The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations

Komaromy, Miriam; Grumbach, Kevin; Drake, Michael V.; Vranizan, Karen; Lurie, Nicole; Keane, Dennis; Bindman, Andrew B.

doi:10.1056/nejm199605163342006

Cited by 732 publications

(450 citation statements)

References 12 publications

(10 reference statements)

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“…Racial matching (minority doctors seeing proportionately more patients of their own race or ethnicity) has been extensively documented in the empirical health literature. After controlling for residential composition of the population, Komaromi et al (1996) find a large and significant effect of doctor race on the racial profile of patients. Stinson and Thurston (2002) find that in ZIP codes where fewer people speak English, Hispanic doctors have more Hispanic patients than non-Hispanic patients.…”

Section: Health Care Markets and The Long-term Effects Of Prejudicementioning

confidence: 88%

Prejudice, clinical uncertainty and stereotyping as sources of health disparities

Balsa

McGuire

2003

Journal of Health Economics

265

194

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Section: Health Care Markets and The Long-term Effects Of Prejudicementioning

confidence: 88%

Prejudice, clinical uncertainty and stereotyping as sources of health disparities

Balsa

McGuire

2003

Journal of Health Economics

265

194

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“…The influence of physician-patient racial and ethnic concordance on patient care has been consistently documented for decades, [16][17][18][19][20] and may partially explain some of the disparities found. Previous studies have demonstrated that despite their best efforts, physicians sometimes struggle to perform as unbiased operators, often allowing their own cultural and social constructs to partially dictate their approach to patient care, including their medication prescribing.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Neighborhood Socioeconomic Status and Race on the Prescribing of Opioids in Emergency Departments Throughout the United States

et al. 2013

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BACKGROUND: Racial and ethnic disparities in opioid prescribing in the emergency department (ED) are well described, yet the influence of socioeconomic status (SES) remains unclear. OBJECTIVES: (1) To examine the effect of neighborhood SES on the prescribing of opioids for moderate to severe pain; and (2) to determine if racial disparities in opioid prescribing persist after accounting for SES. DESIGN: We used cross-sectional data from the National Hospital Ambulatory Medical Care Survey between 2006 and 2009 to examine the prescribing of opioids to patients presenting with moderate to severe pain (184 million visits). We used logistic regression to examine the association between the prescribing of opioids, SES, and race. Models were adjusted for age, sex, pain-level, injury-status, frequency of emergency visits, hospital type, and region. MAIN MEASURES: Our primary outcome measure was whether an opioid was prescribed during a visit for moderate to severe pain. SES was determined based on income, percent poverty, and educational level within a patient's zip code. RESULTS: Opioids were prescribed more frequently at visits from patients of the highest SES quartile compared to patients in the lowest quartile, including percent poverty (49.0 % vs. 39.4 %, P<0.001), household income (47.3 % vs. 40.7 %, P < 0.001), and educational level (46.3 % vs. 42.5 %, P=0.01). Black patients were prescribed opioids less frequently than white patients across all measures of SES. In adjusted models, black patients (AOR 0.73; 95 % CI 0.66-0.81) and patients from poorer areas (AOR 0.76; 95 % CI 0.68-0.86) were less likely to receive opioids after accounting for pain-level, age, injury-status, and other covariates. CONCLUSIONS: Patients presenting to emergency departments from lower SES regions were less likely to receive opioids for equivalent levels of pain than those from more affluent areas. Black and Hispanic patients were also less likely to receive opioids for equivalent levels of pain than whites, independent of SES.

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“…A 2001 survey of medical-school graduates showed "striking differences" between the views of minority and non-minority respondents on societal issues, with much higher percentages of minorities than non-minorities expressing strong agreement with the views that "access to health care continues to be a major problem"; "everyone is entitled to receive adequate medical care"; and "physicians can influence health and disease and prevention" (AAMC, 2002, p. 50). Studies also have found that minority physicians are more likely than non-minority physicians to practice in areas with a shortage of physicians or a higher proportion of residents from underserved minority groups, and are more likely to care for minority, indigent, and uninsured patients (AAMC, 2002;Komaromy, et al, 1996;Keith, et al, 1985;Moy & Bartman, 1995). As members of the minority and the medical communities, moreover, physicians of color can "play a key role" in "hold[ing] the system accountable" (Sullivan Commission, 2004, p. 18).…”

Section: Less Pressure For System Changementioning

confidence: 99%

Culture and Race in Provider-Client Relationships

Schofield

Wang

Chew

2007

Social Work in Public Health

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Given that minority group members are underrepresented in the teaching, medical, and legal professions, minority group members often have White teachers, doctors, and lawyers. This is frequently the case even when students, patients and clients would prefer service providers similar to them in racial or ethnic background. This paper identifies possible cultural barriers to effective one-on-one relationships between White teachers, doctors and lawyers and those who receive their services, explores the potential for biased expectations to influence the services provided and outcomes attained, and contrasts the goals of White and minority educators, doctors, and lawyers, arguing that these differences have potentially negative implications for service recipients. Policy approaches to mitigating potential problems caused by the lack of match are considered, as are potential problems arising from an overly narrow emphasis on match.

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The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations

Abstract: Black and Hispanic physicians have a unique and important role in caring for poor, black, and Hispanic patients in California. Dismantling affirmative-action programs as is currently proposed, may threaten health care for both poor people and members of minority groups.

Cited by 732 publications

References 12 publications

Prejudice, clinical uncertainty and stereotyping as sources of health disparities

Prejudice, clinical uncertainty and stereotyping as sources of health disparities

The Impact of Neighborhood Socioeconomic Status and Race on the Prescribing of Opioids in Emergency Departments Throughout the United States

Culture and Race in Provider-Client Relationships

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