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Transforming Clinical Practice to Eliminate RacialEthnic Disparities in Healthcare
Donna L. Washington, MD, MPH1,2, Jacqueline Bowles, MD, MSCE1,2, Somnath Saha, MD, MPH3,4, Carol R. Horowitz, MD, MPH5, Sandra Moody-Ayers, MD6, Arleen F. Brown, MD, PhD2,Valerie E. Stone, MD, MPH7, and Lisa A. Cooper, MD, MPH8 Writing group for the Society of General Internal Medicine, Disparities in Health Task Force
1Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; 2Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA; 3Section of General Internal Medicine, Portland Veterans Affairs Medical Center, Portland, OR, USA; 4Department of Medicine, Oregon Health & Science University, Portland, OR, USA; 5Departments of Health Policy and Medicine, Mount Sinai School of Medicine, New York, NY, USA; 6Department of Medicine, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, USA; 7General Medicine Unit, Massachusetts General Hospital, Boston, MA, USA; 8Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Racialethnic minorities receive lower quality and intensity of health care compared with whites across a wide range of preventive, diagnostic, and therapeutic services and disease entities. These disparities in health care contribute to continuing racialethnic disparities in the burden of illness and death. Several national medical organizations and the Institute of Medicine have issued position papers and recommendations for the elimination of health care disparities. However, physicians in practice are often at a loss for how to translate these principles and recommendations into specific interventions in their own clinical practices. This paper serves as a blueprint for translating principles for the elimination of racialethnic disparities in health care into specific actions that are relevant for individual clinical practices. We describe what is known about reducing racialethnic disparities in clinical practice and make recommendations for how clinician leaders can apply this evidence to transform their own practices.
KEY WORDS: racial disparities; race; ethnicity; health care delivery; cultural competence; ethnic groups; continental population groups.
J Gen Intern Med 23(5):68591DOI: 10.1007/s11606-007-0481-0 Society of General Internal Medicine 2007
INTRODUCTION
Racial and ethnic disparities in health care have been consistently documented across a wide range of medical conditions and health care services.15 Examples include disparities in...