Disparities in health care complex, hard to correct

Seven years after the landmark IOM study which established that racial minorities had worse health and were getting poorer care than the rest of the population even after other factors had been controlled for, disparities still exist (AHCJ resource). Newsweek‘s Mary Carmichael seeks to explain exactly why health disparities are so difficult to correct.

She discusses study design, classifications for ethnic groups, whether cultural competency training is useful, the quality of care that ethnic groups receive and much more.

Carmichael reports that the medical profession is working to correct disparities, but complex issues like this take time and resources to resolve. Cultural competency training is more common and health care reform proposals include myriad measures intended to help correct disparities. Even if reform doesn’t pass, Carmichael says, those measures could be used as a model for future legislation.

Speaking of solutions, Chris Metinko, of the Oakland Tribune, writes about one effort to address health disparities in some of that city’s poorest areas. Two nurse practitioners and a school board member are working to start a nonprofit organization that “would be a clinic for studying and confronting root causes of health disparities in Oakland and advocating for health equity.” Nurse practitioner Mahedere Solomon “said it would be a place where people could receive health care and where research into some of the area’s most pressing issues could be conducted.” Solomon recently received a 2009-10 Pfizer Community Innovations award, given to nurses who design projects to foster innovation at the local community level.

Meanwhile, HealthLeaders Media reports on a recent study that found nearly half of U.S. doctors say their patient care is being adversely affected by language and other cultural barriers. According to the study, HSC Issue Brief–Modest and Uneven: Physician Efforts to Reduce Racial and Ethnic Disparities, sponsored by the Robert Wood Johnson Foundation, reveals that 48 percent of doctors “reported difficulties communicating with patients because of language or cultural barriers, and said they considered the situation at least a minor problem affecting their ability to provide high-quality care.”

In their series “Shortened Lives,” Suzanne Bohan and Sandy Kleffman profiled people from different (though nearby) ZIP codes, finiding wide disparities in their expected life spans, based on where they live, their social status and the toll of chronic stress. The series explains the effect these disparities have on health care costs, as well as how they are caused and how they might be addressed. Bohan and Kleffman wrote about the project in a piece for AHCJ members and we have included additional resources for those interested in exploring disparities in health care in their own communities.

1 thought on “Disparities in health care complex, hard to correct

  1. Avatar photoM Chris Gibbons

    The IOM report you refer to in this piece was released in 2003. It is now 7 years since it’s release not “more than a decade” as cited in your article.

    Editors note: This has been corrected. Thanks for calling the error to our attention. – PC

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