Unequal Treatment: Confronting Racial and Ethnic Disparities

¶ … Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care The recent report of the Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (2002 Smedley et. al.), indicates that bias, stereotyping, and prejudice may often contribute to the quality of health care that is provided to non-white patients. For anyone entering into the field of health care, this information is beneficial because it uncovers many of the reasons why some patients receive inadequate health care that can lead to future prevention of this problem.

The vast majority of studies reviewed concluded that minorities are less likely to get the same treatment as whites, including necessary procedures. The studies also suggested that patient attitudes cannot explain completely why disparities exist in health care. Clearly, race has become as issue in the health care industry. The report brings to light the depth of the problem when it comes to the disparities in health care for African-Americans and other ethnic minorities.

The report, commissioned by Congress, reviewed the literature, commissioned papers, and gathered information that resulted in two major findings. First, "Racial and ethnic disparities in healthcare occur in the context of broader historic and contemporary social and economic inequality, and evidence of persistent racial and ethnic discrimination in many sectors of American life" (123). Secondly, bias, stereotyping, prejudice, and clinical uncertainty on the part of health care providers may contribute to racial and ethnic disparities in health care.

In addition, the report indicated "patients might also react to providers' behavior associated with these practices in a way that contributes to disparities" (161). The data collected suggested that one set of factors that might be responsible is the operation of the health care system itself, which include language barriers (87). Another set of factors is the clinical encounter itself. This involves a direct relation to bias and prejudice among providers (160).

In fact, the report stated that "physicians use clusters of information in making diagnostic and other complex judgments that must be arrived at without the luxury of the time and other resources to collect all the information that might be relevant" (62). In addition, some ethnic minorities experience a higher rate of some disabling diseases than white counterparts. American Indians, African-Americans, and Hispanics experience higher rates of diabetes, certain cancers and other chronic diseases. (82) Minorities are also less likely to have insurance. (85) In addition, linguistic barriers pose problems when treating minorities.

These barriers create challenges for both patients and providers. Aspects of the clinical encounter also contribute to disparities. The report notes that the patients' and providers' attitudes, expectations and behavior can often produce disparities, which result in discrimination. (160) Discrimination is defined in many ways which include bias, either for or against minorities and greater uncertainty when interacting with minorities. In some cases, patients might react to a provider's behavior, and if a patient does not trust his or her provider, they are less likely to follow advice.

The report also states that many providers may hold minorities in lower regard and thus treat them less well. (161) In conclusion, the report also states that from the health care provider's perspective, "All the theories.