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Author : Institute of Medicine Publisher : National Academies Press Page : 781 pages File Size : 40,41 MB Release : 2009-02-06 Category : Medical ISBN : 030908265X
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
National Academies of Sciences, Engineering, and Medicine
Author : National Academies of Sciences, Engineering, and Medicine Publisher : National Academies Press Page : 583 pages File Size : 36,96 MB Release : 2017-04-27 Category : Medical ISBN : 0309452961
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Author : National Research Council Publisher : National Academies Press Page : 184 pages File Size : 42,19 MB Release : 2004-09-08 Category : Social Science ISBN : 0309165865
As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.
"Unequal Treatment is an eye-opening book that will inform and anger readers who are interested in one of today's hottest issues - women's health. It is a thoroughly researched expose of the way women are treated by doctors, medical researchers, and the people who control the money that goes into funding medical research and health programs. Whether in the case of a medical school professor who inserts slides of centerfold models into his anatomy lectures, or of a female intern who was labeled as crazy by her supervisor because she questioned his methods and stood up for herself, or of a Rockefeller University project that explored the impact of obesity on the tendency for women to develop breast or endometrial cancer, but used only men in the study, the authors have found pervasive, institutionalized prejudice against women in medicine." "Eileen Nechas and Denise Foley reveal some startling information that uncovers the deplorable state of women's health care today, and will inspire women to challenge the quality of the health care they receive and take action against the legislators and institutions that promote and maintain the antifeminine bias in medicine today." "In research clinics, medical schools, and doctors' offices, women are not getting the treatment they need or deserve." "Based on interviews and a thorough review of the medical literature, this timely book puts women's health care, the feminist issue of the nineties, into clear perspective."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved
Author : The National Roundtable on Health Care Quality Publisher : National Academies Press Page : 42 pages File Size : 30,97 MB Release : 1999-02-23 Category : Medical ISBN : 0309570689
The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.
Author : Institute of Medicine Publisher : National Academies Press Page : 781 pages File Size : 34,61 MB Release : 2009-03-06 Category : Medical ISBN : 030921582X
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Author : Institute of Medicine Publisher : National Academies Press Page : 353 pages File Size : 25,32 MB Release : 1999-06-11 Category : Medical ISBN : 0309071542
We know more about cancer prevention, detection, and treatment than ever beforeâ€"yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor peopleâ€"no matter what their ethnicityâ€"often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics.
How can we all work together to eliminate the avoidable injustices that plague our health care system and society? Health is determined by far more than a person's choices and behaviors. Social and political conditions, economic forces, physical environments, institutional policies, health care system features, social relationships, risk behaviors, and genetic predispositions all contribute to physical and mental well-being. In America and around the world, many of these factors are derived from a lingering history of unequal opportunities and unjust treatment for people of color and other vulnerable communities. But they aren't the only ones who suffer because of these disparities—everyone is impacted by the factors that degrade health for the least advantaged among us. In Why Are Health Disparities Everyone's Problem? Dr. Lisa Cooper shows how we can work together to eliminate the injustices that plague our health care system and society. The book follows Cooper's journey from her childhood in Liberia, West Africa, to her thirty-year career working first as a clinician and then as a health equity researcher at Johns Hopkins University. Drawing on her experiences, it explores how differences in communication and the quality of relationships affect health outcomes. Through her work as the founder and director of the Johns Hopkins Center for Health Equity, it details the actions and policies needed to reduce and eliminate the conditions that are harming us all. Cooper reveals with compelling detail how health disparities are crippling our health care system and society, driving up health care costs, leading to adverse health outcomes and ultimately an enormous burden of human suffering. Why Are Health Disparities Everyone's Problem? demonstrates the ways in which everyone's health is interconnected, both within communities and across the globe. Cooper calls for a new kind of herd immunity, when a sufficiently high proportion of people, across race and social class, become immune to harmful social conditions through "vaccination" with solidarity among groups and opportunities created by institutional and societal practices and policies. By acknowledging and acting upon that interconnectedness, she believes everyone can help to create a healthier world. Features • Raises readers' health care inequities literacy through an approachable narrative with specific examples • Introduces the concept of "herd immunity" as it applies to building communal awareness of systemic injustices • Features sections that underscore key takeaways • Includes contributions from the world's leading minds through their research findings and quotations • Guides readers on what can be done at an individual level as a patient, public health professional, and community member • Includes inspiring stories of effective health equity studies and practices around the world, from Ghana's ADHINCRA Project addressing hypertension control to Baltimore's BRIDGE Study for depression in African Americans and the Maryland and Pennsylvania–based RICH LIFE Project for hypertension, diabetes, and other medical conditions Johns Hopkins Wavelengths In classrooms, field stations, and laboratories in Baltimore and around the world, the Bloomberg Distinguished Professors of Johns Hopkins University are opening the boundaries of our understanding of many of the world's most complex challenges. The Johns Hopkins Wavelengths book series brings readers inside their stories, illustrating how their pioneering discoveries benefit people in their neighborhoods and across the globe in artificial intelligence, cancer research, food systems' environmental impacts, health equity, science diplomacy, and other critical arenas of study. Through these compelling narratives, their insights will spark conversations from dorm rooms to dining rooms to boardrooms.
Chicago has long struggled with racial residential segregation, high rates of poverty, and deepening class stratification, and it can be a challenging place for adolescents to grow up. Unequal City examines the ways in which Chicago’s most vulnerable residents navigate their neighborhoods, life opportunities, and encounters with the law. In this pioneering analysis of the intersection of race, place, and opportunity, sociologist and criminal justice expert Carla Shedd illuminates how schools either reinforce or ameliorate the social inequalities that shape the worlds of these adolescents. Shedd draws from an array of data and in-depth interviews with Chicago youth to offer new insight into this understudied group. Focusing on four public high schools with differing student bodies, Shedd reveals how the predominantly low-income African American students at one school encounter obstacles their more affluent, white counterparts on the other side of the city do not face. Teens often travel long distances to attend school which, due to Chicago’s segregated and highly unequal neighborhoods, can involve crossing class, race, and gang lines. As Shedd explains, the disadvantaged teens who traverse these boundaries daily develop a keen “perception of injustice,” or the recognition that their economic and educational opportunities are restricted by their place in the social hierarchy. Adolescents’ worldviews are also influenced by encounters with law enforcement while traveling to school and during school hours. Shedd tracks the rise of metal detectors, surveillance cameras, and pat-downs at certain Chicago schools. Along with police procedures like stop-and-frisk, these prison-like practices lead to distrust of authority and feelings of powerlessness among the adolescents who experience mistreatment either firsthand or vicariously. Shedd finds that the racial composition of the student body profoundly shapes students’ perceptions of injustice. The more diverse a school is, the more likely its students of color will recognize whether they are subject to discriminatory treatment. By contrast, African American and Hispanic youth whose schools and neighborhoods are both highly segregated and highly policed are less likely to understand their individual and group disadvantage due to their lack of exposure to youth of differing backgrounds.
Author : Institute of Medicine Publisher : National Academies Press Page : 359 pages File Size : 47,83 MB Release : 2001-07-19 Category : Medical ISBN : 0309132967
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.