March 27, 2008
More work to do
This week's issue of JAMA has Rebecca Voelker writing about the progress of reducing health disparities after decades of work.
The early weeks of 2008 brought discouraging news for advocates working to narrow health care disparities among racial and ethnic groups. In rapid succession, several studies published in January in peer-reviewed journals showed that despite decades of efforts to raise awareness about disparities and to reduce them, the gaps in some key treatment areas have not budged.
The latest findings build on years of research that has established the extent of inequalities in treatment for cancer, heart disease, diabetes, and many other conditions.
The article provides several possible explanations for the disconnect. For example, when quality of care improves both the majority and minority populations see improved outcomes. If the rate of improvement is the same for both groups any disparity remains unchanged.
The article also states that interventions tend to target one aspect of health care delivery. In a complex system that may not be enough.
Finally, it may be time to move past identifying health disparities and focus efforts on reducing disparity.
BONUS - Tonight at 10pm begins the PBS series Unnatural Causes: Is Inequality Making Us Sick.