While the poorer health status of minority populations in the USDA is primarily attributable to environmental factors (social, physical, biologic, economic and political) as well as to lack of access to health care, a significant contribution is made by racial/ethnic disparities in the diagnosis and treatment of patients already in the health care system. Over the last two decades, more than 600 articles in the peer-reviewed literature have documented such disparities. African Americans, Hispanics and Native Americans received less care, and less intensive care, than white patients. This pattern is found not only for such high-technology interventions such as coronary artery bypass grafting, advanced cancer treatment, renal transplantation or hip and kneww replacement, but also even in basic aspects of clinical care such as the adequacy of physical examinations, histories and laboratory tests. In some studies, denial of indicated treatment was shown to include those at greatest risk and was associated with higher death rates. Recent studies suggest that these differentials reflect covert or unconscious racial stereotyping by decision-making physicians; thus, they reflectracist views in the larger society. Similarly, recent attempts to deny these data or distort their meaning are reflective of a general reactionary attempt to deny that racism remains a significant element in US social, economic and political arrangements.
Learning Objectives: 1. To understand the content and scope of data documenting significant racial/ethnic disparities in diagnosis and treatment in the US health care system 2. To understand the probable causes of these differentials, the role of racial/ethnic stereotyping, and their relationship to racial, ethnic and social class bias in American society 3. To understand attempts to deny or distort the meanings of these data as part of a political attempt to oppose needed reforms by denying that race, ethnicity and social class are significant determinants of health status and health care.
Keywords: Social Inequalities, Minority Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.