Article

Racial and ethnic disparities in care - The perspectives of cardiologists

Duke University, Durham, North Carolina, United States
Circulation (Impact Factor: 14.95). 04/2005; 111(10):1264-9. DOI: 10.1161/01.CIR.0000157738.12783.71
Source: PubMed

ABSTRACT Despite extensive documentation of racial and ethnic disparities in care, provider awareness of disparities has been thought to be low. To be effective, educational efforts for physicians must consider providers' knowledge and beliefs about what causes disparities and what can be done about them.
We conducted a Web-based survey of 344 cardiologists to determine their level of awareness of disparities and views of underlying causes. Responses were assessed by means of 5-point Likert scales. Thirty-four percent of cardiologists agreed that disparities existed in care overall in the US healthcare system, and 33% agreed that disparities existed in cardiovascular care. Only 12% felt disparities existed in their own hospital setting, and even fewer, 5%, thought disparities existed in the care of their own patients. Despite this, most respondents rated the strength of the evidence about disparities as "very strong" or "strong." Respondents identified many potential causes for disparities in care but were more likely to endorse patient and system level factors (eg, insurance status or adherence) rather than provider level factors.
Cardiologists' awareness of disparities in care remains low, and awareness is inversely proportional to proximity to their own practice setting.

Download full-text

Full-text

Available from: Stephanie L Taylor, Jul 05, 2015
0 Followers
 · 
136 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Medical interactions between Black patients and nonBlack physicians are usually less positive and productive than same-race interactions. We investigated the role that physician explicit and implicit biases play in shaping physician and patient reactions in racially discordant medical interactions. We hypothesized that whereas physicians' explicit bias would predict their own reactions, physicians' implicit bias, in combination with physician explicit (self-reported) bias, would predict patients' reactions. Specifically, we predicted that patients would react most negatively when their physician fit the profile of an aversive racist (i.e., low explicit-high implicit bias). The hypothesis about the effects of explicit bias on physicians' reactions was partially supported. The aversive racism hypothesis received support. Black patients had less positive reactions to medical interactions with physicians relatively low in explicit but relatively high in implicit bias than to interactions with physicians who were either (a) low in both explicit and implicit bias, or (b) high in both explicit and implicit bias.
    Journal of Experimental Social Psychology 03/2010; 46(2):436-440. DOI:10.1016/j.jesp.2009.11.004 · 2.22 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper explores the role of racial bias toward Blacks in interracial relations, and in racial disparities in health care in the United States. Our analyses of these issues focuses primarily on studies of prejudice published in the past 10 years and on health disparity research published since the report of the US Institute of Medicine (IOM) Panel on Racial and Ethnic Disparities in Health Care in 2003. Recent social psychological research reveals that racial biases occur implicitly, without intention or awareness, as well as explicitly, and these implicit biases have implications for understanding how interracial interactions frequently produce mistrust. We further illustrate how this perspective can illuminate and integrate findings from research on disparities and biases in health care, addressing the orientations of both providers and patients. We conclude by considering future directions for research and intervention.
    Social Science & Medicine 09/2008; 67(3):478-86. DOI:10.1016/j.socscimed.2008.03.019 · 2.56 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There are large and persistent disparities between the health status of Blacks and Whites in the United States. On average, the mental and physical health of Blacks is much poorer than Whites. In this article, we discuss several potential direct causes of Black–White disparities in health status, which include biological or genetic factors, prejudice and related processes, and socioeconomic factors. We also consider how the system-level, patient-level, and provider-level components of healthcare contribute to disparities in health status. We examine in detail the psychological processes associated with patient- and provider-level factors that may produce healthcare disparities. Of particular interest is the potential impact of racial attitudes and stereotypes on provider–patient interactions. Finally, we propose possible directions for future research on health disparities and discuss policy changes that might reduce disparities in health status and healthcare between social groups.
    Social Issues and Policy Review 11/2007; 1(1):63 - 98. DOI:10.1111/j.1751-2409.2007.00004.x