Minority Health Disparities
ACOI Committee on Minority Health and Cultural Competency
ACOI Board of Directors
Adopted: May 27, 2005
The minority healthcare crisis in America stems from a multitude of factors. In particular, healthcare disparities most greatly affect underrepresented minorities, which include African-Americans, Hispanic-Americans, Asian-Americans, Native Americans and Pacific Islanders. In order to effectively create positive change, certain questions must be addressed. These include, but are not limited to: Which minorities are most affected by disease-specific illness? Why do these disparities exist? What can be done to eliminate them? Will a concerted effort to increase awareness and education about health-care disparities result in improved delivery of quality healthcare?
There is a need for the osteopathic profession and all of organized medicine to develop strategies which address health care disparities among minorities and prepare culturally competent physicians. Guidance should be offered to educate practicing physicians and trainees to better resolve known disparities and serve diverse populations. Efforts must be made to assure cultural competency and to identify and overcome language and other barriers to delivering health care to minorities.
Healthcare disparities include differences in health coverage, health access and quality of care. Health disparities result in a higher burden of illness, injury and mortality experienced by one population group in relation to another.
Cultural competency is a set of academic and personal skills that allow one to understand and appreciate cultural differences among groups. The better a healthcare professional understands a patient’s behavior, values and other personal factors, the more likely that patient will receive effective, high quality care.
Racial and ethnic healthcare disparities caused by problems with access to, and utilization of, quality care may be alleviated through improvements in the cultural competency skills of physicians. Healthcare disparities may also be alleviated through effective recruitment of underrepresented minorities into health professions schools.
The Centers for Disease Control, in conjunction with the U.S. Department of Health and Human Services, created an Office of Minority Health in 1985. Through this collaboration, the Racial and Ethnic Approaches to Community Health Act (REACH) was designed to identify and eliminate disparities in a number of major areas. Disparities in access to care as well as quality of care in these areas result in poorer outcomes for racial and ethnic minorities.
The identified areas of disparity include: 1) infant mortality; 2) breast and cervical cancer screening and malignancy; 3) cardiovascular and cerebrovascular disease; 4) diabetes; 5) HIV/AIDS; and 6) child and adult immunizations. In addition, serious disparities exist in the provision of care for mental health problems, substance abuse and suicide prevention.
The American College of Osteopathic Internists calls for the following actions to be taken to address minority health disparities and to improve cultural competency of its physician members:
The creation of a forum to increase physician knowledge on racial and ethnic healthcare needs, including disparities in the areas listed above;
The elimination of provider stereotypical beliefs that may play a role in clinical decision making;
The evaluation and analysis of statistical information which would permit the targeting of populations who are at greatest risk;
The identification of new methods to involve physician members in the communities in which they serve;
The identification and integration of available resources to better serve minority communities, including houses of worship, schools and local government;
The inclusion of cultural competency training throughout the continuum of osteopathic education;
The development of strategies to actively recruit underrepresented minority physicians into the profession in both primary care and subspecialties;
The development of approaches to encourage all physicians to provide care to underserved minority populations;
The adoption of strategies to assist physicians to effectively communicate with their patients, addressing translation and other barriers to patient understanding.