Unequal Treatment Confronting Racial and Ethnic Disparities in Healthcare

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Description: 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  More...

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Book details

List price: $85.00
Copyright year: 2003
Publisher: National Academies Press
Publication date: 11/2/2002
Binding: Hardcover
Pages: 782
Size: 6.25" wide x 9.00" long x 2.00" tall
Weight: 2.992
Language: English

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 convened by the Institute of Medicine 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 carefully analyzed and discussed. The big question that remains centers on how best 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 book 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. Also included are 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.

Summary
Abstract
Study Charge and Committee Assumptions
Evidence of Healthcare Disparities
Racial Attitudes and Discrimination in the United States
Assessing Potential Sources of Disparities in Care
Interventions to Eliminate Racial and Ethnic Disparities in Healthcare
Data Collection and Monitoring
Needed Research
Introduction and Literature Review
Study Charge and Committee Assumptions
The Relationship Between Racial and Ethnic Disparities in Health Status and Healthcare
Why Are Racial and Ethnic Disparities in Healthcare Important?
Evidence of Racial and Ethnic Disparities in Healthcare
Summary
The Healthcare Environment and Its Relation to Disparities
The Health, Health Insurance, and Language Status of Racial and Ethnic Minority Populations
Racial Attitudes and Discrimination in the United States
The Context of Healthcare Delivery for Racial and Ethnic Minority Patients--An Historical Overview
A Brief History of Legally Segregated Healthcare Facilities and Contemporary De Facto Segregation
The Settings in Which Racial and Ethnic Minorities Receive Healthcare
The Healthcare Professions Workforce in Minority and Medically Underserved Communities
The Participation of Racial and Ethnic Minorities in Health Professions Education
Summary
Assessing Potential Sources of Racial and Ethnic Disparities in Care: Patient- and System-Level Factors
A Model: Sources of Healthcare Disparities
Patient-Level Variables--Preferences, Mistrust, Treatment Refusal, Biological Differences, and Overuse of Services
Health Systems-Level Variables
Summary
Assessing Potential Sources of Racial and Ethnic Disparities in Care: The Clinical Encounter
Medical Decisions Under Time Pressure with Limited Information
Healthcare Provider Prejudice or Bias
Patient Response: Mistrust and Refusal
Conclusion
Interventions: Systemic Strategies
Legal, Regulatory, and Policy Interventions
Health Systems Interventions
Patient Education and Empowerment
Interventions: Cross-Cultural Education in the Health Professions
Background
Cross-Cultural Communication: Links to Racial/Ethnic Disparities in Healthcare
The Foundation and Emergence of Cross-Cultural Education
Approaches to Cross-Cultural Education
Summary
Data Collection and Monitoring
Obstacles to Racial/Ethnic Data Collection
The Federal Role in Racial, Ethnic, and Primary Language Health Data
Other Data Sources to Assess Healthcare Disparities
Models of Measuring Disparities in Healthcare
Data Needs and Recommendations
Needed Research
Understanding Clinical Decision-Making and the Roles of Stereotyping, Uncertainty, and Bias
Understanding Patient-Level Influences on Care
Understanding the Influence of Healthcare Systems and Settings on Care for Minority Patients
Understanding the Roles of Non-Physician Health Professions
Assessing Healthcare Disparities Among Non-African American Minority Groups
Assessing the Effectiveness of Intervention Strategies
Developing Methods for Monitoring Healthcare Disparities
Understanding the Contribution of Healthcare to Health Outcomes and the Health Gap Between Minority and Non-Minority Americans
Mechanisms to Improve Research on Healthcare Disparities
References
Appendixes
Data Sources and Methods
Literature Review
Federal-Level and Other Initiatives to Address Racial and Ethnic Disparities in Healthcare
Racial Disparities in Healthcare: Highlights from Focus Group Findings
Committee and Staff Biographies
Paper Contributions
Racial and Ethnic Disparities in Diagnosis and Treatment: A Review of the Evidence and a Consideration of Causes
Racial and Ethnic Disparities in Healthcare: A Background and History
The Rationing of Healthcare and Health Disparity for the American Indians/Alaska Natives
Patient-Provider Communication: The Effect of Race and Ethnicity on Process and Outcomes of Healthcare
The Culture of Medicine and Racial, Ethnic, and Class Disparities in Healthcare
The Civil Rights Dimension of Racial and Ethnic Disparities in Health Status
Racial and Ethnic Disparities in Healthcare: Issues in the Design, Structure, and Administration of Federal Healthcare Financing Programs Supported Through Direct Public Funding
The Impact of Cost Containment Efforts on Racial and Ethnic Disparities in Healthcare: A Conceptualization
Racial and Ethnic Disparities in Healthcare: An Ethical Analysis of When and How They Matter
Index

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