Report Says U.S. Minorities Get Lower-Quality Health Care; Moral Implications of Widespread Pattern Noted

Minorities in America -- whether insured or not -- receive lower-quality care than do whites, a pattern so widespread and severe that it contributes to higher death rates and shorter life spans, according a report from the Institute of Medicine (IOM).

Researchers identified language barriers, inadequate health insurance coverage, bias among health professionals, and a systemic lack of minority physicians as reasons why nonwhite patients received fewer tests and inferior treatment.

The 562-page report, requested by Congress, is the most exhaustive analysis of the disparities in treatment and health outcomes for minorities. It reveals the effects of patient stereotyping and an expensive health system that often forces patients to ration their own care. "We have a health care system that is the pride of the world, but this report documents that the playing field is not even," said David Williams, a sociology professor at the University of Michigan who described the study as "a wake-up call for every health care professional."

A nonwhite patient in the United States is far more likely to be treated by a white doctor who earns less, received less training and does not have a clear understanding of the patient's native language or cultural heritage. Most remarkably, over the past three decades, the share of black physicians in the US rose from 3.5 percent to 3.9 percent.

The largest discrepancies in health outcomes for minorities came in the areas of cardiovascular disease, HIV/AIDS, cancer and diabetes. African-Americans, Asian-Americans, Hispanics and Native Americans were less likely to receive sophisticated treatments such as angioplasty, bypass surgery, kidney transplantation or combination drug therapy for HIV disease. "Significantly, these differences are associated with greater mortality among African-American patients," the researchers note. "By contrast [minorities] are more likely to receive certain less-desirable procedures, such as lower limb amputations for diabetes."

The report calls for increased awareness, more interpreters, more minority physicians, better data and more money for the Office of Civil Rights, which enforces equity laws.

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