Race, Ethnicity, Culture, and Disparities in Health Care

Dr. Leonard Egede published an editorial in the Journal of General Internal Medicine regarding various issues in health care i.e. race, ethnicity, culture, and disparities. The editorial was published on the premise that existing evidence shows that racial and ethnic minorities obtain lower quality of health care services as compared to non-minorities. This trend continues to exist despite the significant development in the diagnosis and treatment of numerous chronic diseases. The main focus of this editorial was to highlight the disparities in health care delivery due to racial, ethnic, and cultural factors. In this regard, the publisher focused on examining why patients from minorities experience greater mortality and morbidity from several chronic diseases unlike non-minorities despite the significant medical advances. The editorial focused on three studies that were published on the issue of race, ethnicity, and disparities in the delivery of health care services to various patient populations.

The first study by Trivedi and Ayanian focused on examining the sources and root causes of racial and ethnic disparities in health care. To achieve the purpose of the study, the researchers conducted a cross-sectional analysis of more than 54,000 respondents to the California Health Interview of 2001 (Egede, 2006). The cross-sectional analysis was geared towards evaluating the link between perceptions of health care discrimination and utilization of health care services. These researchers found that nearly 5% of the respondents reported to have been subjected to some kind of discrimination in health care. Victims of discrimination were less likely to obtain some preventive health care services. Nonetheless, adjusting for perceived discrimination did not eliminate the observed disparities in delivery of preventive care on the basis of race, gender, and insurance. This study was significant since it highlighted the causes of racial and ethnic disparities in the delivery of health care services. The findings of this study signifies that race/ethnicity plays a crucial factor in disparities in health care. The researchers seemingly postulate that race or ethnicity influence health care disparities through contributing to discrimination that in turn affect access to preventive health care services across different races or ethnic groups. According to Bryan (2014), the various forms discrimination is regarded as major causes for cruel and inhumane treatment, which sometimes result in loss of life among other devastating impacts.

The second study that was reviewed in this editorial was conducted by Huang et al and focused on examining the difference between factor structure and endorsement rates. Additionally, these researchers examined the variance item functioning of the validated Patient Health Questionnaire depression scale among various racial and ethnic patient populations. Some of these racial/ethnic patient populations that were included in the analysis are white, Chinese American, African American, and Latino primary care patients. The study found that the factor structure of the depression scale was consistent across these racial/ethnic groups. However, differences were evident in the differential item functioning for certain items. Consequently, the researchers concluded that this depression scale is an effective depression detection and monitoring tool in diverse patient populations. This study was significant in the review since it highlighted how some medical tools and techniques are utilized in the treatment of various patient populations. The findings of this study signifies that while medical techniques and tools are utilized across patient populations from various racial and ethnic backgrounds, there are differences in health outcomes. In this regard, the variations in some of the items in the differential item functioning are seemingly attributable to racial or ethnic differences.

The editorial also reviewed a publication by Groeneveld et al which examined racial differences in attitudes towards state-of-the-art medical technology. The study participants included a group of 171 white and African American patients in a Veteran Affairs Medical Center located in an urban setting. The researchers utilized a questionnaire that examined various issues relating to the research i.e. general innovativeness and medical innovativeness. In relation to general innovativeness, respondents answered questions regarding to attitudes towards general new concepts. With respect to medical innovativeness, the respondents answered questions on attitudes towards new medical devices, drugs, and procedures. Even though the study found no significant racial differences in general innovativeness, there were significant differences on medical innovativeness. In this regard, whites had higher medical innovativeness and were more willing to accept new prescription drugs in comparison to blacks. The findings of this study were significant in the review in the sense that it highlighted how race plays a crucial element in attitudes towards health care delivery. These findings signify that different racial or ethnic groups have different perspectives and attitudes towards health care. The differences in attitudes and perceptions in turn contribute to variations in acceptance of medical procedures and drugs, which in turn affect health outcomes.

In conclusion, Egede (2006) argues that these findings are highly relevant and seemingly consistent with existing literature on health care disparities on the basis of race, ethnicity, and culture. However, similar to other studies, these three studies have some limitations including the failure to examine the role of socioeconomic factors in health disparities, assumption that race is a valid biological construct, and lack of appropriate definitions of ethnicity and culture. Despite these limitations, these three studies highlight the sources and contributing factors of disparities in health care delivery and quality based on race, ethnicity, and culture. While there could be other factors contributing to these disparities, race, ethnicity, and culture play a major role in determining health outcomes among different patient populations.
References
Bryan, W. V. (2014). Multicultural aspects of human behavior (3rd ed.). Springfield, IL.: Charles C Thomas - Publisher, LTD.
Egede, L.E. (2006, June). Race, Ethnicity, Culture, and Disparities in Health Care. Journal of General Internal Medicine, 21(6), 667-669.