Minority health care still lags, study finds

Treatment for blacks improves

Hispanics, Asians biggest losers

May 08, 2002|By Tom Pelton | Tom Pelton,SUN STAFF

Although doctors have made progress toward improving health care for African-Americans, minorities continue to receive generally worse treatment than whites, with Hispanic- and Asian-Americans the biggest losers in the U.S. health care system, according to a new study.

Dr. Karen Scott Collins, vice president of a New York-based medical research organization called the Commonwealth Fund, reported the conclusions of her national survey of 6,722 adults yesterday at the Pediatric Academic Societies' annual meeting at the Baltimore Convention Center.

The debate that followed Collins' presentation was one of the more lively during the four-day meeting, which has drawn 4,000 scientists from 48 countries to describe 2,300 new studies on subjects ranging from vaccine shortages to lead paint poisoning.

"Most of the medical literature in the past has focused on disparities between whites and blacks, but we are really just beginning to understand what is happening to the other minority populations in our country," said Collins.

In March, a report by the Institute of Medicine concluded that racial stereotyping by doctors contributed to shorter life spans for African-Americans, who are less likely than whites to receive coronary bypass surgery and other treatments when they need them.

Collins' study confirmed that blacks receive worse care than whites in several areas. But the survey, conducted by telephone from May through November last year, also found that a greater percentage of blacks (57 percent) than whites (47 percent) received a physical exam during the past year. More blacks (84 percent) than whites (73 percent) received eye screenings for glaucoma during that time, and a greater percentage of blacks than whites received a Pap smear test for cancer (60 percent vs. 53 percent).

Collins said she was encouraged by these findings, suggesting that they might mean that recent aggressive efforts to target blacks for screenings might be working.

More disturbing, Collins said, was the conclusion that health care quality for Hispanics and Asians often lagged behind the care for whites and blacks, often because of language and cultural barriers.

Her survey found that:

46 percent of Hispanics lacked health insurance some time in the previous year, compared with 30 percent of blacks, 21 percent of Asians and 20 percent of whites.

41 percent of Hispanics lacked a regular doctor, compared with 31 percent of Asians, 28 percent of blacks and 19 percent of whites.

6 percent of Asians over age 50 received colon cancer screening during the past year, compared with 18 percent of Hispanics, 28 percent of whites and 31 percent of blacks.

After Collins' presentation, the audience launched into a wide-ranging discussion of race and medicine. Dr. John Torday of the University of California, Los Angeles suggested that genetic research might soon make the study of racial groups' tendencies to contract illness irrelevant, because doctors might be able to predict an individual patient's likelihood to contract a disease by analyzing his or her DNA.

But Dr. Fernando Mendoza of Stanford Medical School said he doubts that genetic profiling will eliminate the need for racial surveys, because race can also suggest hardships in a person's life, such as poverty and discrimination.

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