Medical Care: Equally Bad, But Disparities Should Not Be Ignored
A new study published in yesterday’s edition of the New England Journal of Medicine has surprised researchers and emboldened conservatives who contend that too much attention is being focused on racial and socioeconomic disparities in healthcare.
The study indicates that only 55 percent of Americans receive recommended health care. In addition, the investigators found that everyone – no matter their racial or economic background – received the same level of primary care. This finding startled researchers as there is a large body of evidence suggesting that whites and the well off receive better care than ethnic minorities and the poor.
Even the lead investigator of the study, Dr. Steven M. Asch was surprised by the study results. According to the Washington Post, he said: “So many previous studies have shown disparities. In a way that is surprising. We looked in as many ways as we could to try to determine if there was a problem with our analysis. I’m convinced that’s not the case.â€
Dr. Sally Satel, a critic of efforts to highlight racial and ethnic disparities in healthcare (see my previous post on Dr. Satel’s assertions) viewed the study as a wake up call. She told the Washington Post: “The obsession with racial disparities is a distraction from what we really need to do, which is improve health care for everyone. This shows us that, if anything, minority groups actually have even somewhat better outcomes.”
Dr. Richard Allen Williams: Conservatives, Don’t Take Comfort In This Study
I asked Dr. Richard Allen Williams, founder of the Association of Black Cardiologists and professor of medicine at the UCLA School of Medicine, to share his opinion on this study with readers of Envisioning 2.0. His exclusive commentary follows.
Dr. Williams On The Key Findings Of This Study
“Based on what I know about this study – I haven’t gotten a chance to read the full New England Journal of Medicine article – I’m not surprised. I have contended all along that if blacks and other minorities receive care equivalent to that which whites receive, [minorities] should do as well as [whites] do regarding outcomes.”
Dr. Williams On The Limitations Of This Study
“A major aspect of the study is that it focuses on people who have had the good fortune to access the healthcare system. It is widely recognized that minorities do not gain access as readily as whites do; these are the individuals who are uninsured, underinsured, or are not included in the system for a variety of other reasons.
I found it interesting that the study [could have suffered from non-response bias, as the Washington Post article indicated.] It is probable that many minorities were not even reachable by those conducting the telephone survey because they [did] not even have telephones.”
On Why Conservatives Should Take No Comfort From This Study
“No one from the conservative side should take comfort in thinking that there are no real healthcare disparities, based on this study. That would be tantamount to saying that the holocaust did not happen. The evidence base for disparities is there, it is real, and the disparities have been documented over and over. How many times does America need to be hit over the head by those indisputable facts before getting the point?”
More Commentary From Dr. Williams Coming Soon
Look for more commentary from Dr. Williams in the third edition of my special feature, “Conversations About Race-Based Medicine,” next week. For the first and second installments of this interview series, please click here and here.
March 22nd, 2006 at 12:42 pm
Dr. Williams has a great point here.
Everybody gets bad care once they get access. But more among minorities are not even able to get access. So while the issue of quality may not have racial fault lines, the issue of access still does!
March 28th, 2006 at 12:33 pm
“A major aspect of the study is that it focuses on people who have had the good fortune to access the healthcare system. It is widely recognized that minorities do not gain access as readily as whites do; these are the individuals who are uninsured, underinsured, or are not included in the system for a variety of other reasons.
This is a great point, but not all of the picture. Numerous studies show that immigrants and people of color typically receive a lower quality of care even when they have similar insurance and similar health problems. Access is a big part of it, but quality of care is just as much a concern, and the conclusions of the Asch study contradict the findings of over 600 peer reviewed studies.
For more on this, check out the rebuttal written by Dr. Brian Smedley, study director for the Institute of Medicine Report “Unequal Treatment: Confronting Racial Disparities in Health Care.” It’s posted over at Matt Holt’s Health Care Blog.
http://www.thehealthcareblog.com
You can also read a letter challengint the findings of the RAND/NEJM study. The letter was written and signed by numerous health care experts and 5 members of congress, and submitted to the New England Journal of Medicine last week.
http://www.opportunityagenda.org/nejmletter
March 28th, 2006 at 1:37 pm
[...] In an earlier post, I highlighted a RAND study published in the New England Journal of Medicine on healthcare quality. I also included commentary by Dr. Richard Allen Williams, founder of the Association Of Black Cardiologists, on the study in that post. [...]
December 12th, 2006 at 6:58 pm
Wow, I agree completely with the first comment. Well done blog by the way.
Don Lapre Watcher
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webmaster@j-ams.org
December 28th, 2006 at 10:15 pm
I understand that it’s always a dilemma for a person to undergo the racial disparities, rest assured it is never a precarious initiative to do what’s right, and probably taking a course to rectify the scenario, should be of benefit to everyone. That’s why health should always remain a priority, beyond socio-political barriers.
November 1st, 2007 at 6:45 pm
Interesting research.