Demographics can mean health care disparities

AMA Leader Commentary. By J. James Rohack, MD, March 7, 2005.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from the chair of the AMA Board of Trustees, J. James Rohack, MD.

"Facts do not cease to exist because they are ignored," noted the famous English author Aldous Huxley. The demographic changes that the United States and my own home state of Texas will undergo over the next 40 years offer sobering facts to those of us who provide medical care -- facts that we can't risk ignoring.

Most of us can envision the coming impact of our aging population, such as the need for certain specialties to treat the growing disease burden. But if we focus only on the aging of our population, we risk overlooking another, powerful demographic shift: By 2050, almost half of our population will consist of African-Americans, Asian-Americans, Hispanic-Americans and American Indians. Thus, another question we need to ask is this: With increasing numbers of minority patients, are we prepared to deliver culturally responsive, equitable care?

Unfortunately, as of today, the answer appears to be "no." Consider the facts. Research has shown that minority groups experience disparities in health care, health status and health outcomes. The Institute of Medicine report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care" (2002), defines disparities in health care as "racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of interventions." Documentation shows that health care disparities exist for Hispanic-Americans, American Indians, Asian-Americans and African-Americans.