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Editor's Note
Features
In Focus Health Highlights
International Health

Fall 2002; Volume 3, Number 2
Features: Equality and Health Care

Eliminating African-American Health Disparity via History-based Policy
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References

1. A definition of health disparities (National Institutes of Health definition): Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States. Usually discussed in terms of six areas: Infant Mortality, Cancer Screening and Management, Cardiovascular Disease, Diabetes, HIV Infection/AIDS, and Immunizations.

2. Historically substantiated health disparities in levels of disease, illness, disability and death historically experienced by Blacks, and traced to race labeling, racism, discrimination and stigma suffered by Blacks during America's chattel slavery period, and perpetuated by racist medical theory and pseudoscience.

3. For purposes of this article, the definition of healthcare we will use is that defined by David Barton Smith in his book, Healthcare Divided: Race and Healing a Nation (University of Michigan Press, 1999). Healthcare is (1) " a mechanism of social control which contributes to social stability. It is part of the way any society, community or large organization tries to maintain itself as an effective collective unit. (2) From an economic perspective, "it is in part a public good. That is, the public in general benefits, and benefits cannot be restricted simply to the person receiving services." (3) Finally, it is an ethical and moral touchstone. Lack of access and social justice... It provides the information we need to plan our lives in face of illness, prevent premature death, alleviate pain, and restore function."

4. The Kaiser Family Foundation Survey of Race, Ethnicity and Medical Care: Public Perceptions and Experiences was conducted in 1999 by telephone and surveyed 3,884 adults (1,479 White, 1, 189 Black, and 983 Latinos). It revealed "significant misperceptions concerning the existence of racial disparities and the impact of race on healthcare treatment.

5. The Kaiser Family Foundation National Survey of Physicians: Part One: Doctors on Disparities in Medical Care, was conducted in 2001, and is based on a nationally representative sample of 2,608 physicians who work directly with patients.

6. Soo-Jin Lee, S., Mountain, J., Koenig, B. "The Meanings of 'Race' in the New Genomics: Implications of Health Disparities Research". Yale Journal of Health Policy, Law and Ethics. Spring 2001. Vol. 1.

7. From the Internet article, "Why Race Matters" by Randall, V. at the University of Dayton (OH) Race, Healthcare and the Law website: http://academic.udayton.edu/health/03access/data.htm.

8. This definition was introduced in a position paper on the topic commissioned by the AAA. After revision and public comment, the AAA Executive Board adopted it on May 17, 1998, as an official statement of AAA's position on "race."

9. Van Ryn, M., Burke, J. "The Effects of Patient Race and Socio-Economic Status on Physician's Perceptions of Patients", Journal of Social Science and Medicine. March 2000, and Schulman, Kevin, et al. "The Effect of Race and Sex on Physician Recommendation for Cardiac Catheterization. 340. New England Journal of Medicine. 618 (1999)

10. McIntosh, P. "White Privilege: Unpacking the Invisible Knapsack" (1990). Available at http://www.uwm.edu/~gjay/Whiteness/mcintosh.htm.

11. Muntaner C, Nagoshi C, Diala C. "Racial ideology and explanations for health inequalities among middle-class whites." Int J Health Serv. 2001;31(3):659-68.

12. Jones, JM. "Psychological Knowledge and the New American Dilemma of Race," in Journal of Social Issues, Vol. 54, 638-652.

13. Gamble VN. A Legacy of distrust: African-Americans and Medical Research. American Journal of Preventive Medicine. 1993.

14. Ibid.

15. Hornblum, A.M., Acres of Skin: Human Experiments at Holmesburg Prison. New York: Rutledge,1998.

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