1. Why do Racial and Ethnic Disparities
Exist in Health Care?
By: Greg Galloway

2.  Racial Disparities in the Treatment of Pain:
 Whites are given more opiod pain relievers than blacks
(klonoff, 2009)
 Minorities were given non-opiod analgesic (Klonoff, 2009)
 In emergency room Native Americans were perceived to be
exaggerating their symptoms and pain in order to get pain
medications (Klonoff, 2009)
Why do Racial and Ethnic Disparities Exist
in Health Care 2

3.  Racial Disparities in Cardio Vascular Disease and
Treatment:
 Blacks and Whites in the 1950’s had identical mortality rates from heart
disease, by the year 2000 blacks had a 30% higher rate
(Williams & Jackson 2005)
 African Americans are more likely to receive older treatments and less
likely to receive newer cardiac treatments (Klonoff, 2009)
 Blacks are less likely to receive cardiac catheterization, revascularization
and smoking cessation counseling (Klonoff, 2009)
Why do Racial and Ethnic Disparities Exist
in Health Care 3

4.  Role of Income on SES and Race and Health:
 SES is a strong predictor of health. Americans with a low SES
have levels of illness in their 30’s & 40’s that are not seen with
higher SES until three decades later
 Death rates form heart disease are 3 times higher in low
income blacks & whites than their middle income equivalents
 Blacks at all income levels have a higher heart disease death
rate than whites
 Mortality form heart disease in black women of low income is
65% higher than comparable white women
* (Williams & Jackson, 2005)
Why do Racial and Ethnic Disparities Exist
in Health Care 4

5.  Race and SES and Health Practices:
 Ethnic adolescents in lower SES more likely to have a sedentary
lifestyle (Braveman et al, 2010)
 Disadvantaged racial groups and those from a low SES less likely
to reduce high-risk behavior or to initiate new healthier practices
(Williams & Jackson, 2005)
 Blacks and individuals in low SES less likely to stop smoking
(Braveman et al, 2010)
 Positive or negative changes in heath practices are shaped by
race and SES (Braveman et al, 2010)
Why do Racial and Ethnic Disparities Exist
in Health Care 5

6.  Geographical and Racial Differences in Health Care:
 Neighborhoods can influence healthy or unhealthy behaviors
 Neighborhoods lack healthier food options which result in poor
diets and high rates in obesity
 Residents of these neighborhoods are typically minorities
*(Center for Medicare Advocacy, Inc, n.d)
Why do Racial and Ethnic Disparities Exist
in Health Care 6

7.  Neighborhood Quality:
 Neighborhood quality contributes to racial disparities
 Poor environmental conditions and exposure to toxin can cause health
problems
 Ethnic minorities and are often exposed harmful pollutants because of
the neighborhoods they live in
 Blacks tend to live in poorer neighborhoods that whites in the same SES
*(Williams & Jackson, 2005)
Why do Racial and Ethnic Disparities Exist
in Health Care 7

8.  Geographical Location and Disparities in Providers:
 More affluent areas contain more providers with higher quality of
care (KFF, 2008)
 Areas that are poor and have a large minority population are
medically underserved (KFF, 2008)
 Blacks and whites typically have different providers, those that
treat minorities are often less clinically trained (Chandra, 2009)
 Clinics and providers in these locations often have fewer
resources (Chandra, 2009)
Why do Racial and Ethnic Disparities Exist
in Health Care 8

9.  What are the Options:
 Increasing the Knowledge Base:
Increasing the knowledge base will require investing in routinely
collecting and analyzing data on health care use across racial/ethnic
groups. Data from national surveys, health insurers, and different
health settings are needed to better understand the problems and
impact of interventions. One reason we know so little about patterns
of health care use for many racial/ethnic groups is that we have not
collected the data or have insufficient sample sizes in publicly available
data sources (KFF, 2008)
Why do Racial and Ethnic Disparities Exist
in Health Care 9

10.  What are the Options:
 Raising Public and Provider Awareness:
Perceptions of a problem often influence the actions taken (or not
taken) to change policy and practices. If the public or providers are
unaware that a problem exists, or misunderstands the nature of the
problem, it can be difficult to direct resources to address that
problem. Efforts to raise the public’s awareness of racial/ethnic health
care disparities have achieved modest success (KFF, 2008)
Why do racial and Ethnic Disparities Exist
in Health Care 10

11.  What are the Options:
 Improving the Number and Capacity of Providers in Underserved
Communities:
Despite efforts since the 1970s to increase the number of health professionals
in medically underserved areas, members of racial/ethnic minority groups are
still underrepresented in the health care workforce and are more likely than
Whites to live in neighborhoods that lack adequate health resources… African
Americans and Latinos are also twice as likely as Whites to rely upon a hospital
outpatient department as their regular source of care, rather than a doctor’s
office where opportunities for continuity of care and patient-centered care are
greater. This is a result of many factors, including the higher rates of uninsured
and the limited availability of primary care physicians in some communities of
color (KFF, 2008)
Why do racial and Ethnic Disparities Exist
in Health Care 11

12.  Racial Disparities Exist in Treatment of Pain and Cardio Vascular disease.
 Socioeconomic status and income is a strong predictor of health. SES and
race predict health or unhealthy health practices.
 Geographical location and neighborhoods influence health behaviors.
Access to quality providers is determined by race and geographical location.
 Options in eliminating disparities:
 Increasing the Knowledge Base
 Raising Public and Provider Awareness
 Improving the Number and Capacity of Providers in
Underserved Communities
Why do Racial and Ethnic Disparities Exist
in Health Care 12

13.  Agency for Healthcare Research and Quality (2011, March). National healthcare disparities reports
2010. Agency for Healthcare Research and Quality. Retrieved November 3, 2011, from
http://www.ahrq.gov/qual/nhdr10/nhdr10.pdf
 Apter, A. J., & Casillas, A. M. (2009). Eliminating heath disparities: What have we done and what
do we do next. Journal of Allergy and Clinical Immunology, 123, 1237-9. doi:10.1016/j.jcai.2009.04.028
 Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuck, E. (2010). Socioeconomic
disparities in health in the United States: What the patterns tell us. American Journal of Public
Health, 100(S1), s186-196. doi:10.2105/ajph.2009.166082
 Center for Medicare Advocacy, Inc. (n.d.). Racial and ethnic health care disparities. Center for
Medicare Advocacy, Inc.. Retrieved November 11, 2011, from
http://www.medicareadvocacy.org/medicare-info/health-care-disparities/
 Chandra, A. (2009). Who you are and where you live race and the geography of healthcare.
Medical Care, 47(2), 135-7.
 Kaiser Family Foundation (2008, October 24). Eliminating Racial/Ethnic Disparities in Health Care:
What are the Options?. Kaiser Family Foundation. Retrieved November 13, 2011, from
http://www.kff.org/minorityhealth/h08_7830.cfm
 Klonoff, E. A. (2009). Disparities in the provision of medical care: an outcome in search of an
explanation. Journal of Medicine, (32), 48-63. doi:10.1007/s10865-008-9192-1
 Williams, D. R., & Jackson, P. B. (2005). Social sources of racial disparities in health.
 Heath Affairs, 24(2), 325-334. doi:10.1377/hlthaff.24.2.325
Why do racial and Ethnic Disparities Exist
in Health Care 13