Receive Lower Quality Healthcare
In 1999, Congress requested that the
Institute of Medicine (IOM), conduct a study to assess
disparities in the kinds and quality of healthcare
received by racial and ethnic minorities and non minorities.
The stated purpose of this study was
to assess the extent of racial and ethnic differences
in health care that are not otherwise attributable
to ability to pay or insurance coverage and to evaluate
potential sources of racial and ethnic disparaties
including the role of bias, discrimination and stereotyping.
The IOM reported its findings in the 2002 report titled
"Unequal Treatment: Confronting Racial and
Ethnic Disparities in Healthcare."
According to the report, some of the
strongest and most consistent evidence of racial and
ethnic disparities in care is found in studies of
cardiovascular care. The study reports that African-American
men and women were treated significantly less than
whites with coronary artery bypass graft surgery.
African-American patients were also one third less
likely to receive cardiovascular services as whites.
Moreover, white patients were 50% more likely to receive
thrombolytics than black patients. Black patients
also waited longer than white patients for their first
In a study of racial disparities in
cancer care, the charts of 7,781 women treated for
breast cancer in 107 hospitals were reviewed. This
study showed that African-American women were less
likely than white women to receive a prognostic test,
were less likely to receive radiation therapy in combination
with radical/modified mastectomy, and were less likely
to receive rehabilitation support services following
In another larger study of 20,000 colorectal
cancer patients, it was found that African-Americans
were 41% less likely than whites to receive a major
procedure fro treatment of colorectal cancer.
In the area of kidney transplants, several
studies were consistent in finding that African-American
patients are less likely to be judged as appropriate
for transplantation, are less likely to appear on
transplantation waiting lists, and are less likely
to undergo transplantation procedures, even after
patients' insurance status and other factors are considered.
African-Americans with HIV infection
are less likely to receive antiretroviral therapy,
less likely to receive prophylaxis for pneumocystic
pneumonia, and are less likely to receive protease
inhibitors than non-minorities with HIV.
Many other areas of medicine revealed
similiar disparities. In a study of racial differences
in total knee arthroplasty among older adult patients,
a study concluded that African-Americans were less
likely than whites to receive total knee arthroplasty(1.5-2.0
for women and 3.0 to 5.1 for men). Similiar disparities
were found in the areas of cerebrovascular disease,
prenatal and child delivery and lumbar spine treatment.
The study concludes that the healthcare
workforce and its ability to deliver quality care
for racial and ethnic minorities can be improved substantially
by increasing the proportion of underrepresented racial
and ethnic minorities among health professionals.
In addition, both patients and healthcare providers
could benefit from education. Cross cultural curricula
should be integrated early into the training of future
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