March Public Health Forum to Examine Health Care Disparities

When compared to whites, minority groups in the United States have higher rates of chronic diseases and mortality -- and poorer health outcomes. Asked by Congress to assess the extent of racial and ethnic disparities in health care, the Institute of Medicine (IOM) published a study entitled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” in 2003. The IOM study committee reported that “disparities exist in a number of disease areas, including cancer, cardiovascular disease, HIV/AIDS, diabetes, and mental illness, and are found across a range of procedures.”

The report concluded that “although myriad sources contribute to these disparities, some evidence suggests that bias, prejudice, and stereotyping on the part of healthcare providers may contribute to differences in care.” Economic, social, and environmental factors also contribute to health disparities. For example, limited health insurance or lack of income can have a profoundly negative impact on access to care.

The IOM report recommends the following steps to help eliminate disparities in care:

• Increase awareness of racial and ethnic disparities in health care among the general public, key stakeholders, and health care providers
• Promote the consistency and equity of care through evidence-based practice guidelines and enhanced patient-provider communication and trust
• Structure payment systems to ensure adequate services to minority patients
• Implement patient education programs to increase patient knowledge of how to best access care and participate in treatment decisions
• Integrate cross-cultural education into the training of health professionals

In 2004, the Massachusetts Legislature created the Commission to Eliminate Racial and Ethnic Health Care Disparities to “examine the racial, ethnic and linguistic disparities in health and provide an action plan for the state to address these disparities.” The report, scheduled for release in the next couple of months, will provide recommendations that will foster the design, implementation, and improvement of new or existing health programs and services. Alice Coombs, M.D., chair of the MMS Committee on Diversity in Medicine, is serving as the Society’s representative to the Commission.

In conjunction with the Harvard School of Public Health’s Division of Public Health Practice, the Massachusetts Medical Society’s 2nd Annual Public Health Leadership Forum will address health disparities (see box, right). “Given the increasing emphasis on this topic, we believe it is the number-one public health issue for us to explore,” said Howard Koh, M.D., M.P.H., chair of the MMS Committee on Public Health.

– Susan Webb