Time to focus on care disparities

Many minority Americans receive lower quality health care than their white counterparts; physicians have an important role to play in ending that difference.

Editorial. April 14, 2003.

Think about the patients you see in your practice -- the adults with cardiovascular disease, children who have asthma, elderly patients who need flu shots or other preventive care. Now think about the following statistics based on studies sponsored by the Agency for Healthcare Research and Quality:

• The odds of not having necessary angiography are 49% higher among African-American patients, compared with white ones.
• African-American and Hispanic children with asthma are 31% and 42% less likely, respectively, than their white peers to be using inhaled anti-inflammatory medication, even when they share similar insurance and sociodemographic characteristics.
• Only 46% of elderly African-Americans receive flu shots, compared with 68% of whites.

April is Minority Health Month -- an ideal time for the medical profession as a whole and individual physicians to refocus their attention on this problem.

There is much to be done. An Institute of Medicine report issued in March 2002 concluded that "racial and ethnic minorities tend to receive a lower quality of health care than non-minorities." This holds true even when patient insurance status and income was factored into the equation.

The reasons for the disparities are varied, ranging from the bureaucratic processes used by the health care system to a shortage of minority health professionals, and from language and cultural barriers to stereotyping by health professionals. The consequences can be dire for minority patients -- poor medical outcomes or even early death, the IOM stated.