There is debate about what causes health disparities between ethnic and racial groups. However, it is generally accepted that disparities can result from three main areas:
- From the personal, socioeconomic, and environmental characteristics of different ethnic and racial groups (such as how certain racial groups, on average, live in poorer areas with high incidence of lead-based paint, which can harm children). A great deal of research on social determinants of health and the socio-ecological model have also surfaced, which connect economic and social conditions in determining a community's or a population's health.
- From the barriers certain racial and ethnic groups encounter when trying to enter into the health care delivery system; and
- From the quality of health care different ethnic and racial groups receive.
Each of these dimensions have been suggested as possible causes for disparities between racial and ethnic groups. However, most attention on the issue has been given to the health outcomes that result from differences in access to medical care among groups, and the quality of care different groups receive.
Additionally, attention on health care disparities is largely focused on race and ethnicity; data on racial and ethnic disparities are relatively widely available. In contrast, data on socioeconomic health care disparities are collected less often, often using education as the indicator of socioeconomic status.
The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist.
Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data.
Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources.
A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data.
The Institute of Medicine report, ''Race, Ethnicity, and Language Data'' identifies current models for collecting and coding race, ethnicity, and language data; ascertains the challenges involved in obtaining these data in health care settings; and makes recommendations for improvement.
A study of 20,000 cancer patients in the United States found that African Americans are less likely than European Americans to survive breast, prostate and ovarian cancer even when given equal care, but that other forms of cancer had equal survival chances, which suggests that biological factors may be at work.
Transplantation rates differ based on race, sex, and income. A study done with patients beginning long term dialysis showed that the sociodemographic barriers to renal transplantation present themselves even before patients are on the transplant list.
For example, different groups express definite interest and complete the pretransplant workup at different rates. Previous efforts to create fair transplantation policies had focused on patients currently on the transplantation waiting list.
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