Report: Whites Get Better Health Care


By Randolph E. Schmid


March 20, 2002  |  Washington -- Minorities in the United States receive lower-quality health care than whites -- both for serious conditions and routine services -- the Institute of Medicine reported Wednesday.


"Disparities in the health care delivered to racial and ethnic minorities are real and are associated with worse outcomes in many cases, which is unacceptable," said Dr. Alan Nelson, chairman of the committee that prepared the report.


"The real challenge lies not in debating whether disparities exist, because the evidence is overwhelming, but in implementing strategies to reduce and eliminate them," said Nelson, a retired physician and current consultant to the American College of Physicians-American Society of Internal Medicine in Washington.


The report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," was prepared by the Institute of Medicine, an arm of the National Academy of Sciences, at the request of Congress.


This isn't the first study to conclude that minority health care in the United States lags.


In January the Centers for Disease Control and Prevention reported that, while Americans made advances in the 1990s against a broad range of diseases, racial and ethnic disparities remain.


The new report says minorities are less likely than whites to receive appropriate heart medicine, undergo bypass surgery or receive kidney dialysis or transplants. It found differences in receiving cancer treatment and said minorities are less likely to receive the newest treatment for AIDS.


Among the examples:


--A study of nearly 11,000 patients with lung cancer found that 76 percent of whites and 64 percent of blacks had surgery. After five years the survival rate was 26 percent for blacks and 34 percent for whites.


--A report on more than 13,000 heart patients found that for every 100 white patients who had a procedure to clear the heart artery, only 74 blacks did.


--Among 15,578 people who sought care in an urban emergency room, blacks were 1.5 times more likely to be denied authorization by their managed-care providers.


The report said the differences exist even when insurance, income, age and the severity of the disease are the same for both groups.


The committee recommended changing health insurance programs to reduce disparities among economic groups and setting up education programs to increase health care providers' awareness of the problem.


Other recommendations included recruiting more minorities into health care, expanding patient education programs and improving enforcement of laws against discrimination.


The National Academy of Sciences is an independent organization chartered by Congress to provide advice to the government on scientific topics.


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