Health Reform and Racial and Ethnic Health Disparities
One of the most troubling aspects of the U.S. health care system is the existence, and extent, of racial and ethnic health disparities. Research has amply documented that members of racial and ethnic minority groups receive fewer health care services and lower quality health care than non-minority patients (see, for example, the rather damning portrait drawn by the Institute of Medicine’s 2003 study titled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care”). These disparities remain even when insurance status, socioeconomic status, and other important factors are controlled for in scientific studies.
There are many likely causes of race- and ethnicity-based health disparities. Among them: patient-level variables such as cultural preferences, mistrust of health care providers, and degrees of knowledge; system-level factors such as the geographic availability of health care providers, the use of managed care in publicly sponsored health care programs, and a general lack of institutional funding for language interpretation and translation services; and provider-level variables such as prejudice, stereotyping, and clinical uncertainty when treating minority patients.
Yet for all the evidence showing the existence of racial and ethnic health disparities, government agencies, health care providers, and health plans and insurers do not routinely collect data pertaining to patients’ race, ethnicity, and primary language.