Unequal Treatment

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. Table of Contents Front Matter Summary 1 Introduction and Literature Review 2 The Healthcare Environment and Its Relation to Disparities 3 Assessing Potential Sources of Racial and Ethnic Disparities in Care: Patient- and System-Level Factors 4 Assessing Potential Sources of Racial and Ethnic Disparities in Care: The Clinical Encounter 5 Interventions: Systemic Strategies 6 Interventions: Cross-Cultural Education in the Health Professions 7 Data Collection and Monitoring 8 Needed Research References Appendixes A Data Sources and Methods B Literature Review C Federal-Level and Other Initiatives to Address Racial and Ethnic Disparities in Healthcare D Racial Disparities in Healthcare: Highlights from Focus Group Findings E Committee and Staff Biographies Paper Contributions Racial and Ethnic Disparities in Diagnosis and Treatment: A Review of the Evidence and a Consideration of Causes - H. Jack Geiger Racial and Ethnic Disparities in Healthcare: A Background and History - W. Michael Byrd and Linda A. Clayton The Rationing of Healthcare and Health Disparity for the American Indians/Alaska Natives - Jennie R. Joe Patient-Provider Communication: The Effect of Race and Ethnicity on Process and Outcomes of Healthcare - Lisa A. Cooper and Debra L. Roter The Culture of Medicine and Racial, Ethnic, and Class Disparities in Healthcare - Mary-Jo DelVecchio Good, Cara James, Byron J. Good, and Anne E. Becker The Civil Rights Dimension of Racial and Ethnic Disparities in Health Status - Thomas E. Perez Racial and Ethnic Disparities in Healthcare: Issues in the Design, Structure, and Administration of Federal Healthcare Financing Programs Supported Through Direct Public Funding - Sara Rosenbaum The Impact of Cost Containment Efforts on Racial and Ethnic Disparities in Healthcare: A Conceptualization - Thomas Rice Racial and Ethnic Disparities in Healthcare: An Ethical Analysis of When and How They Matter - Madison Powers and Ruth Faden Index