Diabetes. Diabetes is a condition in which blood glucose is unable to enter the cells More than 80% of people with diabetes die from cardiovascular disease. …
Health care Disparities: Facts and IssueS
Source:
The Commonwealth Fund 2001 Health Care
Quality Survey
Source: Physicians Characteristics and Distribution in the US, 2004
Edition American Medical Association
———————–
Introduction
Not all Americans have access to the high quality of care that is available
in this country And not all patients are treated in the same manner For
example:
Providers may order fewer diagnostic tests for patients of different
cultural backgrounds because they may not understand or believe the
patients description of symptoms
Patients are less likely to adhere to a prescribed treatment or medical
advice if they do not understand or trust the medical provider
To receive the best quality of care, it is important that providers become
more aware of the specific needs of minority populations, and increasingly
comfortable in
dealing with patients from differing backgrounds Healthcare
consumers and advocates should also educate themselves in order to insure
the best care for everyone
Sources: National Healthcare Disparities Report 2003, The Providers Guide
to Quality Culture wwwercmshorg
African Americans
The cardiovascular disease death rate for both men and women far exceeds
the rate for the majority population and for other ethnic groups
The prevalence of diabetes is substantially higher than among the
majority population, and the incidence of complications, including lower-
limb amputations and end-stage renal disease is double
African-American women are far more likely than women of the general
population to be infected with HIV, and about 64 of all women with new
HIV infections in a given year are African American
African-Americans have a higher incidence of hypertension, sickle cell
anemia and are more likely to be lactose intolerant than the general
population Certain diseases, including prostate and breast cancer, may
progress more rapidly than in the general population
Source: The Providers Guide to
Quality Culture wwwercmshorg
Women
Females have traditionally been diagnosed and treated as if their bodies
were the same as males Women are often excluded from clinical trials
Less than 1/3 of uninsured pregnant women get proper prenatal care, while
well-insured pregnant women suffer from many unnecessary interventions,
such as cesarean sections, episiotomies, labor inductions and continuous
electronic fetal monitoring
Some insurance companies have sought to deny coverage to battered women
on the grounds that they constitute a high risk population
Women are at a disadvantage paying for care, because they are paid less
than men
Source: Reed, Alyson Womens Healthcare Disparities and Discrimination
Civil Rights Journal, Fall 1999
Hispanics/Latinos
Overweight and obesity are common in some Hispanic groups: for example,
combined overweight and obesity are found among 639 of Mexican-American
men and 659 of Mexican-American women
The incidence of cervical cancer in Hispanic women is double that of non-
Hispanic European-American women
Hypertension is common in
Hispanic populations
Although Hispanics have a lower incidence of breast, oral cavity,
colorectal, and urinary bladder cancers, their mortality from these
cancers is similar to that of the majority population
Diabetes is twice as prevalent among Hispanics as among the majority of
the population
Source: The Providers Guide to Quality Culture wwwercmshorg
Factors Resulting in Poor Care
Entry Barriers: A lack of health insurance, lack of a usual source of
care, unmet needs
Structural Barriers: Difficulties in getting care, lengthy waiting times
Patients Perceptions: Provider-Patient Communication, provider lack of
cultural competency skills, linguistic barriers, lack of culturally or
linguistically specific healthcare information
Financial incentives to limit services, high cost of care,
Fragmentation of healthcare financing and delivery
Source: National Healthcare Disparities Report 2003, IOM Unequal
Treatment: Confronting Racial and Ethnic Disparities 2002
General Recommendations
Increase awareness of racial and ethnic disparities in health care among
the general public
and key stakeholders, and increase health care
providers awareness of disparities
Promote the consistency and equity of care through the use of evidence-
based guidelines
Provide the use of interpretation services where community need exists
The use of community health workers and multidisciplinary treatment and
preventive care teams should be encouraged
Implement patient education programs to help increase patient knowledge
of how to best access and maximize care
Integrate cross-cultural education into the training of all current and
future health professionals
Conduct further research to identify sources of racial and ethnic
disparities and assess promising intervention strategies
Source: National Healthcare Disparities Report 2003, IOM Unequal
Treatment: Confronting Racial and Ethnic Disparities 2002
Asian-Americans
Lactose intolerance is common
Common sites of cancer among Chinese women are the lungs, breast, colon,
stomach and pancreas Invasive cancer rates are much higher among
Southeast Asian women in general than in the majority US population
The rates of cervical
cancer incidence and mortality for Vietnamese
American women exceed those of any other minority or majority population
in the US
Some Asians may develop a severe form of Glucose-6-phosphate
dehydroginase G-6PD deficiency
Source: The Providers Guide to Quality Culture wwwercmshorg
Immigrants
Newcomers may have tuberculosis, Hepatitis B, internal parasites or
malaria
Sickle-cell anemia occurs in populations originating in Africa, India,
Saudi Arabia and Sicily
Recent immigrants may suffer from dental concerns as a result of poor
dental care in their own country or increased consumption of processed
foods since their arrival in the United States
Recent immigrants may experience cultural or linguistic difficulties
Source: The Providers Guide to Quality Culture wwwercmshorg
American Indians/Alaska Natives
Almost 3 times as likely to have diabetes as non-Hispanic European
Americans of similar age
Native Alaskan men and women suffer disproportionately higher rates of
cancers of the colon and rectum compared to European Americans
Source: The Providers Guide to
Quality Culture wwwercmshorg
Source:fredonia.edu
