, Volume 18, Issue 2, pp 146-152

Racial and ethnic disparities in the use of health services

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Abstract

African Americans and Latinos use services that require a doctor’s order at lower rates than do whites. Racial bias and patient preferences contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and health behaviors. Research has shown that doctors have poorer communication with minority patients than with others, but problems in doctor-patient communication have received little attention as a potential cause, a remediable one, of health disparities. We evaluate the evidence that poor communication is a cause of disparities and propose some remedies drawn from the communication sciences.

This project was supported by grant number 3 P01 HS10876 from the Agency for Healthcare Research and Quality. Drs. Haidet, Gordon, and Petersen are recipients of Research Career Development Awards from the Health Services Research and Development Service of the U.S. Department of Veterans’ Affairs. Dr. Collins is supported by a Minority Medical Faculty Development Award from the Robert Wood Johnson Foundation. The authors are the investigators of the Houston Excellence Center to Eliminate Ethnic/Racial Disparities. The Houston EXCEED program is one of nine funded by grants from the U.S. Agency for Healthcare Research and Quality and the NIH Office of Research on Minority Health, and is supported in part by the Department of Veterans’ Affairs and Baylor College of Medicine.