Journal of General Internal Medicine

, Volume 23, Issue 5, pp 685–691 | Cite as

Transforming Clinical Practice to Eliminate Racial–Ethnic Disparities in Healthcare

  • Donna L. Washington
  • Jacqueline Bowles
  • Somnath Saha
  • Carol R. Horowitz
  • Sandra Moody-Ayers
  • Arleen F. Brown
  • Valerie E. Stone
  • Lisa A. Cooper
  • Writing group for the Society of General Internal Medicine, Disparities in Health Task Force

Racial–ethnic minorities receive lower quality and intensity of health care compared with whites across a wide range of preventive, diagnostic, and therapeutic services and disease entities. These disparities in health care contribute to continuing racial–ethnic disparities in the burden of illness and death. Several national medical organizations and the Institute of Medicine have issued position papers and recommendations for the elimination of health care disparities. However, physicians in practice are often at a loss for how to translate these principles and recommendations into specific interventions in their own clinical practices. This paper serves as a blueprint for translating principles for the elimination of racial–ethnic disparities in health care into specific actions that are relevant for individual clinical practices. We describe what is known about reducing racial–ethnic disparities in clinical practice and make recommendations for how clinician leaders can apply this evidence to transform their own practices.


racial disparities race ethnicity health care delivery cultural competence ethnic groups continental population groups 



The authors gratefully acknowledge Judy Ann Bigby, Society of General Internal Medicine (SGIM) past President, who originated the idea for this paper, and members of the SGIM Disparities Task Force for valuable reflection and feedback. Drs. Washington (#RCD-00-017), Saha (#RCD-00-028), and Moody (#RCD-03-183) are supported by career development awards from the Department of Veterans Affairs, Health Services Research and Development Service. Dr. Saha is supported by a Generalist Physician Faculty Scholar award from the Robert Wood Johnson Foundation (RWJF). Drs. Horowitz (#P60 MD00270) and Brown (#P20MD00148) are supported by grants from the National Center on Minority Health and Health Disparities (NCMHD). Dr. Brown also received support from the University of California, Los Angeles, Resource Center in Minority Aging Research (#AG02004) and the Beeson Career Development Award (#AG26748). Dr. Cooper is supported by a grant from the National Heart, Lung, and Blood Institute (NHLBI) (K24HL083113). The views expressed within are solely those of the authors and do not necessarily reflect the views of the Department of Veterans Affairs, the RWJF, NCMHD, or NHLBI.

Conflict of Interest

Dr. Stone reports both consultancies for and receiving honoraria from Pfizer, Gilead Sciences, Bristol Myers Squibb, and Abbott Labs. Dr. Stone has also received honoraria from GlaxoSmithKline. Dr. Cooper has received research grant funding from Amgen. No other authors have conflicts of interest to report.


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Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Donna L. Washington
    • 1
    • 2
  • Jacqueline Bowles
    • 1
    • 2
  • Somnath Saha
    • 3
    • 4
  • Carol R. Horowitz
    • 5
  • Sandra Moody-Ayers
    • 6
  • Arleen F. Brown
    • 2
  • Valerie E. Stone
    • 7
  • Lisa A. Cooper
    • 8
  • Writing group for the Society of General Internal Medicine, Disparities in Health Task Force
  1. 1.Division of General Internal MedicineVA Greater Los Angeles Healthcare SystemLos AngelesUSA
  2. 2.Department of MedicineUniversity of California, Los Angeles, David Geffen School of MedicineLos AngelesUSA
  3. 3.Section of General Internal MedicinePortland Veterans Affairs Medical CenterPortlandUSA
  4. 4.Department of MedicineOregon Health & Science UniversityPortlandUSA
  5. 5.Departments of Health Policy and MedicineMount Sinai School of MedicineNew YorkUSA
  6. 6.Department of MedicineSan Francisco Veterans Affairs Medical Center, University of California, San FranciscoSan FranciscoUSA
  7. 7.General Medicine Unit, Massachusetts General HospitalBostonUSA
  8. 8.Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreUSA

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