Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

Front Cover

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received.

In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed.

How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider‚€"patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

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Contents

Summary
1
1 Introduction and Literature Review
29
2 The Healthcare Environment and Its Relation to Disparities
80
Patient and SystemLevel Factors
125
The Clinical Encounter
160
Systemic Strategies
180
CrossCultural Education in the Health Professions
199
7 Data Collection and Monitoring
215
Highlights from Focus Group Findings
392
E Committee and Staff Biographies
406
Paper Contributions
415
A Review of the Evidence and a Consideration of CausesH Jack Geiger
417
A Background and HistoryW Michael Byrd and Linda A Clayton
455
The Rationing of Healthcare and Health Disparity for the American IndiansAlaska NativesJennie R Joe
528
The Effect of Race and Ethnicity on Process and Outcomes of HealthcareLisa A Cooper and Debra L Roter
552
The Culture of Medicine and Racial Ethnic and Class Disparities in HealthcareMaryJo DelVecchio Good Cara James Byron J Good and Anne E Becker
594

8 Needed Research
235
References
244
Appendixes
269
A Data Sources and Methods
271
B Literature Review
285
C FederalLevel and Other Initiatives to Address Racial and Ethnic Disparities in Healthcare
384
The Civil Rights Dimension of Racial and Ethnic Disparities in Health StatusThomas E Perez
626
Issues in the Design Structure and Administration of Federal Healthcare Financing Programs Supported Through Direct Public FundingSara Rosenba...
664
A ConceptualizationThomas Rice
699
An Ethical Analysis of When and How They MatterMadison Powers and Ruth Faden
722
Index
739
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