Minorities in U.S. get worse medical care than whites, study says

Report recommends more minority doctors, civil rights enforcement

March 21, 2002|By Tom Pelton | Tom Pelton,SUN STAFF

The United States needs more minority physicians and more vigorous civil rights law enforcement to stop doctors from providing inferior medical care to blacks and other minorities, according to a report released yesterday by a leading scientific organization.

More than 100 studies reviewed by a 15-member committee of the Institute of Medicine concluded that racial minorities in the United States receive worse health care than whites, even when the minorities had the same income and health insurance as whites.

Racial stereotyping by doctors under increasing time pressure to see as many patients as possible may contribute to the inferior treatment for minorities, according to the 468-page study, "Unequal Treatment." And some minorities have a mistrust of doctors that can worsen the problem.

"The stereotyping process is an unconscious process and an automatic process," said David Williams, a member of the committee and professor of sociology at the University of Michigan. "Many individuals who ... are committed to egalitarian values will nevertheless unconsciously treat minority patients differently."

Among the solutions suggested by the committee are cultural education programs for doctors, increased awareness of bias, better education for patients and more federal money for the civil rights office of the U.S. Department of Health and Human Services.

According to the report, medical schools should educate more minority doctors. Little progress has been made in opening the medical field to blacks and Hispanics since 1968, when 3.5 percent of physicians in the United States were minorities. Now, 3.9 percent of doctors are minorities.

Dr. Donald E. Wilson, dean of the University of Maryland School of Medicine, said the study confirms what many had suspected for decades. "We really do need to get more minority physicians," he said. "They are much more likely to serve in underserved communities and minority communities than other doctors."

At the University of Maryland, 8.5 percent of the 150 first-year med students are black or Hispanic, as compared with 15 percent of second-year students, 18 percent of third-year students and 18 percent of fourth-year students.

The drop-off might be explained by the chilling effect of recent lawsuits challenging affirmative action programs at Maryland and elsewhere, Wilson said.

The Institute of Medicine is part of the National Academy of Sciences, an independent organization chartered by Congress to provide advice to the government on scientific topics.

The panel concluded that the shorter life span of minorities might be explained in part by worse medical care.

Among the study's findings:

Whites are nearly four times more likely than blacks to receive coronary bypass surgery when they need it, according to a 1992 study of 86,000 Medicare patients.

Nearly twice as many black prostate cancer patients (12.5 percent) as whites (6.6 percent) received no treatment for the disease, according to a 1991 study of 4,154 Medicare claims.

Black and Hispanic patients with HIV or AIDS were 24 percent less likely than whites to receive protease inhibitors or reverse transcriptase inhibitors.

Among 15,578 people who sought care in an urban emergency room, blacks were 1.5 times more likely to be denied authorization by their managed-care providers.

The Associated Press contributed to this article.

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