Journal of General Internal Medicine

, Volume 18, Issue 2, pp 146–152

Racial and ethnic disparities in the use of health services

Bias, preferences, or poor communication?
  • Carol M. Ashton
  • Paul Haidet
  • Debora A. Paterniti
  • Tracie C. Collins
  • Howard S. Gordon
  • Kimberly O’Malley
  • Laura A. Petersen
  • Barbara F. Sharf
  • Maria E. Suarez-Almazor
  • Nelda P. Wray
  • Richard L. StreetJr.
Perspectives

DOI: 10.1046/j.1525-1497.2003.20532.x

Cite this article as:
Ashton, C.M., Haidet, P., Paterniti, D.A. et al. J GEN INTERN MED (2003) 18: 146. doi:10.1046/j.1525-1497.2003.20532.x

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.

Key words

communicationracial disparitiesracehealth care utilization

Copyright information

© Society of General Internal Medicine 2003

Authors and Affiliations

  • Carol M. Ashton
    • 1
    • 3
  • Paul Haidet
    • 1
    • 3
  • Debora A. Paterniti
    • 1
    • 3
  • Tracie C. Collins
    • 1
    • 3
  • Howard S. Gordon
    • 1
    • 3
  • Kimberly O’Malley
    • 1
    • 3
  • Laura A. Petersen
    • 1
    • 3
  • Barbara F. Sharf
    • 2
  • Maria E. Suarez-Almazor
    • 1
    • 3
  • Nelda P. Wray
    • 1
    • 3
  • Richard L. StreetJr.
    • 2
  1. 1.Baylor College of MedicineHouston
  2. 2.Texas A&M UniversityCollege Station
  3. 3.VA Medical Center (152)Houston