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Eliminating Racial Discrimination in Healthcare

A Call for State Healthcare Anti-Discrimination Law

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Eliminating Healthcare Disparities in America

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Abstract

Equal access to quality healthcare is a crucial issue facing the United States (2). For too long, too many Americans have been equal access to quality healthcare based on race, ethnicity, and gender (3). Many factors contribute to disparities: cultural incompetence of healthcare providers, socioeconomic inequities, disparate impact of facially neutral practices and policies, inadequacy of civil rights laws and enforcement, and multiple forms of discrimination. These disparities exist in health status, access to healthcare services, participation in health research and receipt of healthcare financing (4). This disparity in healthcare is doubly significant given the devastating racial disparity in health status that exists. The combination of racial disparity in health status, institutional racism in healthcare and inadequate legal protection points to a need for a major civil rights law for healthcare.

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References

  1. Derrick, A. B., Jr. (1987) And We Are Not Saved: The Elusive Quest For Raciai. Justice, Basic Rooks (hereinafter, Not Saved).

    Google Scholar 

  2. See e.g., Brian D. Smedley, Adrienne Y. Stith, and Alan R. Nelson, editors, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy (2002) (hereinafter, “IOM Report”); The United States Commission on Civil Rights, The Health Care Challenge: Acknowledging Disparity, Confronting Discrimination, and Ensuring Equality, Volume I, The Role of Governmental and Private Health Care Programs and Initiatives. 287 pp. No. 902-00062-2. (Sept., 1999) (Hereinafter, U.S. Commission on Civil Rights I).

    Google Scholar 

  3. See e.g., W. Michael Byrd and Linda A. Clayton, “An American Health Dilemma: A Medical History of African Americans and the Problem of Race, Beginnings to 1900” (2000) (Hereinafter, “An American Health Dilemma I”); W. Michael Byrd and Linda A. Clayton, “An American Health Dilemma: A Medical History of African Americans and the Problem of Race, 1900 to Present” (2002) (Hereinafter, “An American Health Dilemma II”); U.S. Commission on Civil Rights I, supra note 2.

    Google Scholar 

  4. See, e.g., U.S. Commission on Civil Rights I, supra note 2.; U.S. Commission on Civil Rights II, supra note 2.

    Google Scholar 

  5. Social Security Amendments of 1965, Pub. L. No. 89-97, Titles XVIII, 79 Stat 286; the act does not contain any general anti-discrimination clauses although the implementing regulations require providers and facilities to abide by Title VI.

    Google Scholar 

  6. Id.

    Google Scholar 

  7. 20 U.S.C. §§ 1681–88 (2002) (limited to sex discrimination in educational programs).

    Google Scholar 

  8. 42 U.S.C. §§ 291–291o (2002) (requires uncompensated care and community service by facilities that receive funding under Hill-Burton Acts).

    Google Scholar 

  9. See, e.g., David Barton Smith, Health Care Divided: Race and Healing a Nation (1999); David Barton Smith, Addressing Racial Inequities In Health Care: Civil Rights Monitoring And Report Cards, 23 J. Health Pol. Pol’y 1. 75 (1998); Vernellia R. Randall, Racist Health Care: Reforming an Unjust Health Care System to Meet The Needs of African-Americans, 3 Health Matrix 127 (Spring 1993).

    Google Scholar 

  10. See, e.g., Barbara Noah, Racial Disparities in the Delivery of Health Care?, 35 San Diego L. Rev. 135 (1998); Daniel K. Hampton, Title VI Challenges by Private Parties to the Location of Health Care Facilities: Toward a Just and Effective Action, 37 B.C. L. Rev. 517 (1996); Marianne L. Engelman Lado, Breaking the Barriers of Access to Health Care: a Discussion of the Role of Civil Rights Litigation and the Relationship Between Burdens of Proof and the Experience of Denial, 60 Brook. L. Rev. 239 (1994).

    CAS  Google Scholar 

  11. Title VI of the 1964 Civil Rights Act, Pub. L. No. 99-352, 378 252 (codified at 42 U.S.C.) 2000d-200d-4 (1982).

    Google Scholar 

  12. Title VI of the 1964 Civil Rights Act, Pub. L. No. 99-352, 378 252 (codified at 42 U.S.C.) 2000d-200d-4 (1982).

    Google Scholar 

  13. Alexander v. Choate, 469 U.S. 287 (1985).

    Google Scholar 

  14. See e.g., Terry Smith, Everyday Indignities: Race, Retaliation and the Promise of Title VII, 34 Colum. Hum. Rts. L. Rev. 529 (2003); cf. Lynn V. Regents of University of California 656 F.2d 1337, 1343 n.5 (C.A.G. 1981). In Lynn v, Regents, the said: “... We are saying only what Title VII commands: when plaintiffs establish that decisions regarding academic employment are motivated by discriminatory attitudes relating to race or sex, or are rooted in concepts which reflect such discriminatory attitudes, however subtly, courts are obligated to afford the relief provided by Title VII”.

    Google Scholar 

  15. See, Peggy C. Davis, Law as Microaggression, 98 Yale L.J. 1559, 1576 (1989).

    Google Scholar 

  16. cf., Robert Belton, Mixed-Motive Cases in Employment Discrimination Law Revisited: A Brief Updated View of the Swamp, 51 Mercer L. Rev. 651, 662–663 (2000) (noting the inability of easily distinguishing direct and circumstantial evidence in the employment discrimination context); Michael Selmi, Subtle Discrimination: A Matter of Perspective Rather Than Intent, 34 Colum. Hum. Rts. L. Rev. 657, 667 n.40 (2003) (“The distinction between direct and circumstantial evidence is often a difficult one to make, and in recent years courts have narrowed the range of behavior that is defined as direct evidence”).

    Google Scholar 

  17. See, e.g., M. Gregg Bloche, Race and Discretion in American Medicine, 1 Yale J. Health Pol’y L. & Ethics 95, 95–96 (2001) (noting that since 1999 topic of racial bias in American health care has been targeted as topic for research, discussion and intervention by variety of public and private sector initiatives); René Bowser, Racial Profiling in Health Care: An Institutional Analysis of Medical Treatment Disparities, 7 Mich. J. Race & L. 79, 80–91 (2001) (discussing racial bias in medicine and reviewing medical literature demonstrating that African Americans receive lower quality health care than similarly situated white patients); Barbara A. Noah, Racial Disparities in the Delivery of Health Care, 35 San Diego L. Rev. 135, 137 (1998) (discussing “racial bias in the delivery of [health] care”); Mary Crossley, Infected Judgment: Legal Responses to Physician Bias, 48 Villanova L. Rev. 195 (2003).

    Google Scholar 

  18. See e.g., Marian E. Gornick, Vulnerable Populations and Medicare Services: Why Do Disparities Exist? 43 (2000) (noting that physicians may believe that minority patients are more likely to misunderstand complex information and less likely to adhere to doctor’s orders).

    Google Scholar 

  19. See, e.g., Jessie Allen, A Possible Remedy for Unthinking Discrimination, 61 Brook. L. Rev. 1299 (1995) (arguing that the failure to cover non-motivational forms of discrimination under Title VII “may actually discourage employers... from acknowledging, let alone actively investigating, the risks of their own unconscious racism,” because “[t]hey receive no credit for doing so and may subject themselves to greater potential liability”).

    Google Scholar 

  20. See e.g., Allen, Unthinking Discrimination, supra note 19.

    Google Scholar 

  21. Charles Lawrence’s The Id, the Ego, and Equal Protection: Reckoning with Unconscious Racism, 39 Stan. L. Rev. 317 (1987).; See also, Comm. on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare 83–87 (Brian D. Smedley et al. eds., 2003) [hereinafter Unequal Treatment]; David B. Oppenheimer, Negligent Discrimination, 141 U. Pa. L. Rev. 899, 967–972 (1993) (setting forth theory of negligent discrimination under Title VII).; Sheri Lynn Johnson, Unconscious Racism and the Criminal Law, 73 Cornell L. Rev. 1016 (1988); See generally Ann C. McGinley, Viva La Evolucion!: Recognizing Unconscious Motive in Title VII, 9 Cornell J. L. & Pub. Pol’y 415 (2000); see also Ann C. McGinley, The Emerging Cronyism Defense and Affirmative Action: A Critical Perspective on the Distinction Between Colorblind and Race Conscious Decision Making Under Title VII, 39 Ariz. L. Rev. 1003 (1997); Charles Lawrence, The Id, the Ego, and Equal Protection: Reckoning with Unconscious Racism, 39 Stan. L. Rev. 317, 329–330 (1987) (describing how discrimination laws fail to deal with the realities of unconscious racism); Jessie Allen, Note, A Possible Remedy for Unthinking Discrimination, 61 Brook. L. Rev. 1299, 1299–1304 (1995) (asserting that the failure of civil rights laws is related to the reluctance to expand the definition of discrimination to include an objective standard that would address unconscious use of stereotypes).; See, e.g., Jody David Armour, Negrophobia and Reasonable Racism: The Hidden Costs of Being Black in America 68–80 (1997); Paul Brest, The Supreme Court, 1975 Term-Forward: In Defense of the Antidiscrimination Principle, 90 Harv. L. Rev. 1, 6–7 (1976); Judith Olans Brown et al., Some Thoughts About Social Perception and Employment Discrimination Law: A Modest Proposal for Reopening the Judicial Dialogue, 46 Emory L.J. 1487, 1493–1497 (1997); Martha Chamallas, The Architecture of Bias: Deep Structures in Tort Law, 146 U. Pa. L. Rev. 463, 466–467 (1998); Peggy C. Davis, Law as Microaggression, 98 Yale L.J. 1559, 1560 (1989); Barbara J. Flagg, “Was Blind, But Now I See”: White Race Consciousness and the Requirement of Discriminatory Intent, 91 Mich. L. Rev. 953 passim (1993); Sheri Lynn Johnson, Unconscious Racism and the Criminal Law, 73 Cornell L. Rev. 1016 passim (1988); Linda Hamilton Krieger, Civil Rights Perestroika: Intergroup Relations After Affirmative Action, 86 Cal. L. Rev. 1251, 1279, 1286–1291 (1998) [hereinafter Krieger I]; Linda Hamilton Krieger, The Content of Our Categories: A Cognitive Bias Approach to Discrimination and Equal Employment Opportunity, 47 Stan. L. Rev. 1161, 1164 (1995) [hereinafter Krieger II]; Charles R. Lawrence III, The Id, The Ego, and Equal Protection: Reckoning with Unconscious Racism, 39 Stan. L. Rev. 317 passim (1987); Anne C. McGinley, Rethinking Civil Rights and Employment at Will: Toward a Coherent Discharge Policy, 57 Ohio St. L.J. 1443, 1463–1473 (1996); David Benjamin Oppenheimer, Negligent Discrimination, 141 U. Pa. L. Rev. 899, 900–917 (1993); Michael Selmi, Testing for Equality: Merit, Efficiency, and the Affirmative Action Debate, 42 UCLA L. Rev. 1251, 1283–1289 (1995); David A. Strauss, Discriminatory Intent and the Taming of Brown, 56 U. Chi. L. Rev. 935, 960–962 (1989); Jessie Allen, Note, A Possible Remedy for Unthinking Discrimination, 61 Brook. L. Rev. 1299, 1311–1315 (1995); Pamela S. Karlan, Note, Discriminatory Purpose and Mens Rea: The Tortured Argument of Invidious Intent, 93 Yale L.J. 111, 124–128 (1983).

    Google Scholar 

  22. Lawrence, 39 Stan. L. Rev. 322 (1987). (suggesting that racism is so ingrained that it can be classified neither as intentional nor as unintentional).

    Google Scholar 

  23. David R. Williams, Race, Health, And Health Care 48 St. Louis U. L.J. 13 (Fall 2003); See Unequal Treatment, supra note 171–173.

    Google Scholar 

  24. David R. Williams, Race, Health, And Health Care 48 St. Louis U. L.J. 13 (Fall 2003); See Unequal Treatment, supra note 171–173.

    Google Scholar 

  25. David R. Williams, Race, Health, And Health Care 48 St. Louis U. L.J. 13 (Fall 2003); See Unequal Treatment, supra note 171–173.

    Google Scholar 

  26. David R. Williams, Race, Health, And Health Care 48 St. Louis U. L.J. 13 (Fall 2003).

    Google Scholar 

  27. See e.g., Susan T. Fiske, Controlling Other People: The Impact of Power on Stereotyping, 48 Am. Psychologist 621, 627 (1993) (“Our main program of research... has been showing that social structure affects attention, and if people pay more attention, at least some of them are less likely to stereotype.”); Susan T. Fiske & Peter Glick, Ambivalence and Stereotypes Cause Sexual Harassment: A Theory with Implications for Organizational Change, J. Soc. Issues, Spring 1995, at 97, 110–12 (discussing ways in which organizations can decrease the effect of stereotyping); Samual L. Gaertner et al., Reducing Intergroup Bias: Elements of Intergroup Cooperation, 76 J. of Personality & Soc. Psychol. 388, 398 (1999) (“Any intergroup activity that induces the perception of common identity among the groups has the potential to reduce intergroup bias, with or without the components of intergroup cooperative interaction.”); Steven L. Neuberg, The Goal of Forming Accurate Impressions During Social Interactions: Attenuating the Impact of Negative Expectancies, 56 J. of Personality & Soc. Psychol. 374, 374 (1989) (arguing that having a goal of forming accurate impressions reduces the detrimental impact of negative expectancies); Philip E. Tetlock, Accountability: A Social Check on the Fundamental Attribution Error, 48 Soc. Psychol. Q. 227, 233 (1985) (discussing how accountability or requiring people to justify their decisions can result in “debiasing” under certain circumstances).

    Article  CAS  Google Scholar 

  28. Susan T. Fiske, Stereotyping, Prejudice and Discrimination, in 2 The Handbook on Social Psychology 357 (Daniel T. Gilbert et al. eds., 4th ed. 1998).

    Google Scholar 

  29. See, H.r. Doc. No. 318, 88th Cong., 2d Sess. (1964). See generally, Mitchell Rice & Woodrow Jones, Jr., Public Policy Compliance/Enforcement and Black American Health: Title VI of the Civil Rights Act of 1964, in Health Care Issues in Black America: Policies, Problems and Prospects 100–117 (Woodrow Jones, Jr. & Mitchell F. Rice Eds., 1987); Sidney Watson, Reinvigorating Title VI: Defending Health Care Discrimination-it Shouldn’t Be So Easy?, 58 Fordham L. Review 939, 943–948 (1990).

    Google Scholar 

  30. 45 C.F.R. 80.3(b)(2) (1991). (Emphasis added).

    Google Scholar 

  31. 45 C.F.R. 80.13(i) (1991).

    Google Scholar 

  32. 42 U.S.C.A. 2000d-1 (1981); 4 2 U.S.C.A. 2000d-4 (1981).

    Google Scholar 

  33. 45 C.F.R. 80.3(b) (6) (i) (1991).

    Google Scholar 

  34. 45 C.F.R. 80.3(B)(1)(vii)(2) (1991).

    Google Scholar 

  35. 45 C.F.R. 80.3(B)(1)(vii)(2) (1991).

    Google Scholar 

  36. 45 C.F.R. 80.3(b)(1)(i) (1991).

    Google Scholar 

  37. 45 C.F.R. 80.3(b)(1)–(3) (1991).

    Google Scholar 

  38. Id.

    Google Scholar 

  39. In Alexander v. Choate, the Supreme Court 469 U.S. 287 (1985) made it clear that a claim seeking a remedy for discrimination based on disparate impact under Title VI must involve a violation of agency regulations promulgated under § 602.

    Google Scholar 

  40. See, Alexander v. Sandoval, 532 U.S. 275, 280 (2001)

    Google Scholar 

  41. See e.g., Allen, Unthinking Discrimination, supra note 19; Interestingly, some members if congress clearly understand the difference between conscious and unconscious bias. For instance, in its discussion of the American with Disabilities Act, several members explained that the ADA was intended to address “institutional, structural, and psychological barriers”. 136 Cong. Rec. H2599, H2622 (daily ed. May 22, 1990) (statement of Rep. Hoyer); see also 135 Cong. Rec. S10765, S10802 (daily ed. Sept. 7, 1989) (statement of Sen. Heinz).

    Google Scholar 

  42. See e.g., Sidney Watson, Reinvigorating Title VI: Defending Health Care Discrimination-it Shouldn’t Be So Easy?, 58 Fordham L. Review 939 (1990); Vernellia R. Randall, Racist Health Care: Reforming an Unjust Health Care System to Meet The Needs of African-Americans, 3 Health Matrix 127 (Spring 1993); Marianne L. Engelman Lado, Breaking The Barriers Of Access To Health Care: A Discussion Of The Role Of Civil Rights Litigation And The Relationship Between Burdens Of Proof And The Experience Of Denial, 60 Brook. L. Rev. 239 (1994), Daniel K. Hampton, Title VI Challenges By Private Parties To The Location Of Health Care Facilities: Toward A Just And Effective Action, 37 B. C. L. Rev. 517 (1996).

    Google Scholar 

  43. 28 C.F.R. § 42.406(a) (1992); 45 C.F.R. § 80.6(b) (1991).

    Google Scholar 

  44. See e.g., Sidney Watson, Health Care in the Inner City: Asking the Right Question, 71 N.C. L. Rev. 1647 (1993).

    Google Scholar 

  45. See e.g., Smith, Health Care Divided, supra note 9.

    Google Scholar 

  46. See e.g., 45 C.F.R. § 80.3(b) (1991); Watson, Health Care in the Inner City, supra note 44.

    Google Scholar 

  47. See e.g., Watson, Health Care in the Inner City, supra note 44.

    Google Scholar 

  48. Id.

    Google Scholar 

  49. But see, Lesley v. Chie, 250 F.3d 47, 53 (1st Cir. 2001) (discussing physicians’ receipt of Medicaid funds in relationship to the Rehabilitation Act.); Howe v. Hull, 874 F. Supp. 779, 789 (N.D. Ohio 1994) (discussing physicians’ receipt of Medicare and Medicaid funds in relationship to the Rehabilitation Act); However, it is open question whether physicians who receive payment through a managed care plan will be covered.

    Google Scholar 

  50. See e.g., U.S. Commission on Civil Rights II, supra note 2, 275–276.

    Google Scholar 

  51. Subtle discrimination is not necessarily the same as unconscious discrimination. Conscious discrimination can be directed in subtle ways. Michael Selmi, Response to Professor Wax Discrimination as Accident: Old Whine, New Bottle, 74 Ind. L.J. 1233 (Fall, 1999); See, also Elizabeth Young-Bruehl, The Anatomy of Prejudices 73 (1996); Michael Selmi, Subtle Discrimination: a Matter of Perspective Rather than Intent, 34 Colum. Hum. Rts. L. Rev. 657 (2003).

    Google Scholar 

  52. See, e.g., Jessie Allen, A Possible Remedy For Unthinking Discrimination, 61 Brook. L. Rev. 1299 (1995) (advocating strict liability for unconscious discrimination).

    Google Scholar 

  53. cf. Justin D. Cummins, Refashioning the Disparate Treatment and Disparate Impact Doctrines in Theory and in Practice, 41 How. L.J. 455, 468 (1998) (suggesting that problem is not the requirement of intent but how discriminatory intent is defined and proposing that a more comprehensive intent standard, which includes unconscious bias, be adopted); but see, Amy Wax, Discrimination as Accident, 74 Ind. L.J. 1129, 1206 (Fall, 1999) (Asserting that the costs of remedying unconscious discrimination are too high for employers to bear, and the victims of discrimination are the “cheapest cost avoiders”).

    Google Scholar 

  54. See e.g., Stan Dorn et al., Anti-Discrimination Provisions and Health Care Access, 20 Clearinghouse Rev. 439, 441 & n.27 (1986); Desnick v. American Broadcasting, 44 F.3d 1345, 1352 (1995) (use of test patients with concealed cameras did not support claim for trespass under Illinois law, infringement of right of privacy, or illegal wiretapping).

    Google Scholar 

  55. See, e.g., Ian Ayres, Fair Driving: Gender and Race Discrimination in Retail Car Negotiations, 104 Harv. L. Rev. 817 (1991) (conducting rigorous testing for gender and race discrimination in new-car purchase negotiations and disclosing that women and minorities fare significantly worse in such negotiations than white males); Stephen E. Haydons, A Measure of Our Progress: Testing for Race Discrimination in Public Accommodations, 44 UCLA L. Rev. 1207 (April, 1997).

    Article  Google Scholar 

  56. 42 U.S.C. s 3604.

    Google Scholar 

  57. See, e.g., Stephen E. Haydons, A Measure of Our Progress: Testing for Race Discrimination in Public Accommodations, 44 UCLA L. Rev. 1207 (April, 1997); Havens Realty Corp. v. Coleman. 455 U.S. 363 (1982) (Unanimous court endorsing the use of testers).

    Google Scholar 

  58. See, e.g., Michael J. Yelnosky, Filling an Enforcement Void: Using Testers to Uncover and Remedy Discrimination in Hiring for Lower-Skilled, Entry-Level Jobs, 26 U. Mich. J.L. Reform 403 (1993) (arguing that Congress should amend Title VII to give the EEOC the power to use testers to uncover discrimination in hiring for lower-skilled, entry-level jobs).

    Google Scholar 

  59. See, e.g., Michelle Landever, Note, Tester Standing in Employment Discrimination Cases Under 42 U.S.C. s 1981, 41 Clev. St. L. Rev. 381 (1993) (arguing that employment testers have standing to sue under s 1981).

    Google Scholar 

  60. Linda R.S. v. Richard D., 410 U.S. 614, 617 n.3 (1973) citing Hardin v. Kentucky Utilities Co., 390 U.S. 1, 6, 88 S.Ct. 651, 654, 19 L.Ed.2d 787 (1968).

    Google Scholar 

  61. See, e.g., Derek Black, Picking up the Pieces after Alexander V. Sandoval: Resurrecting a Private Cause of Action for Disparate Impact, 81 N.C. L. Rev. 356 (December, 2002).

    Google Scholar 

  62. See, e.g., Derek Black, Picking up the Pieces after Alexander V. Sandoval: Resurrecting a Private Cause of Action for Disparate Impact, 81 N.C. L. Rev. 356 (December, 2002).

    Google Scholar 

  63. See, e.g., Derek Black, Picking up the Pieces after Alexander V. Sandoval: Resurrecting a Private Cause of Action for Disparate Impact, 81 N.C. L. Rev. 356 (December, 2002).

    Google Scholar 

  64. See, e.g., Stephen E. Haydons, A Measure of Our Progress: Testing for Race Discrimination in Public Accommodations, 44 UCLA L. Rev. 1207 (April, 1997).

    Google Scholar 

  65. See, e.g., Fair Housing Council Finds Discrimination Against Hispanics in dc 66 No. 40 Interpreter Releases 1154 (October 16, 1989).

    Google Scholar 

  66. E.g., Macon Dandridge Miller, Catalysts as Prevailing Parties under the Equal Access to Justice Act, 69 U. Chi. L. Rev. 1347 (Summer 2002).

    Article  Google Scholar 

  67. See, e.g., See, for example, Civil Rights Act of 1964, Pub L No 88-352, 78 Stat 259, codified at 42 USC § 2000e-5(k) (1994); Civil Rights Attorney’s Fees Awards Act of 1976, Pub L No 94-559, 90 Stat 2641, codified at 42 USC § 1988(b) (1994 & Supp 2000); Equal Access to Justice Act, Pub L No 96-481, 94 Stat 2325 (1980), codified at 5 USC § 504, 28 USC § 2412 (1994 & 1998 Supp); 66 Stat 813 (1952), codified at 35 USC § 285 (1994).

    Google Scholar 

  68. See, for example, Stanton v Southern Berkshire Regional School District, 197 F3d 574, 577 (1st Cir 1999) (interpreting prevailing party to include catalysts); Marbley v Bane, 57 F3d 224, 234 (2d Cir 1995) (recognizing the catalyst theory as a viable form of recovery as a prevailing party); Baumgartner v Harrisburg Housing Authority, 21 F3d 541, 551 (3d Cir 1994) (holding that “there is no legal impediment to application of the ‘catalyst theory’ to show that plaintiffs were ‘prevailing parties’ notwithstanding the absence of a judgment or consent decree”); Environmental Defense Fund, Inc. v EPA, 716 F2d 915, 919 (DC Cir 1983) (holding that a party can achieve prevailing party status without having received a final judgment in its favor).

    Google Scholar 

  69. Jason P. Pogorelec, under What Circumstances Did Congress Intend to Award Punitive Damages for Victims of Unlawful Intentional Discrimination under Title Vii?, 40 B.C. L. Rev. 1269 (September, 1999)

    Google Scholar 

  70. See e.g, Jason P. Pogorelec, under What Circumstances Did Congress Intend to Award Punitive Damages for Victims of Unlawful Intentional Discrimination under Title Vii?, 40 B.C. L. Rev. 1269 (September, 1999); H.R. Rep. No. 102-40(I), at 64–65 (1991), reprinted in 1991 U.S.S.C.A.N. 549, 602–603.

    Google Scholar 

  71. See e.g., Mathew J. Klaben, Split-Recovery Statutes: The Interplay of the Takings and Excessive Fines Clauses, 80 Cornell L. Rev. 104, 105 (1994). Leo M. Stepanian II, Comment, The Feasibility of Full State Extraction of Punitive Damages Awards, 32 Duq. L. Rev. 301, 317 (1994).

    Google Scholar 

  72. See e.g., Williams, David R., Race/Ethnicity and Socioeconomic Status: Measurement and Methodological Issues, 26(3) International Journal of Health Services 483–505 (1996); Sidney D. Watson, Race, Ethnicity and Quality of Care: Inequalities and Incentives, 27 Am. J. L. & Med. 203 (2001).

    Article  PubMed  CAS  Google Scholar 

  73. See e.g., U.S. Commission on Civil Rights I, Adrienne Y. Stith, and Alan R. Nelson, Editors, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy (2002) (hereinafter, “IOM Report”) supra note_2, 50–52.

    Google Scholar 

  74. See e.g., David Williams, Race/Ethnicity and Socioeconomic Status: Measurement and Methodological Issues, 26(3) Int. J. Health Services 483–505 (1996).

    CAS  Google Scholar 

  75. See e.g., U.S. Commission on Civil Rights I, Adrienne Y. Stith, and Alan R. Nelson, Editors, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy (2002) (hereinafter, “IOM Report”) supra note 2, 50–52.

    Google Scholar 

  76. David Williams, Race/Ethnicity and Socioeconomic Status: Measurement and Methodological Issues, 26(3) Int. J. Health Services 483–505 (1996).

    CAS  Google Scholar 

  77. See Madison-Hughes v. Shalala, 80 F.3d 1121, at 1123 (6th Cir. 1996) (dismissing for lack of subject matter jurisdiction); U.S. Commission on Civil Rights, “Federal Title VI Enforcement to Ensure Nondiscrimination in Federally Assisted Programs,” (Washington, D.C., 1996), at 246; Marianne Engelman Lado, Unfinished Agenda: the Need for Civil Rights Litigation to Address Race Discrimination and Inequalities in Health Care Delivery, 1. 6 Tex. F. on C.L. & C.R. 1 (Summer 2001).

    Google Scholar 

  78. Bagley, C., a Plea for Ignoring Race and Including Insured Status in American Research Reports on Social Science and Medicine, 40 Soc. Sci. Med. 1017–1019 (1995).

    Article  PubMed  CAS  Google Scholar 

  79. Williams, Race and Health, Adrienne Y. Stith, and Alan R. Nelson, Editors, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy (2002) (hereinafter, “IOM Report”) supra note 2, 322–333.

    Google Scholar 

  80. Williams, Race and Health, Adrienne Y. Stith, and Alan R. Nelson, Editors, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy (2002) (hereinafter, “IOM Report”) supra note 2 322–333.

    Google Scholar 

  81. Randall, Racist Health Care, supra note 12, 127–194.

    Google Scholar 

  82. Williams, Race and Health, Adrienne Y. Stith, and Alan R. Nelson, Editors, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy (2002) (hereinafter, “IOM Report”) supra note 2, 322–333.

    Google Scholar 

  83. Prejudice and Racism, Adrienne Y. Stith, and Alan R. Nelson, Editors, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care, Board on Health Sciences Policy (2002) (hereinafter, “IOM Report”) supra note 2, 352–356.

    Google Scholar 

  84. E.g., David Barton Smith, Addressing Racial Inequities in Health Care: Civil Rights Monitoring and Report Cards, 23 J. Health Pol. Pol’y & L. 75 (February, 1998).

    CAS  Google Scholar 

  85. David Barton Smith, Health Care Divided, supra.note 9; H. Jack Geiger, Race and Health Care—an American Dilemma, 335 New Eng. J. Med. 815, 816 (1996); René Bowser, Racial Profiling in Health Care: an Institutional Analysis of Medical Treatment Disparities, 7 Mich. J. Race & L. 79 (Fall 2001).

    Google Scholar 

  86. See, David Barton Smith, Addressing Racial Inequities in Health Care: Civil Rights Monitoring and Report Cards, 23 J. Health Pol. Pol’y & L. 75 (February 1998).

    CAS  Google Scholar 

  87. E.g., David Barton Smith, Health Care Divided, supra note 9 at 326; Nat’l Comm. Quality Assurance, Health Plan and Employer Data Information Set (version 3.0 1998); Alain C. Enthoven & Carol B. Vorhaus, A Vision of Quality In Health Care Delivery, Health Aff., May/June 1997; René Bowser, Racial Profiling in Health Care: an Institutional Analysis of Medical Treatment Disparities, 7 Mich. J. Race & L. 79 (Fall 2001).

    Google Scholar 

  88. E.g., Sidney D. Watson, Book Review Essay Health Care Divided: Race And Healing A Nation David Barton Smith (University of Michigan Press, Ann Arbor, Michigan, 1999), 386 pages, $39.50., 21 J. Legal Med., 601 J. Legal Med. (December, 2000).

    Google Scholar 

  89. E.g., Sidney D. Watson, Book Review Essay Health Care Divided: Race And Healing A Nation David Barton Smith (University of Michigan Press, Ann Arbor, Michigan, 1999), 386 pages, $39.50., 21 J. Legal Med., 601 J. Legal Med. (December, 2000).

    Google Scholar 

  90. E.g., Sidney D. Watson, Reinvigorating Title VI: Defending Health Care Discrimination—it Shouldn’t Be So Easy, 58 Fordham L. Rev. 939 (1990). Smith, Health Care Divided supra note 9; David Barton Smith, Addressing Racial Inequities In Health Care: Civil Rights Monitoring And Report Cards, 23 J. Health Politics, Policy & L. 75 (1998); Randall, Racist Health Care, supra note 5.

    Google Scholar 

  91. See e.g., Noah, Racial Disparities, supra note 5; Daniel K. Hampton, Title VI Challenges By Private Parties To The Location Of Health Care Facilities: Toward A Just And Effective Action, 37 Boston College L. Rev. 517 (1996); Barbara A. Noah, Racist Health Care?, 35 San Diego L. Rev. 135 (1998); Marianne L. Engelman Lado, Breaking The Barriers Of Access To Health Care: A Discussion Of The Role Of Civil Rights Litigation And The Relationship Between Burdens Of Proof And The Experience Of Denial, 60 Brooklyn L. Rev. 239 (1994).

    Google Scholar 

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  1. The University of Dayton School of Law, Dayton, Ohio

    Vernellia R. Randall B.S.N., M.S.N., J.D. (Professor of Law)

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  1. Vernellia R. Randall B.S.N., M.S.N., J.D.
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  1. The David Geffen School of Medicine at UCLA, USA

    Richard Allen Williams MD (Clinical Professor of Medicine, President/CEO and Chairman of the Board) (Clinical Professor of Medicine, President/CEO and Chairman of the Board)

  2. The Minority Health Institute, Inc., Los Angeles, California

    Richard Allen Williams MD (Clinical Professor of Medicine, President/CEO and Chairman of the Board) (Clinical Professor of Medicine, President/CEO and Chairman of the Board)

  3. Institute for the Advancement of Multicultural and Minority Medicine, Washington, DC

    Richard Allen Williams MD (Clinical Professor of Medicine, President/CEO and Chairman of the Board) (Clinical Professor of Medicine, President/CEO and Chairman of the Board)

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Randall, V.R. (2007). Eliminating Racial Discrimination in Healthcare. In: Williams, R.A. (eds) Eliminating Healthcare Disparities in America. Humana Press. https://doi.org/10.1007/978-1-59745-485-8_9

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