Racial Disparity Despite Quality Care
Even in Identical Health Plans, Blacks' Health Outcomes Worse Than Whites'
More Than Doctors Alone Can Fix continued...
Why is racial disparity in health care so hard to get rid of?
"At the core here, we have a problem in the culture -- in the culture of
medicine, in the culture of the country, and in the culture of
African-Americans and their behavior," LaVeist tells WebMD. "It is much
bigger than just health care alone.
"Health disparities track with disparities in education, in wealth, and
in incarceration," he says. "All these disparities track each other. It
is not something those in the health industry alone can fix; it is a broader
Ayanian says a lot could be learned from high-quality health plans that have
eliminated racial disparity in health outcomes. But there's a problem here. Of
the 151 plans studied, only a single plan had the same racial outcomes on more
than one measure -- and that plan eliminated disparity on only two of the
Other studies, Ayanian says, offer hints about how health plans can lessen
disparities and improve outcomes for all patients.
"It is important for plans to have accurate and up-to-date information
on whether patients are achieving good control; to provide reminders both to
doctors and patients when they don't have good control," Ayanian says. It
is also important, he continues, to "potentially have nutritionists or
health navigators work with patients to understand barriers to good