Name of Report: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Executive Summary
Organizational Affiliation: Institute of Medicine ; National Academy of Sciences
Editors: Brian D. Smedley, Adrienne Y. Stith, and Alan R. Nelson
Date: 2003
Contact Information: N/A
Pages: 27
Content Summary
This report is an in-depth analysis of racial and ethnic disparities in health care. The authors target policymakers and health care providers and make a series of suggestions for eliminating the large disparities in health care. For the purposes of this study, disparities are defined as "differences in the quality of healthcare that are not due to access related factors or clinical needs, preferences, and appropriateness of intervention." Using this definition they reveal that differences persist even after controlling for socioeconomics. The goals of this paper are to assess the extent to which these disparities exist, evaluate the sources of disparities, and recommend interventions for elimination of these disparities. The analyses focused on legal and regulatory aspects of the healthcare system as well as individual discrimination on the part of health care providers. The report analyzed results from current literature which reveal misdirection of services and challenged the appropriateness of care provided to racial minorities. For example the report revealed that there are large disparities in cancer diagnostic tests, treatments, and pain relief prescription. The report also reveals racially disparate trends in managing coronary heart care. However, other diseases were not included in this report, but may be found in the committee report for this project. At the end of this report are a series of boxes which summarize the key findings and recommendations of this report. Another useful aspect of this report is that it is available online. This report is easy to read and provides clear explanations for the findings and recommendations which are accessible for health care providers as well as the general public.
Major Findings
The report suggests that racial disparities in health care access are part of a larger trend of racial discrimination in American social an economic life. Similarly, the report addresses how patient preferences, treatment refusal, and clinical appropriateness of care contribute to care disparities. In assessing the system-level sources of racial disparities, the report suggests language barriers, physician time constraints, and geographic limitations. The process-level sources studied in this report are bias, stereotyping, and uncertainty each of which is based on a lack of cultural understanding on the part of health care providers. In describing the patient aspect, the report clearly examines the possible explanations for patient mistrust and non-compliance which is attributed to previous experiences of racial discrimination. The report suggests that healthcare financing and delivery should be monitored bearing in mind the racial disparities that exist. A series of suggestions including patient and provider education programs, Civil Rights enforcement, financial incentives for healthcare providers, and interpretation and community health worker services are delineated for improving the treatment provided to racial and ethnic minorities by the health care system. The report also suggests that improvements in collecting data on race need to be established by the health care system to monitor disparities.
Unaddressed Issues and Concerns
One of the greatest strengths of this report is the attention to detail. This report meticulously addresses a broad array of areas in which racial disparities exist. The report addresses potential social factors that cause these disparities including cultural insensitivity, insufficient health literacy, and limits to health care access which are also assessed in other literature (Anachebe S37). The unaddressed issues in this report are explored in the specific committee reports, according to the report itself.
Reference List
Anachebe, Ngozi F. and Madeline Y. Sutton. (2003). " Racial Disparities in Reproductive Health Outcomes." American Journal of Obstetrics and Gynecology . 188(4): S37-42.
How to Access Report http://books.np.edu/catalog/10260.html