Tuesday, September 15, 2015

Viewpoint: Racial Bias in Health Care and Health, Challenges and Opportunities

The August 11, 2015 edition of the Journal of the American Medical Association included the Viewpoint article,
Racial Bias in Health Care and Health, Challenges and Opportunities.

In it, the authors discuss the landmark report from the Institute of Medicine (IOM) in 2003 documented that from the simplest to the most technologically advanced diagnostic and therapeutic interventions, African American (or black) individuals and those in other minority groups receive fewer procedures and poorer-quality medical care than white individuals. The Viewpoint discusses the potential contribution of societal racial bias to disparities in health care and health status.

"When the health of black and white people are compared at equivalent levels of income and education, racial disparities are reduced but remain evident at all levels of socioeconomic status. A growing body of evidence suggests that societal racial bias contributes to these residual effects of race in multiple ways. Scientific evidence indicates that conscious and unconscious bias combine to create patterns of racial/ethnic discrimination in employment, bank loans, housing, purchasing a car, and hailing a taxi. Individuals who face discrimination are aware of some of these experiences, which are a source of psychosocial stress. A recent review documented that self-reported measures of discrimination were adversely related to multiple indicators of health (eg, hypertension, all-cause mortality, incident asthma, incident breast cancer, and poor mental health), several early indicators of clinical disease (eg, inflammation, carotid intima-media thickness, visceral fat, obesity, coronary artery calcification, shorter telomeres, and cortisol dysregulation), and health behaviors (eg, poor sleep quantity and quality, cigarette smoking, and substance use)."

The authors end by recommending that medical schools, health care organizations, and credentialing bodies should pay greater attention to disparities in health and health care as a high national priority. The authors state that these organizations should redouble their efforts to increase awareness of disparities, enhance diversity in the health professions, and work toward eliminating discrimination and its adverse effects on health and health care.

How are you addressing equity?

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