren't statistically bulletproof.

However, according to the CDC,

Numerous reports and research studies have documented major disparities between key health indicators among racial and ethnic minorities and those among white populations.

I would refer you again to the links I posted on page 1. Given that the CDC's raison d'etre is epidemiology, I don't think that its conclusions on this topic can be dismissed out of hand.