Talking about Race and Health
News • Questions & Answers • Tools

Overview: Few subjects in America are more complex than the question of race. While biologists now agree that there is nothing in a person’s genetic makeup that supports the idea of race.

Still, most people believe there are inherent “racial differences,” especially between people with light tan skin and those with darker brown skin.

The persistence of this idea—that your skin color is important to who you are—is embedded in our culture, affecting every aspect of it. Race may not exist, but racism still does, and its effects are evident in the way people of color are treated differently and respond differently, within our health care system and within the larger society.

News
Latest research and opinion on race and health

• New! Doctors Miss Cultural Needs in Diabetes Care A new study of diabetes patients found racial disparities even among patients treated by the same doctor and attributes the differences less to overt racism than to a systemic failure to tailor treatments to patients’ cultural norms. “It isn’t that providers are doing different things for different patients,” said the author, Dr. Thomas D. Sequist, an assistant professor of health care policy at Harvard Medical School. “It’s that we’re doing the same thing for every patient and not accounting for individual needs.”
• The relationship between "race" and genetics Human genome sequencing offers new tools to determine if health disparities are actually due to biological differences. This article discusses genetic variation among African Americans and Hispanic Americans and its implications for "race," and concludes that the casual use of "race" to define groups in biomedical research limits understanding of the complex disease etiology and risk factors driving health disparities.
  A related article in Social Science and Medicine asserts that advances in the Human Genome Project have unwittingly strengthened the idea that race/ethnicity does have a genetic basis.
• Who’s responsible for fixing race-based health disparities? Content analysis of news coverage on racial healthcare disparities in the USA between 1994 and 2004 reveals that public awareness of healthcare inequalities in the USA has increased. But at the same time the public has become less supportive of federal responsibility to address healthcare inequalities, according to Harvard researchers writing in Social Science and Medicine.
• Stuff White People Like A tongue-in-cheek website that pokes fun at “white culture” and, by implication, the idea that any race, ethnic group or culture is homogenous in its likes and dislikes.

Thanks to Hennepin County for assistance in compiling news items. Contact Lindsey Van Klei to receive a daily email digest of research headlines.

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Race: Questions & Answers
Tips on providing equitable treatment for patients of all races

• Do different groups of people really have different health outcomes?
• Is collecting information about a patient against the law?
• How do I overcome patient and staff reluctance to talk about race?

Q. Do different groups of people really have different health outcomes?

A. Yes. Even though there is no essential biological difference between people of one race or another, the rate of disease — and mortality from specific diseases — varies tremendously between people identified as one race or another. For example,

• The mortality rate for cardiovascular disease among African American women is 67 percent higher than for white women.
• Mexican American adults are almost twice as likely to have diabetes as non-Latino whites of the same age.
• Asian Indians, Chinese and Japanese people living in the US have lower death rates for stroke than the white population. But Samoans in the US die of stroke at almost five times the rate of whites.

The medical literature proves that different racial and ethnic groups have different health outcomes. Teasing out the reasons, and establishing can be done about them about them, is more complex.

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Q. Is collecting information about a patient against the law?

A. No, Collection and reporting of data on race, ethnicity and primary language are legal, according to Title VI of the federal Civil Rights Act of 1964. No federal statutes prohibit this collection. At the state level, Minnesota law does not prohibit collection of this information, either.

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Q. How do I overcome patient and staff reluctance to talk about race?

A. Collecting information about sensitive topics should be done… sensitively. There are ways to ask patients about race, ethnicity and language that reassure patients about our intentions. When collecting this data, always

• Assure the patient that the data will be kept confidential, and that it will never be used to deny them care.
• Explain why the data is being gathered. A simple explanation like “We need to know this so we can improve services for all of our patients,” may suffice, but if someone really wants to know, you can talk about your organization’s commitment to reducing health care disparities for minority patients.

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Got a question? Share it on the Exchange members' discussion forum.

Tools:
Key publications, websites and organizations on race and health

National resources

Racial, Ethnic and Primary Language Data Collection in the Health Care System: An Assessment of Federal Policies and Practices. More information on the legality of data collection by the Commonwealth Fund of Massachusetts, September 2001.

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (2002), a comprehensive report by the Institutes of Medicine.

Provider’s Guide to Quality & Culture, a comprehensive website run by several federal health agencies. Sample the site by reviewing a summary of health problems among specific racial and ethnic groups in the US, such as sub-Saharan Africans, Latinos and African Americans.

Minnesota connections

Minnesota Black Physicians Association: Offers health literacy, advocacy and leadership in promoting policies to improve the health status of all Minnesotans.

Minnesota Department of Health, Office of Minority and Multicultural Health
Administers an Eliminating Health Disparities grant program, funding community initiatives for American Indians, Africans/African Americans, Asians, and Latinos in eight health disparity areas.

Populations of Health Status Reports: Demographic and economic profiles, birth related health indicators, mortality rates and cause of death, illness and injury, and access to health care.