Unequal Treatment

Unequal Treatment

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-02-06

Total Pages: 781

ISBN-13: 030908265X

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Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.


Race in a Bottle

Race in a Bottle

Author: Jonathan Kahn

Publisher: Columbia University Press

Published: 2013

Total Pages: 330

ISBN-13: 0231162987

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Approved by the FDA in 2005 as the first drug with a race-specific indication on its label, BiDil was touted as a pathbreaking therapy to treat heart failure in black patients. Kahn reveals that, at the most basic level, BiDil became racial through legal maneuvering and commercial pressure as much as through medical understandings of how the drug worked. He examines the legal and calls for a more reasoned approach to using race in biomedical research and practice.


On Race and Medicine

On Race and Medicine

Author: Richard Garcia

Publisher: Rowman & Littlefield

Published: 2015-04-22

Total Pages: 180

ISBN-13: 144224836X

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Health disparities exist between races in America. These inequalities are cataloged in numerous studies, reports, conferences, articles, seminars, and keynote speeches. Various studies include reports on income, health insurance, cultural differences between patients and their physicians, language barriers, and biological “racial” differences in the discourse of health disparities. On Race and Medicine: Insider Perspectives is a collection of enlightening personal essays written by an interdisciplinary group of scholars, physicians, and medical school deans. They invite readers to evaluate disparities differently when considering race in American healthcare. They address the very real, everyday circumstances of healthcare differences where race is concerned, and shine light on the realities of race itself, inequalities in healthcare, and on the very way these American complexities can be discussed and considered. This is not another chronicle of studies cataloging differences in health care based on race. The essays are narrated from practical and personal stances examining disparate health between the races. Decreasing inequalities in health for racial minorities, who are sicker in so many areas—diabetes, heart disease, stage of cancer, etc.—is financially good for everyone. But understanding health inequalities in race is of even greater human importance. How race intersects with medicine is striking given the existence of racial issues throughout the rest of American history. These authors attempt to explain and explore the truth about health disparities, which is necessary before we can turn our national attention toward eliminating differences in health based on race.


Race, Science and Medicine, 1700-1960

Race, Science and Medicine, 1700-1960

Author: Waltraud Ernst

Publisher: Routledge

Published: 2002-01-04

Total Pages: 287

ISBN-13: 1134676441

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Considering cases from Europe to India, this collection brings together current critical research into the role played by racial issues in the production of medical knowledge. Confronting such controversial themes as colonialism and medicine, the origins of racial thinking and health and migration, the distinguished contributors examine the role played by medicine in the construction of racial categories.


Understanding Racial and Ethnic Differences in Health in Late Life

Understanding Racial and Ethnic Differences in Health in Late Life

Author: National Research Council

Publisher: National Academies Press

Published: 2004-09-08

Total Pages: 184

ISBN-13: 0309165865

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As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.


Medicalizing Blackness

Medicalizing Blackness

Author: Rana A. Hogarth

Publisher: UNC Press Books

Published: 2017-09-26

Total Pages: 291

ISBN-13: 1469632888

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In 1748, as yellow fever raged in Charleston, South Carolina, doctor John Lining remarked, "There is something very singular in the constitution of the Negroes, which renders them not liable to this fever." Lining's comments presaged ideas about blackness that would endure in medical discourses and beyond. In this fascinating medical history, Rana A. Hogarth examines the creation and circulation of medical ideas about blackness in the Atlantic World during the late eighteenth and early nineteenth centuries. She shows how white physicians deployed blackness as a medically significant marker of difference and used medical knowledge to improve plantation labor efficiency, safeguard colonial and civic interests, and enhance control over black bodies during the era of slavery. Hogarth refigures Atlantic slave societies as medical frontiers of knowledge production on the topic of racial difference. Rather than looking to their counterparts in Europe who collected and dissected bodies to gain knowledge about race, white physicians in Atlantic slaveholding regions created and tested ideas about race based on the contexts in which they lived and practiced. What emerges in sharp relief is the ways in which blackness was reified in medical discourses and used to perpetuate notions of white supremacy.


Medical Apartheid

Medical Apartheid

Author: Harriet A. Washington

Publisher: Vintage

Published: 2008-01-08

Total Pages: 530

ISBN-13: 076791547X

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NATIONAL BOOK CRITICS CIRCLE AWARD WINNER • The first full history of Black America’s shocking mistreatment as unwilling and unwitting experimental subjects at the hands of the medical establishment. No one concerned with issues of public health and racial justice can afford not to read this masterful book. "[Washington] has unearthed a shocking amount of information and shaped it into a riveting, carefully documented book." —New York Times From the era of slavery to the present day, starting with the earliest encounters between Black Americans and Western medical researchers and the racist pseudoscience that resulted, Medical Apartheid details the ways both slaves and freedmen were used in hospitals for experiments conducted without their knowledge—a tradition that continues today within some black populations. It reveals how Blacks have historically been prey to grave-robbing as well as unauthorized autopsies and dissections. Moving into the twentieth century, it shows how the pseudoscience of eugenics and social Darwinism was used to justify experimental exploitation and shoddy medical treatment of Blacks. Shocking new details about the government’s notorious Tuskegee experiment are revealed, as are similar, less-well-known medical atrocities conducted by the government, the armed forces, prisons, and private institutions. The product of years of prodigious research into medical journals and experimental reports long undisturbed, Medical Apartheid reveals the hidden underbelly of scientific research and makes possible, for the first time, an understanding of the roots of the African American health deficit. At last, it provides the fullest possible context for comprehending the behavioral fallout that has caused Black Americans to view researchers—and indeed the whole medical establishment—with such deep distrust.


Black Man in a White Coat

Black Man in a White Coat

Author: Damon Tweedy, M.D.

Publisher: Picador

Published: 2015-09-08

Total Pages: 302

ISBN-13: 1250044642

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A NEW YORK TIMES BESTSELLER • ONE OF TIME MAGAZINE'S TOP TEN NONFICTION BOOKS OF THE YEAR A LIBRARY JOURNAL BEST BOOK SELECTION • A BOOKLIST EDITORS' CHOICE BOOK SELECTION One doctor's passionate and profound memoir of his experience grappling with race, bias, and the unique health problems of black Americans When Damon Tweedy begins medical school,he envisions a bright future where his segregated, working-class background will become largely irrelevant. Instead, he finds that he has joined a new world where race is front and center. The recipient of a scholarship designed to increase black student enrollment, Tweedy soon meets a professor who bluntly questions whether he belongs in medical school, a moment that crystallizes the challenges he will face throughout his career. Making matters worse, in lecture after lecture the common refrain for numerous diseases resounds, "More common in blacks than in whites." Black Man in a White Coat examines the complex ways in which both black doctors and patients must navigate the difficult and often contradictory terrain of race and medicine. As Tweedy transforms from student to practicing physician, he discovers how often race influences his encounters with patients. Through their stories, he illustrates the complex social, cultural, and economic factors at the root of many health problems in the black community. These issues take on greater meaning when Tweedy is himself diagnosed with a chronic disease far more common among black people. In this powerful, moving, and deeply empathic book, Tweedy explores the challenges confronting black doctors, and the disproportionate health burdens faced by black patients, ultimately seeking a way forward to better treatment and more compassionate care.


Communities in Action

Communities in Action

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2017-04-27

Total Pages: 583

ISBN-13: 0309452961

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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.


Race in Contemporary Medicine

Race in Contemporary Medicine

Author: Sander L. Gilman

Publisher: Routledge

Published: 2013-09-13

Total Pages: 206

ISBN-13: 1136764550

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This collection of articles addresses contemporary debates regarding race in medicine today, answering questions from a bio-medical and social perspective.