Breaking the Barriers

Four years ago, in response to a national survey,¹ a majority of physicians said that disparities in how people are treated in the health care system were not based on income, fluency in English, education, or racial or ethnic background. Two years later, however, an Institute of Medicine report² stated that such factors were the basis of disparities in health care and were often associated with worse outcomes.

What are some of these disparities? Specific to respiratory care, in both 2000 and 2001, in 12 of 15 areas assessed, blacks received poorer care than did whites.³ Areas assessed included immunizations, treatment of upper respiratory infection, asthma management, and treatment of pneumonia. Hispanics, compared to non-Hispanic whites, fared worse in nine of the 15 areas.

There is encouraging news, though. According to a recent study¹ conducted by the Institute for Ethics at the American Medical Association, more physicians acknowledge that disparities in health care do exist, and they are becoming involved in eliminating them. More than half the respondents (55%) agreed that minority patients generally receive lower quality care than white patients, and 62% report that they have witnessed a patient receive poor-quality health care because of race or ethnicity. Now they are trying to do something about these disparities by speaking with colleagues about ways to address health care needs specific to minority patients and by speaking with community health workers about the health needs of patients in their practice community. Many attend educational events or read journal articles on improving the health of minority patients. These physicians believe that it is possible to provide high-quality care to all of their patients and further believe that they are in a position to make a difference.

All medical professionals who work in communities with a high proportion of minority patients are well aware of the barriers to high-quality health care their patients face—poverty, lack of insurance, limited access to nonemergency care—and greater access must be made available. In addition, practitioners must examine their own practices to ensure that their biases do not affect their clinical judgment.

What can you do? Take a good look at your own practice patterns and those of your facility. Talk to your colleagues about how best to care for minority patients so that no disparities exist, attend educational sessions or read journal articles on improving the health of minority patients, familiarize yourself with what is being done to reform Medicaid, and support the efforts of medical societies to develop practice parameters that include criteria that would eliminate racial and ethnic disparities.

To learn more, visit the National Minority Health Month Foundation at: www.nmhm.org. 

—Marian Benjamin
mbenjamin@ascendmedia.com

References
1. Kaiser Family Foundation. National Survey of Physicians. 2002. Available at: www.kff.org/minorityhealth/loader.cfm?url=?commonspot/security/getfile.cfm&PageID=13955.   Accessed April 25, 2005.
2. Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. 2003. Available at: www.nap.edu/books/030908265X/html.   Accessed April 25, 2005.
3. Agency for Healthcare Research and Quality. National Healthcare Disparities Report. 2004. Available at: www.qualitytools.ahrq.gov/disparitiesreport/browse/browse.aspx.   Accessed April 25, 2005.