Racial Disparities in Health Care Quality

Past research yields mixed evidence regarding whether ethnoracial minorities trust physicians less than Whites. Using the 2002 and 2006 General Social Surveys, variegated ethnoracial differences in trust in physicians are identified by disaggregating a multidimensional physician trust scale. Compared to Whites, Blacks are less likely to trust the technical judgment and interpersonal competence of doctors. Latinos are less likely than Whites to trust the fiduciary ethic, technical judgment, and interpersonal competence of doctors. Black-Latino differences in physician trust are a function of ethnoracial differences in parental nativity. The ways ethnoracial hierarchies are inscribed into power-imbalanced clinical exchanges are discussed.

As medicine emerged as a humanist and scientific
discipline positioned to cure and eradicate disease, there were
great hopes that it could additionally transform race relations
because of the principles of universalism—particularly the notion
of value-free clinicians with good hearts and helping hands. Yet,
American medicine, like other White controlled institutions,
maintained a deliberate path of racial marginalization and gross
inequalities mainly ensconced in racial ideology over the Black
body. Centuries-old racist practices have consequences and
repercussions for its targets. As this paper demonstrates, looking at the experiences of African Americans, the effects of living with unrelenting racism(s) has produced significant physiological damage in the form of the stress response.

This historical study examined the slave narratives collected during the Depressive Era by the Federal Writers’ Project (FWP) as sources to gain understanding of the impact of the social experience of slavery and the transition from slavery to freedom on the former slaves’ health outcomes and to identify possible factors that may help to explain differences in longevity between Black and White populations. 
Disparities in longevity among Blacks and Whites in the United States have existed since the period of slavery and therefore cannot be viewed in isolation from its history of slavery, racism, and legal segregation.  This study looks at a cohort population who share a common
ancestral descent from people historically indigenous to Sub-Saharan Africa and how diverse causal paths of resilience become differentiated over time.  By examining the institution of slavery through the eyewitness accounts of those who experienced it, whose average age was 85 years old -- and among whom nearly one in every ten claimed to be 100 years old (Welds and Grimke, 1839) this historical study utilizes the slaves narratives to reveal  the day-to-day life of former slaves, their handling of oppression, diseases, hopes, and fears in search of risk factors to
longevity that may explain the current health discrepancy between Blacks and Whites.
Results: The analyses of over 230 slave narratives and other source data revealed that
health disparities circumscribed the lives of former slaves and that their resiliency changed across time as circumstances and situations changed and appears to be explained by the timing of
the influences of social inequalities, changes in resilient pathways which once served to insulate
them from the effects of racism, leaving the former slaves more vulnerable to the consequences of health.
Conclusion:  The disparities in health between Blacks and Whites appear to be more of a social phenomenon as opposed to a matter of biology or genetics.

A Glimpse of Chapter 11, "Social Determinants of Health Among African-American Men." A key takeaway from Chapter 11 is that contemporary racism in medical care is a significant cause of poor health outcomes among Black men.

Published on MEDIUM.COM (by AN INJUSTICE!) Read here: https://aninjusticemag.com/prejudiced-providers-the-impact-of-medical-racism-on-black-men-19c5eea74706

Since the early 20th century, a marked increase in obesity, diabetes, and chronic kidney disease has occurred in
the American Indian population, especially the Pima Indians of the Southwest. Here, we review the current
epidemic and attempt to identify remediable causes. A searchwas performed using PubMed and the search terms
American Indian and obesity,American Indian and diabetes, American Indian and chronic kidney disease, and American
Indian and sugar or fructose, Native American, Alaska Native, First Nations, Aboriginal, Amerind, and Amerindian for
American Indian for articles linking American Indians with diabetes, obesity, chronic kidney disease, and sugar;
additional references were identified in these publications traced to 1900 and articles were reviewed if they were
directly discussing these topics.Multiple factors are involved in the increased risk for diabetes and kidney disease
in the American Indian population, including poverty, overnutrition, poor health care, high intake of sugar, and
genetic mechanisms. Genetic factors may be especially important in the Pima, as historical records suggest that
this groupwas predisposed to obesity before exposure toWestern culture and diet. Exposure to sugar-sweetened
beverages may also be involved in the increased risk for chronic kidney disease. In these small populations in
severe health crisis, we recommend further studies to investigate the role of excess added sugar, especially sugar sweetened beverages, as a potentially remediable risk factor.

Racial inequities in healthcare in the US and the UK are well documented, yet disparities stubbornly persist at disturbing levels in high-income countries such as these. While some healthcare institutions have been using anti-bias training to address the problem, it has had no impact on reducing inequities. While well-intentioned, it could be argued that mere training, without legally enforceable procedures to reduce racial bias, will maintain the status quo.

Purpose: Past research indicates that blacks are less trusting of physicians than are whites; yet, researchers have not examined within group differences in physician trust by religious denomination – an effort that is complicated by the high correlated nature of race and religion. To better understand black-white differences in physician trust, this paper examines heterogeneity in trust levels among blacks associated with religious designations that distinguish Black Protestants from other ethnoreligious groups.
Methodology/Approach: Using data from the 2002 and 2006 General Social Surveys, this study adopts an intersectional (i.e., race X religion) typology of religious denomination to understand the black-white gap in physician trust. Weighted multivariate linear regression is employed.
Findings: Black-white differences in physician trust are identified only when religious affiliation is considered but not when religious affiliation is omitted. Blacks who are affiliated with Black Protestant churches are more trusting than other religious groups, including Evangelical Protestants, Mainline Protestants, and blacks who are affiliated with other faiths.
Originality/Value of Paper: This paper indicates that there is more heterogeneity in trust levels among blacks than between blacks and whites. Moreover, the findings suggest that religion can play an important role in bridging the trust gap between blacks and the medical sciences.

This paper describes the methods used and the challenges encountered during data collection for an ethnographic study on language barriers and ad-hoc interpreting in a linguistically diverse inner-city hospital emergency department (ED). Data collection relied on ethnographic participant observation and transcripts of audio-recorded clinician-patient interactions to describe and analyse how staff, patients, and ad-hoc interpreters interact in an ED setting. This paper reviews the different practical steps that needed to be undertaken before embarking on data collection, with a view to stirring the discussion on these issues and facilitating future research.

African Americans experience mental health disadvantages relative to European Americans with respect to financial barriers, barriers to help seeking, and poorer quality services. This paper provides an overview of these mental health inequalities, and offers recommendations for addressing them.

There is still a great divide between journal articles, government studies, and the actual care that women receive at their local gynecologist's office. If you add disparities involving race, class, and other socioeconomic and immigration issues, you'll find that although some women may be receiving gender-specific interdisciplinary holistic care, others are receiving treatments thought to be abandoned during the Victorian era.

The literature on medical interpreting shows that lack of a common language between a patient and a doctor is a major cause of health disparities in healthcare in multilingual environment. This problem is exacerbated around the world by the fact that emergency departments are becoming increasingly diverse and cater for multicultural as well as multilingual societies. Language barriers pose frequent problems between patients and caregivers, and this contribution stems from a project that is seeking to identify ways of dealing more effectively with multilingualism on in hospitals. As 80% of the diagnosis depends on oral communication, medical mishaps in emergency departments often result from vulnerable communication processes, due to language barriers; this area of research is under-represented in the growing focus on medical interpreting. Furthermore, considering that the conditions for communication in emergency departments are very different from primary care settings, this contribution presents the results of a research conducted to better understand interpreting needs in this context. This chapter hence reports on practices, emerging needs, and varying degrees of concerted, institutional responses in two specific local contexts (in which the research was carried out) that may be representative of endemic situations.

On 8 October 2014, Liberian citizen Thomas Eric Duncan, died from the Ebola Virus Disease (EVD) in Dallas, Texas. Following his untimely death, concerns about the spread of Ebola in the United States reached a fever pitch, and the word Ebola itself became a subtext for stigmatization and alienation of an entire continent and group of people.

Language barriers in healthcare lead to a lower quality of health services, worse patient health outcomes, and higher treatment costs. The best remedy is to use professional interpreters. In reality, however, hospital staff may face a number of challenges in making effective use of professional interpreters, in particular in specific contexts such as an Emergency Department (ED). As a result, hospital staff often revert to non-trained, ad hoc interpreters instead. Drawing on the existing quantitative literature as well as on their own qualitative research, Cox and Lázaro-Gutiérrez establish a link between the poor utilization of professional interpreters and the chaotic and hectic context of the ED. They also pinpoint important pitfalls of working with ad-hoc interpreters in the ED, and discuss the ensuing implications for ED management and interpreter training.