Unequal Treatment: Confronting Racial and Ethnic Disparities in Health CareInstitute of Medicine, Board on Health Sciences Policy, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care National Academies Press, 2002 M10 2 - 780 pages 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 providerâ€"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. |
From inside the book
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... practice norms, tied to varying per capita resource constraints (Bloche, 2001). Equalizing access to high-quality ... practices that fragment the care system” (IOM, 2001, p. 13). Recommendation 5-1: Avoid fragmentation of health plans ...
... practice, however, a pragmatic balance must be sought between the advantages and limitations of guidelines, such as the tension between the goal of standardization versus the need for clinical flexibility. Disclosing health plans ...
... practices that reduce barriers and encourage evidence-based practice. Interpretation Services As noted above, many racial and ethnic minorities find that language barriers pose a significant problem in their efforts to access healthcare ...
... practices that reduce barriers and encourage evidence-based practice. Recommendation 5-9: Support the use of interpretation services where community need exists. is effective in improving provider knowledge of cultural and behavioral ...
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Contents
1 | |
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 |