Los Angeles Times - March 21, 2002
Milton Carrero Galarza, Times Staff Writer

Disparities are particularly evident in the treatment of chronic illnesses. Minorities are less likely to undergo sophisticated treatments such as bypass surgeries, kidney dialysis or organ transplants. They have less access to appropriate cardiac and HIV medications and are more likely to suffer lower-limb amputations as a result of diabetes, the congressionally commissioned study being released today found.

"Without question, this is overwhelming evidence of health care disparities across the country," said Joseph Betancourt, a lead researcher on the project who is a senior scientist at the Institute for Health Policy in Massachusetts General Hospital-Harvard Medical School. Researchers reviewed nearly 600 other studies, conducted focus-group interviews with patients and health care providers, and recorded testimony from minority groups around the country. Although previous research has accounted for variables such as income and insurance, the researchers say this is the first to so comprehensively include those as well as race, age and other factors, according to Betancourt.

"We looked at everything that happens once the patient gets into the system," he said.

The study says that bias and stereotyping on the part of health care providers may contribute to differences in care, said Dr. Alan R. Nelson, former president of the American Medical Assn. and chairman of the research committee. For instance, the study showed that Latino patients in Los Angeles received less pain medication, which could be attributed to the myth that Latinos can endure more pain.

"There is no evidence to justify that stereotype," he said.

Nelson said medical professionals should be better educated about cultural differences and become more ethnically diverse. Hospitals should hire more language interpreters to help ease what he considers to be a "crisis" in disparity of care for non-English speakers.

The study showed an improvement in patients' participation and satisfaction when the health care provider is of the same ethnic group. It also found that minority patients refuse recommended treatments more often than whites do, but the committee noted that the doctor or nurse should shoulder more responsibility for seeing that treatments are accepted.

Betancourt said he hopes the results of the study help "raise awareness among patients that disparity exists and encourage them to get more information about how to navigate the health care system."

The researchers suggested the federal government should boost resources of the U.S. Department of Health and Human Services' Office of Civil Rights to enforces laws that prohibit discrimination in health care. "These disparities are costing the health care system now. Initially it might cost us money, but it may save us money in the long run," Betancourt said.
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