Elsevier

The Annals of Thoracic Surgery

Volume 76, Issue 4, October 2003, Pages S1377-S1381
The Annals of Thoracic Surgery

Supplement: understanding disparities in cardiovascular and thoracic surgical outcomes in African-Americans
Unequal treatment: report of the institute of medicine on racial and ethnic disparities in healthcare

Presented at the symposium on Understanding Disparities in Cardiovascular and Thoracic Surgical Outcomes in African Americans, San Diego, CA, Jan 30, 2003.
https://doi.org/10.1016/S0003-4975(03)01205-0Get rights and content

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Committee methods

The committee determined, at the outset, to require a rock-solid evidence base for its findings and recommendations. The 15 member panel met five times, conducted an extensive review and analysis of the relevant health care literature, and used liaison panels, focus groups, and commissioned papers by experts in various aspects of the committee's charge to add to its comprehensive inquiry. We received testimony from educators, accrediting organizations, representatives of managed care

Evidence in cardiovascular disease

According to the report some of the strongest and most consistent evidence for the existence of racial and ethnic disparities in care is found in studies of cardiovascular care. The committee referenced, in its annotated bibliography, 26 studies that looked at disparities in diagnosis or treatment of cardiovascular diseases. All met the criteria set for inclusion: the studies were published in the past 10 years, publication was in peer-reviewed journals, contained original findings, and met

Findings

Racial and ethnic disparities in health care exist and, because they are associated with worse outcomes in many patients, they are unacceptable.

Racial and ethnic disparities in health care occur in the context of broader historic and contemporary social and economic inequality, and evidence of persistent racial and ethnic discrimination in many sectors of American life.

Many sources (health systems, healthcare providers, patients, and utilization managers) contribute to racial and ethnic

Recommendations

The committee devoted a great deal of attention to recommendations that might be expected to reduce and eventually eliminate disparities in the United States.

First, the committee believes that the existence of disparities is still largely unrecognized, and that public and professional awareness is an essential starting point for efforts at reduction, so one of our most important recommendations is to increase awareness of racial and ethnic disparities in health care among the general public and

Conclusions

The committee was acutely aware, at each stage of its work, of the value-laden and sensitive nature of the subject of its charge. Some of us were shocked at the extent of evidence that exhibits broad and unacceptable disparities in health care in this country. Although disparities in the quality of care may be reflective of inequalities in other aspects of American life, such as housing, jobs, and education, healthcare workers are professionals and beneficence, as an element of professionalism,

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