The Physician 's Lack Of Certification

Barriers in health care can lead to disparities in meeting health needs and receiving appropriate care, including preventive services and the prevention of unnecessary hospitalizations (HealthyPeople.gov, 2012). In their 2008 annual report, the Agency for Healthcare Research and Quality lists several disparities’ in health care. They report that racial and ethnic minorities in the United States

In doing so, he pays particularly close attention to black patients and their relations with health care policies and practices. Smedly maintains that blacks are not only the victims of, inpatient and outpatient treatment, racial policies, and other services but also the victims of its consequences. He argues that many health care administrators are agents to a system of inequality that support provider and administrator biases, geographical inequalities, and racial stereotypes (Smedly 2012).

In 1964 Congress passed the Civil Rights Act in which Title VI specifically forbade the distribution of federal funds to organizations that practiced discrimination. Enforcement of Title VI was a major priority within the Johnson administration as they implemented the Medicare program (Reynolds, 1997). Despite a mandate of equal treatment, significant patterns of segregated health care utilization have remained to the present. In an analysis of Medicare beneficiaries, Bach and colleagues found that their was a small proportion of physicians – 22% - who provided the majority of visits - 80% - by black patients (Bach, Pham, Schrag, Tate, & Hargraves, 2004). This may represent a pattern of racial concordance, patients choosing providers of their own race, but the physicians seeing the majority of black patients did not the same resources available as those seeing the majority of white patients. Compared with physicians seeing the mostly white patients, physicians seeing mostly black patients were 33% less likely to report always having access to high quality specialists, and 40% less likely to report always having access to high quality diagnostic imaging. In short, black patients are using a different health system than white patients on average and the health system black patients are using has fewer resources (Bach, et al., 2004).

A notable discrepancy exists between health care received by the black population in comparison to the white population. However, the foundation of health care inconsistencies has yet to be firmly established. Instead, conflicting views prioritize causes of health care disparities as due to social determinants or due to individual responsibility for health (Woolf & Braveman, 2011). Emerging literature also indicates that health care providers propagate disparities by employing implicit biases (Chapman, Kaatz, & Carnes, 2013; Dovidio, Fiske, 2012). This paper aims to discuss black health care disparities as a function of socially constructed beliefs that both consciously and unconsciously influence health care professionals practice.

Since the publication of the Institute of Medicine’s “Unequal Treatment Report” in 2002, highlighting the startling but harsh truths behind these health care differences, there has been a renewed interest in understanding the sources of these inconsistencies, with any seeking to identify contributing factors in hopes of creating an effective solution in reducing or eliminating racial and ethnic disparities in health care

Although the United States is a leader in healthcare innovation and spends more money on health care than any other industrialized nation, not all people in the United State benefit equally from this progress as a health care disparity exists between racial and ethnic minorities and white Americans. Health care disparity is defined as “a particular type of health difference that is closely linked with social or economic disadvantage…adversely affecting groups of people who have systematically experienced greater social and/or economic obstacles to health and/or clean environment based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion” (National Partnership for Action to End Health Disparities [NPAEHD], 2011, p. 3). Overwhelming evidence shows that racial and ethnic minorities receive inferior quality health care compared to white Americans, and multiple factors contribute to these disparities, including geography, lack of access to adequate health coverage, communication difficulties between patients and providers, cultural barriers, and lack of access to providers (American College of Physicians,

disparities are exclusive to certain groups of racial and ethnic populations in the nation. Health

Health disparities amongst African-Americans continue to destabilize not just the various communities but the health care system as a whole. Minority groups especially African-Americans are more probable to agonize from certain health illnesses, have higher mortality rates and lower life expectancy than another other race in the nation. Health disparities are complex and incorporate lifestyle choices, socioeconomic factors such as income, education and employment and access to care services. For the elimination of health disparities within the African-American community, there requires a need for equivalent access to health care and cultural suitable health ingenuities.

Sally Satel on the other hand is a supporter of the fact that racism is not a serious problem in the health care system. Even though she agrees with IOM about health care disparity, she thinks racism is not a cause. That is what she shows the reader in her article. She argues that the health care system is colorblind. Satel she mentions the causes of health care disparities as well as ways to correct the disparities. In her opinion, “racism isn't to blame for health disparities, but rather race itself” (Satel 2). Satel identifies two possible reasons to counter the notion that racism is the cause of health care disparities. First, she quotes that, “white and black patients, on average, do not even visit the same population of physicians—making the idea of preferential treatment by individual doctors a far less compelling explanation for disparities in health” (Satel 2). Another reason is “that a higher proportion of the doctors that black patients tend to see may not be in a position to provide optimal care” (Satel 1).

In summary, the text elaborates on the issues at hand with both the business and social aspects of the inconsistencies in reaching fair and equitable healthcare within the United States. The aim is to reduce these discrepancies of racial/ethnic or socioeconomic disparities within the healthcare system by implementing interventions. A vital intervention is escalating responsibility and taking a closer look to polish up the quality of clinical care given for individual patients and communities. While working on these health imbalances, the healthcare organizations want to know that there will be a return on investment.

The United States is world renowned for having the best health care if not the most accessible. Citizens have at their disposal a plethora of hospitals, physicians, and therapists to improve their well-being. Statistical data was taken back in 2010 under the Central Texas Region and studied health care coverage and income in regards to the community. The data displayed in the surveys heavily suggest that income/ health in general have a high correlation. The issue that arose with the given data imply that those who are on the lower end of the income spectrum subsequently have no health care coverage and poorer health than those with higher income. In any case with high correlation there are a number of factors influencing the statistical evidence, and in this case sociological barriers are present in regards of inequality and health care.

Changes in access to health care across different populations are the chief reason for current disparities in health care provision. These changes occur for several reasons, and some of the main factors that contribute to the problem in the United States are: Lack of health insurance – Several racial, ethnic, socioeconomic and other minority groups lack adequate health insurance coverage in comparison with people who can afford healthcare insurance. The majority of these individuals are likely to put off health care or go without the necessary healthcare and medication that is needed. Lack of financial resources – Lack of accessibility to funding is a barrier to health care for a lot of people living in the United States

Hi Michelle, I, too, work in an inner city, Newark, which is the largest city in New Jersey. The population is very diverse, e.g. African-American, Hispanic, Indian, and Asian-American. The diversity of the community is in turn reflected in the composition of the hospital’s patients’ population. However, the diversity is not only with regards to the ethnicities of the group, but is also reflective of the socio-demographics characteristics of an inner city. The findings of the Institute of Medicine (IOM) that “individuals in minority groups experience disproportionately higher rates of chronic diseases and do not receive the same quality of health care as individuals in majority groups” (Hart & Mareno, 2013, p. 2224), runs true to majority of

An unfortunate reality of health in the United States is that there are two very different standards of care within the health system: a very high standard with excellent health outcomes for the wealthy and privileged with better health insurance, and an insufficient standard with poor health outcomes for those with less resources, many of those belong to the minority groups (Gable, 2011).

Accessibility to health care is another factor that leads to health inequalities. As mentioned above, the poor are less likely to have access to health care. According to Braveman et al. (2010), there is also a great deal of evidence that, after accounting for socioeconomic status, minorities receive “fewer medical procedures and poorer quality medical care than whites”. It also seems that the biggest difference between minorities and whites concerns disease progression, rather than incidence rate (Braveman et. al, 2010).