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
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.
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