Clinical Orthopaedics and Related Research®

, Volume 467, Issue 10, pp 2598–2605

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

Symposium: ABJS Carl T. Brighton Workshop on Health Policy Issues in Orthopaedic Surgery

DOI: 10.1007/s11999-009-0993-5

Cite this article as:
Dykes, D.C. & White, A.A. Clin Orthop Relat Res (2009) 467: 2598. doi:10.1007/s11999-009-0993-5


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).

Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  1. 1.Twin Cities Spine CenterMinneapolisUSA
  2. 2.Harvard Medical SchoolBostonUSA