Race, Ethnicity, and the Patient-Caregiver Relationship

Dedier, Julien; Penson, Richard T.; Williams, Winfred W.; Lynch, Thomas J.

doi:10.1634/theoncologist.7-suppl_2-43

Cited by 11 publications

(4 citation statements)

References 11 publications

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“…6,10,11 Recent analysis of racial disparities in cancer treatment have suggested that the lower survival rate among AAs when compared with Caucasians can be attributed to the lower frequency of AA patients receiving the defined "optimal" or standard of care treatment when compared with Caucasians. 10,13,18 Physician bias may play an important role in cervical carcinoma treatment choice and subsequently patient survival. A recently published study evaluated the presence of racial and gender bias toward certain types of treatment among primary care physicians.…”

Section: Discussionmentioning

confidence: 99%

Equal care ensures equal survival for African‐American women with cervical carcinoma

Farley¹,

Hines²,

Taylor³

et al. 2001

Cancer

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BACKGOUND.It was the purpose of this study to investigate whether race is an independent prognostic factor in the survival of patients with cervical carcinoma in a health care system with minimal racial bias, and few barriers to access to care. METHODS. RESULTS.One thousand five hundred fifty-three patients were obtained for review.Sixty-five percent of patients were Caucasian, and 35% were minorities. Of the minorities, 29% were African Americans (AAs). Mean age of diagnosis was similar among AAs and Caucasians, 44 and 42 years, respectively. There was no statistically significant difference between the distribution of age, stage, grade, or histology between Caucasians and AAs. Forty-six percent of patients were treated with surgery and 56% with radiation therapy, with no difference in type of treatment between the Caucasian and AA groups. Five-and 10-year survival rates for Caucasians and AAs were 75%, and 76%, and 64% 65% (P ϭ 0.59), respectively. CONCLUSIONS.In an equal access, unbiased, nonracial environment, race is not an independent predictor of survival for patients with cervical carcinoma. This study has shown, for the first time to the authors' knowledge, that when they receive equal treatment for cervical carcinoma, AA women's survival can approach that of their nonminority counterparts (75% at 10 years). Cancer 2001;91:869 -73.

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Section: Discussionmentioning

confidence: 99%

Equal care ensures equal survival for African‐American women with cervical carcinoma

Farley¹,

Hines²,

Taylor³

et al. 2001

Cancer

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“…To a certain extent, these differences may have lead to disparities in the outcomes (67). Other reasons could be racism (68), physicians' perceptions of patients (69), preferences of the patients (70,71), or the patient-caregiver relationship (72).…”

Section: Conclusion -After Adjustingmentioning

confidence: 99%

Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

et al. 2005

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OBJECTIVE -To determine the influence of ethnic differences in diabetes care on inequalities in mortality and prevalence of end-stage complications among diabetic patients. The following questions were examined: 1) Are there ethnic differences among diabetic patients in mortality and end-stage complications and 2) are there ethnic differences among diabetic patients in quality of care?RESEARCH DESIGN AND METHODS -A review of the literature on ethnic differences in the prevalence of complications and mortality among diabetic patients and in the quality of diabetes care was performed by systematically searching articles on Medline published from 1987 through October 2004.RESULTS -A total of 51 studies were included, mainly conducted in the U.S. and the U.K. In general, after adjusting for confounders, diabetic patients from ethnic minorities had higher mortality rates and higher risk of diabetes complications. After additional adjustment for risk factors such as smoking, socioeconomic status, income, years of education, and BMI, in most instances ethnic differences disappear. Nevertheless, blacks and Hispanics in the U.S. and Asians in the U.K. have an increased risk of end-stage renal disease, and blacks and Hispanics in the U.S. have an increased risk of retinopathy. Intermediate outcomes of care were worse in blacks, and they were inclined to be worse in Hispanics. Likewise, ethnic differences in quality of care in the U.S. exist: process of care was worse in blacks.CONCLUSIONS -Given the fact that there are ethnic differences in diabetes care and that ethnic differences in some diabetes complications persist after adjustment for risk factors other than diabetes care, it seems the case that ethnic differences in diabetes care contribute to the more adverse disease outcomes of diabetic patients from some ethnic minority groups. Although no generalizations can be made for all ethnic groups in all regions for all kinds of complications, the results do implicate the importance of quality of care in striving for equal health outcomes among ethnic minorities. Diabetes Care 28:2280 -2288, 2005D iabetes is one of the most common chronic diseases in Europe and the U.S. (1-3). Diabetes is divided into etiologic subclasses, of which type 1 and type 2 are the most prevalent (4). The prevalence of type 1 and, in particular, type 2 diabetes is rising in all European countries (2). Type 2 diabetes is the major contributor to the epidemic rise in diabetes because this type accounts for Ͼ90% of diabetes. In the U.S., the overall prevalence of diabetes increased from 4.9% in 1990 to 6.5% in 1998 (5). There is a parallel rise in the prevalence of complications related to diabetes.The prevalence of diabetes varies, among other factors, by ethnicity. Several studies (3,6,7) on ethnic differences in diabetes have reported higher prevalence and incidence rates among ethnic minorities. Furthermore, end-stage complications of diabetes have been reported to be more common among ethnic minorities (8 -10), who also experience higher morta...

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“…Recent studies suggest physicians' prejudices substantially influence their feelings about patients and their treatment decisions [21,69]. As a result, such prejudices appear to be major contributing factors to healthcare disparities.…”

Section: Where Are We Now? the Patientmentioning

confidence: 99%

Getting to Equal: Strategies to Understand and Eliminate General and Orthopaedic Healthcare Disparities

Dykes

White

2009

Clinical Orthopaedics &Amp; Related Research

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The 2001 Institute of Medicine report entitled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care pointed out extensive healthcare disparities in the United States even when controlling for disease severity, socioeconomic status, education, and access. The literature identifies several groups of Americans who receive disparate healthcare: ethnic minorities, women, children, the elderly, the handicapped, the poor, prisoners, lesbians, gays, and the transgender population. Disparate healthcare represents an enormous current challenge with substantial moral, ethical, political, public health, public policy, and economic implications, all of which are likely to worsen over the next several decades without immediate and comprehensive action. A review of recent literature reveals over 100 general and specific suggestions and solutions to eliminate healthcare disparities. While healthcare disparities have roots in multiple sources, racial stereotypes and biases remain a major contributing factor and are prototypical of biases based on age, physical handicap, socioeconomic status, religion, sexual orientation or other differences. Given that such disparities have a strong basis in racial biases, and that the principles of racism are similar to those of other ''isms'', we summarize the current state of healthcare disparities, the goals of their eradication, and the various potential solutions from a conceptual model of racism affecting patients (internalized racism), caregivers (personally mediated racism), and society (institutionalized racism).

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Race, Ethnicity, and the Patient-Caregiver Relationship

Cited by 11 publications

References 11 publications

Equal care ensures equal survival for African‐American women with cervical carcinoma

Equal care ensures equal survival for African‐American women with cervical carcinoma

Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

Getting to Equal: Strategies to Understand and Eliminate General and Orthopaedic Healthcare Disparities

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