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Overcoming Racial Disparities

Other disparities

We have also compiled resources regarding lesbian, gay, bisexual and transgender disparities in healthcare.


"Disparities in the healthcare delivered to racial and ethnic minorities are real and are associated with worse outcomes in many cases, which is unacceptable.

The real challenge lies not in debating whether disparities exist, because the evidence is overwhelming, but in developing and implementing strategies to reduce and eliminate them."

—Alan Nelson, retired physician, former president of the American Medical Association and chair of the committee that wrote Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care



General Resources

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care
Published in 2002, this Institute of Medicine report is still one of the most valuable studies of racial disparities in the US healthcare system. It examines the role of bias, discrimination, and stereotyping at the individual (provider and patient), institutional, and heath system levels and provides evidence-based interventions to eliminate disparities.

HRET Disparities Toolkit: Collecting Race, Ethnicity, and Primary Language Information from Patients
To better understand and rectify any disparities in your own organization, it helps to have accurate data at baseline and as you make changes. This toolkit will help you systematically collect accurate, useful data about several populations.

Race-Ethnicity, Poverty, Urban Stressors, and Telomere Length in a Detroit Community-Based Sample
This study, published in the Journal of Health and Social Behavior, examines the impact of enduring racism over the generations, which affects physical health (early aging-related disease and excess mortality) even in the absence of lower socioeconomic status.

"This isn't about me...I provide the same care to all people"
Even well-meaning people who are not overtly biased or prejudiced may demonstrate unconscious negative racial attitudes and stereotypes. Take a moment to examine yourself by completing this Implicit Bias Assessment.

A Physician's Practical Guide to Culturally Competent Care
A self-directed e-learning course (CME/CE is offered) sponsored by the HHS Office of Minority Health and designed for physicians, physician assistants, and nurse practitioners.

Physician Focus, April 2014
Unequal Treatment—Disparities in Health Care
Produced by the Massachusetts Medical Society, physicians discuss the impact of demographic changes on disparities, the “unwitting and subconscious bias” of providers that impedes equal care, and how technology can help to reduce disparities in care. (30 minutes)


Reducing disparities through culturally competent health care: an analysis of the business case
This article, published in Quality Management in Health Care, reviews the potential role of cultural competence in reducing racial and ethnic health disparities, the strength of healthcare organizations' current incentives to adopt cultural competence techniques, and the limitations inherent in these incentives that will need to be overcome if cultural competence techniques are to become widely adopted.

Setting- or Condition-Specific Resources

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Washington's readmission rates for Medicare beneficiaries vary substantially by race
In nearly half of Washington communities, the difference between the races/ethnicities with the lowest and highest rehospitalization rates is greater than the state’s overall readmission rate. Download the findings. Learn more about our work to reduce rehospitalizations.

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In Washington, end-of-life cancer care, treatment for upper respiratory infections, and dementia-related care can vary by race. Learn more about our examination of these disparities.


Disparities, Superutilizers and New Approaches for Health Equity
September 2015 webinar hosted by Qualis Health
We all have limited resources. With changes to reimbursement driven by penalty programs and value-based payment, we must ensure our interventions to reduce avoidable hospitalizations and readmissions affect our key measures. Disease/diagnosis-based targets can only take us so far—and may not have the required impact.

Guide to Preventing Readmissions Among Racially and Ethnically Diverse Medicare Beneficiaries
Patient characteristics such as race, ethnicity, language proficiency, age, socioeconomic status, place of residence, and disability, among others—particularly when tied to complicated medical conditions such as heart failure, pneumonia, and acute myocardial infarction—are predictors of elevated readmission risk. This practical, actionable guide helps hospitals prevent readmissions while caring for an increasingly diverse population.

Factors Influencing the Increasing Disparity in LDL Cholesterol Control Between White and Black Patients with Diabetes in a Context of Active Quality Improvement
According to this study published in the American Journal of Medical Quality, even when there are successful efforts to improve the overall care for patients in particular areas (e.g., diabetes management), disparities between majority and minority populations often remain and at times may widen.

The effect of race on the referral process for invasive cardiac procedures
Multiple studies have demonstrated that Blacks are less likely to be referred for certain invasive cardiac procedures. Few studies have examined the effect of race on physician and patient decision-making in referrals for cardiac procedures. The authors present a framework for the complex series of steps involved in obtaining invasive cardiac care. Patient race can affect each of these steps, and differences in physician and patient race may be a particular impediment to effective communication about symptoms and preferences and to the establishment of a therapeutic partnership. Published in Medical Care Research and Review.