| |
| |
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 | |