Racial and ethnic disparities in health care: a position paper of the American College of Physicians American College of Physicians Ann Intern Med 2004 141 226 232 15289223

Annals of internal medicine (Impact Factor: 17.81). 09/2004; 141(3):226-32. DOI: 10.7326/0003-4819-141-3-200408030-00015
Source: PubMed


Disparities clearly exist in the health care of racial and ethnic minorities. This position paper of the American College of Physicians (ACP) provides ample evidence illustrating that minorities do not always receive the same quality of health care, do not have the same access to health care, are less represented in the health professions, and have poorer overall health status than nonminorities. The ACP finds this to be a major problem in our nation's health system that must be addressed. The ACP is dedicated to working toward eliminating all disparities in health care. This position paper sets forth specific positions for reducing these disparities and will be the foundation for public policy advocacy by ACP for eliminating racial and ethnic disparities in health care.

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    • "Epidemiologic research has long shown that these populations suffer disproportionately from several diseases [35, 36, 68]. Immigrant groups also differ from the indigenous population in their reports of pain, the way they communicate symptoms, their beliefs about the cause of illness, and their understanding of concepts such as “risk factors” or “being at risk” [51, 52, 69–71]. "
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    ABSTRACT: Recent research has shown that patients frequently experience difficulties understanding health-relevant numerical concepts. A prominent example is denominator neglect , or the tendency to pay too much attention to numerators in ratios (e.g., number of treated patients who died) with insufficient attention to denominators (e.g., overall number of treated patients). Denominator neglect can lead to inaccurate assessments of treatment risk reduction and thus can have important consequences for decisions about health. Here, we reviewed a series of studies investigating (1) different factors that can influence patients’ susceptibility to denominator neglect in medical decision making—including numerical or language-related abilities; (2) the extent to which denominator neglect can be attenuated by using visual aids; and (3) a factor that moderates the effectiveness of such aids (i.e., graph literacy). The review spans probabilistic national U.S. and German samples, as well as immigrant (i.e., Polish people living in the United Kingdom) and undergraduate samples in Spain. Theoretical and prescriptive implications are discussed.
    Full-text · Article · May 2012 · The Scientific World Journal
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    • "Strategies to overcome language barriers in practice include employing a diverse healthcare workforce and using translation services when necessary [50]. Preparing healthcare professionals to serve in diverse communities can be done by offering medical language courses in medical schools to help familiarise students with medical terminologies they will encounter in different communities [51]. "
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    ABSTRACT: Nationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals' views on barriers to starting insulin therapy in people with type 2 diabetes. Healthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach. Insulin initiation was found to be affected by patient, healthcare professional and system factors. Patients' barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals' barriers include negative attitudes towards insulin therapy and the 'legacy effect' of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges. Tackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds.
    Full-text · Article · Apr 2012 · BMC Family Practice
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    • "Although Americans have recently experienced an increase in life expectancy and overall health, not everyone is benefiting equally from medical advances and public health Campaigns (Groman and Ginsburg 2004; Sullivan Commission 2004). African Americans have the highest death rate and shortest survival of any racial and ethnic group in the United States for most cancers, including breast and colorectal cancer, both of which are most effectively treated in early stages (ACS 2011). "
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    ABSTRACT: Few studies examine the use of family history to influence risk perceptions in the African American population. This study examined the influence of a family health history (FHH) intervention on risk perceptions for breast (BRCA), colon (CRC), and prostate cancers (PRCA) among African Americans in Pittsburgh, PA. Participants (n = 665) completed pre- and post-surveys and FHHs. We compared their objective and perceived risks, classified as average, moderate, or high, and examined the accuracy of risk perceptions before and after the FHH intervention. The majority of participants had accurate risk perceptions post-FHH. Of those participants who were inaccurate pre-FHH, 43.3%, 43.8%, and 34.5% for BRCA, CRC, and PRCA, respectively, adopted accurate risk perceptions post-FHH intervention. The intervention was successful in a community setting. It has the potential to lead to healthy behavior modifications because participants adopted accurate risk perceptions. We identified a substantial number of at-risk individuals who could benefit from targeted prevention strategies, thus decreasing racial/ethnic cancer disparities.
    Full-text · Article · Jul 2011 · Journal of Genetic Counseling
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