Examining Awareness of Racial and Ethnic Health Disparities among U.S. Physicians

Research Objectives: Although many aspects of health in the U.S. have improved over the past several decades, significant racial and ethnic disparities remain. Physicians' perceptions—and misperceptions—about disparities can influence the how the problem is addressed at the level of the individual patient encounter, as well as the broader systems level. This study asks: To what extent are physicians aware of the existence of racial and ethnic differences in health status and health care? Does physicians' awareness differ by racial or ethnic group, health care status, or condition? To what extent are physicians aware of and/or using information campaigns and tools that address racial and ethnic disparities in health? Study Design: Findings are based on a representative sample of 253 mailed, self-administered paper questionnaires completed by practicing physicians from April to June 2009. A random sample of approximately 700 physicians from the AMA Masterfile was purchased from an AMA authorized vendor. A response rate of 36 percent was achieved to yield 253 completes. The majority (56%) were in private practice. Principal Findings: Awareness of racial and ethnic health disparities is quite high among the sample of practicing physicians. Awareness of disparities between African Americans and Whites is highest at 92 percent with awareness of disparities between Hispanics/Latinos and Whites also quite high at 86 percent. Physicians' perceptions of relative health disparities between groups are in correspondence with the recent data for several conditions. However, physicians lack awareness about the stark disparities in the prevalence of HIV/AIDS and diabetes for African Americans and Hispanics/Latinos compared to Whites. Although physicians demonstrate high levels of overall awareness of disparities, the results suggest that the responding physicians are not receiving information about health care disparities from public reports and campaigns. Physician awareness is quite low with only 27 percent aware of Healthy People 2010, 17 percent aware of AHRQ's disparity report, and only 22 percent aware of IOM's report. There is some evidence that provider settings are making efforts to close any language based racial and ethnic disparities through the use of translators and bilingual staff (81%), translated patient materials (77%), and translated signs (49%). Conclusions: Overall awareness among physicians is significantly higher than among the general population. However, physicians continue to underestimate important disparities like HIV/AIDS and diabetes between racial and ethnic minorities and Whites. Physicians report relatively low levels of familiarity and contact with important health disparities reports and awareness campaigns.