Racial and ethnic minorities continue to be subjected to a sustained pattern of disparate treatment in health care with no panacea for the confluence of contributing factors. In the 2003 provocative landmark report, Unequal Treatment; Confronting Racial and Ethnic Disparities in Health Care, the Institute of Medicine (IOM) exposed a painful truth about the health care system. When racial and ethnic minorities enter the clinical arena, they are less likely to receive routine medical procedures, appropriate cardiac medications, or essential clinical services. The differences in how minorities are treated in health care contribute to their higher rate of disability and mortality.
Since the 2003 IOM report, the tendency for racial and ethnic minorities to receive an inferior level of care has not abated. A 2007 systematic review conducted by the Department of Veterans Affairs (VA) found that African American male veterans received less aggressive pain management for osteoarthritis, providers gave them less information about cancer, and clinical decision making varied based on the veteran’s race. More recently, the Agency for Healthcare Research and Quality revealed in the 2016 National Healthcare Quality and Disparities Report that “most disparities have not changed significantly for any racial and ethnic groups…especially among people in poor and low-income households, uninsured people, Hispanics, and Blacks.” Although the gap in health insurance coverage between minorities and whites has narrowed, differences have actually widened for quality indicators such as annual foot exams and prevention of lower extremity amputations among diabetics. Indeed, the persistence of health care disparities, which the Institute of Medicine defined as “differences in the quality of healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness or intervention,” is alarming and depicts a dismal reality for ethnic and racial groups.