Unequal Treatment


Book Description

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.




Understanding Racial and Ethnic Differences in Health in Late Life


Book Description

As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.




Eliminating Health Disparities


Book Description

Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.




Race, Ethnicity, and Health


Book Description

Race, Ethnicity and Health, Second Edition, is a critical selection of hallmark articles that address health disparities in America. It effectively documents the need for equal treatment and equal health status for minorities. Intended as a resource for faculty and students in public health as well as the social sciences, it will be also be valuable to public health administrators and frontline staff who serve diverse racial and ethnic populations. The book brings together the best peer reviewed research literature from the leading scholars and faculty in this growing field, providing a historical and political context for the study of health, race, and ethnicity, with key findings on disparities in access, use, and quality. This volume also examines the role of health care providers in health disparities and discusses the issue of matching patients and doctors by race. New chapters cover: reflections on demographic changes in the US based on the current census; metrics and nomenclature for disparities; theories of genetic basis for disparities; the built environment; residential segregation; environmental health; occupational health; health disparities in integrated communities; Latino health; Asian populations; stress and health; physician/patient relationships; hospital treatment of minorities; the slavery hypertension hypothesis; geographic disparities; and intervention design.




Race, Ethnicity, and Language Data


Book Description

The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.




Health Disparities in the United States


Book Description

Challenging students to think critically about the complex web of social forces that leads to health disparities in the United States. The health care system in the United States has been called the best in the world. Yet wide disparities persist between social groups, and many Americans suffer from poorer health than people in other developed countries. In this revised edition of Health Disparities in the United States, Donald A. Barr provides extensive new data about the ways low socioeconomic status, race, and ethnicity interact to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term. This thoroughly updated edition focuses on a new challenge the United States last experienced more than half a century ago: successive years of declining life expectancy. Barr addresses the causes of this decline, including what are commonly referred to as "deaths of despair"—from opiate overdose or suicide. Exploring the growing role geography plays in health disparities, Barr asks why people living in rural areas suffer the greatest increases in these deaths. He also analyzes recent changes under the Affordable Care Act and considers the literature on how race and ethnicity affect the way health care providers evaluate and treat patients. As both a physician and a sociologist, Barr is uniquely positioned to offer rigorous medical explanations alongside sociological analysis. An essential text for courses in public health, health policy, and sociology, this compelling book is a vital teaching tool and a comprehensive reference for social science and medical professionals.




Guidance for the National Healthcare Disparities Report


Book Description

The Agency for Healthcare Research Quality commissioned the Institute of Medicine establish a committee to provide guidance on the National Healthcare Disparities Report is of access to health care, utilization of services, and the services received. The committee was asked to con population characteristics as race and ethnicity, society status, and geographic location. It was also asked to examine factors that included possible data sources and types of measures for the report.




Critical Perspectives on Racial and Ethnic Differences in Health in Late Life


Book Description

In their later years, Americans of different racial and ethnic backgrounds are not in equally good-or equally poor-health. There is wide variation, but on average older Whites are healthier than older Blacks and tend to outlive them. But Whites tend to be in poorer health than Hispanics and Asian Americans. This volume documents the differentials and considers possible explanations. Selection processes play a role: selective migration, for instance, or selective survival to advanced ages. Health differentials originate early in life, possibly even before birth, and are affected by events and experiences throughout the life course. Differences in socioeconomic status, risk behavior, social relations, and health care all play a role. Separate chapters consider the contribution of such factors and the biopsychosocial mechanisms that link them to health. This volume provides the empirical evidence for the research agenda provided in the separate report of the Panel on Race, Ethnicity, and Health in Later Life.




Diversity and Inclusion in Quality Patient Care


Book Description

No other hospital department cares for patients as diverse as those who come to the Emergency Department (ED). These patients encompass all stages and positions of life and health. Many belong to distinct minority cultures defined by the patient's sexual orientation and gender identity, disability, spirituality, language, race, and ethnicity. It has been well documented that minorities experience inadequate emergency treatment and face poorer healthcare outcomes. Furthermore, research has established that the elderly, ethnic minorities, the poor, and persons with Medicaid coverage are more likely than other people to utilize the emergency department rather than primary care services. With the passage of the Affordable Care Act, particularly the Medicaid expansion, EDs across the United States are poised to care for an unprecedented number of underserved minorities. The need to equip emergency healthcare professionals to practice medicine that is culturally competent in the broadest possible sense has never been greater. Diversity and Inclusion in Quality Patient Care aims to fill this need.