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From page 739... ... Index A African Moors, 498 Agassiz, Louis, 501 AAHP. See American Association of Health Age-adjusted death rates Plans for all causes of death by race and AAMC. Read the entire page →
From page 740... ... 740 INDEX AMA. See American Medical Association Asthma, 62-63, 296-297 American Association of Health Plans Attitude of healthcare providers, 400-401 (AAHP) Read the entire page →
From page 741... ... 741 INDEX Bureau of the Census. Read the entire page →
From page 742... ... 742 INDEX CHF. See Congestive heart failure CLAS. Read the entire page →
From page 743... ... 743 INDEX Community Access Program (CAP) , 388-389 impact on racial and ethnic disparities in Community Action Grant Program, 390 healthcare, 699-721 Community and Migrant Health Centers managed competition, 705-706 Program, 112 racial and ethnic disparities, 706 Community health centers (CHCs) Read the entire page →
From page 744... ... 744 INDEX Culturally appropriate patient education data needs and recommendations, 232 programs, increasing patients' 234 knowledge of accessing care and data sources to assess healthcare participating in treatment disparities, 223-226, 271-284 decisions, 198 federal role in racial, ethnic, and primary Culture language health data, 219-223 defined, 522 Home Mortgage Disclosure Act expression of mental illness, 614 (HMDA) , 651-653 "Culture, Communication, and Health" models of measuring disparities in course, 209 healthcare, 226-232 Culture of medicine, 594-625 in mortgage lending, 651-653 addressing healthcare disparities obstacles to racial/ethnic data collection, through the training of healthcare 217-219 professionals, 606-611 standardizing, 215 African Americans and the "over- Data Council, 221 diagnosis" of schizophrenia, 612- Data needs and recommendations, 232-234 613 Data sources to assess healthcare bias of efficacy, 603-604 disparities, 223-226, 271-284 case analyses of disparities in mental California Health Interview Survey health services, 611-612 (CHIS) Read the entire page →
From page 745... ... 745 INDEX Demography, defined, 465, 522 DRGs. See Diagnosis-related groups Department for the Diseases of Children, DSM-III, 615 484 DSM-IV, 608 Destabilization, patchy, 508 Duke University Medical Center, 140, 429 DHHS. Read the entire page →
From page 746... ... 746 INDEX Ethnic groups, 495-496 Executive Office of the President, 384 defined, 523 Office of Management and Budget, 384 Ethnicity, defined, 462, 474, 523 Executive Orders, 657 Eugenics, 504 Eye care, 71-74, 338-341 European American, defined, 523 Evidence-based cost control, 15-16, 189-190 F Evidence-based guidelines, promoting the consistency and equity of care Fadiman, Anne, 605 through the use of, 16, 20, 189-190 Failed reform and corporate takeover, 508 Evidence of race-concordance Fair Housing Act, 98-99 consequences for the Federal Employees Health Benefits Plan communication process, 574 (FEHBP) , 699n Evidence of racial and ethnic disparities in Federal Financial Institutions Examination healthcare, 5-6, 38-77 Council (FFIEC) Read the entire page →
From page 747... ... 747 INDEX FEHBP. See Federal Employees Health Glazer, Nathan, 496 Benefits Plan Great Chain of Being, 497 FFIEC. Read the entire page →
From page 748... ... 748 INDEX by Asian-American and Pacific Islander Healthcare disparities subgroups vs. whites, 86 addressing through the training of by race and ethnicity, 679-680 healthcare professionals, 606-611 Health Insurance Portability and among non-African American minority Accountability Act (HIPAA) Read the entire page →
From page 749... ... 749 INDEX Healthcare providers, 89-90 Hip fractures, 66 biases in social stereotypes and attitudes, Hippocratic Oath, 497-498 169-171 Hispania, 480 clinical uncertainty, 167-169 Hispanic Americans, 87-88, 480-482 consequences of stereotypes, 171-172 defined, 32n, 34, 463, 523 functions of stereotypes and attitudes, 169 subgroups, 482 prejudice, 10-11, 162-174 Hispanic Colorectal Cancer Outreach and provider beliefs and stereotypes, 169 Education Project, 387 stereotypes and healthcare disparities, Hispanic Medical Association (HMA) , 421 172-174 Historical determinants, of contemporary Healthcare services, defined, 31 minority health professions Healthcare settings, 400 workforce, 105-108 influence on care for minority patients, Historical perspective, on inequities and 237-239 bias, 496-497 Healthcare systems-level factors, 8-9 Historical thinking, 496 Healthcare systems-level variables, 140-159 History of racial and ethnic disparities in availability and access to services, 143- healthcare, 102-103, 455-527 144 American Indians or Alaska Natives, fragmentation of healthcare systems, 477-478, 528-534 147-148 American racial and ethnic relations, language barriers, 141-143 458-460 legal and regulatory policy and Asian Americans or Pacific Islanders, healthcare disparities, 155-159 478-480 managed care revolution, 150-154 Blacks or African Americans (not of maneuvering through clinical Hispanic origin) Read the entire page →
From page 750... ... 750 INDEX HLA-based organ allocation, 436 Research Conference, 284 HMA. See Hispanic Medical Association Southwest Native American Cardiology Hmong language, 89, 386 Program, 389 HMOs. Read the entire page →
From page 751... ... 751 INDEX Institutionalized racism, 429, 494 cross-cultural education in the health defined, 523-524 professions, 19-20, 199-214 Insurance status of racial and ethnic findings summary, 19 minority populations, 83-87 health systems interventions, 15-18, 188 African Americans, 84-85 196 American Indians and Alaska Natives, legal, regulatory, and policy 85 interventions, 13-15, 181-188 Asian Americans and Pacific Islanders patient education and empowerment, (API) , 85-86 18-19, 196-198 health insurance coverage among Latino recommendations summary, 20-21 subgroups, 88 system strategies, 180-198 health insurance coverage by Asian- Into the Valley: Death and the Socialization of American and Pacific Islander Medical Students, 599 subgroups vs. Read the entire page →
From page 752... ... 752 INDEX Language access, 8, 141-143, 191, 393-395. healthcare providers, 89-90 See also Interpretation services Hispanics or Latinos, 88 addressing the critical financing linguistically isolated households, by challenge, 658-659 race and ethnicity, 89 developing a comprehensive, 657-660 Linnaeus, Carl, 499 developing research agenda on language Literature review, 5-6, 38-77, 271, 273, 285 access, 659-660 383, 632-637 encouraging innovation, 659 analgesia, 64-66, 290-295, 326-327 getting more foundations involved, 658 asthma, 62-63, 296-297 training providers on their obligation to cancer, 52-57, 298-305 provide language assistance cardiovascular disease, 39, 42-52, 306 services, 658 325, 328-329 Laotian language, 89 cerebrovascular disease, 57-58, 328-331 Laparoscopy, 425 children's health services, 68-69, 330-335 Latin American origins, 481 control over key clinical characteristics, Latino ("Spanish origin") Read the entire page →
From page 753... ... 753 INDEX M Medicaid payments per recipient by race, 680 Madison Hughes v. Shalala, 679n Medicaid MCOs, 217 Magnetic resonance imaging, 129 regulations for, 222 Mainstream, 455 Medical decisions, under time pressure, defined, 524 with limited information, 11-12, Malone-Heckler Report, 487 161-162 Mammography, 194 Medical Expenditure Panel Survey (MEPS) Read the entire page →
From page 754... ... 754 INDEX N Meriam Report, 477, 531 Merton, Robert K., 599 NAACP, 505 Metaracism, 494 NACHM. See National Advisory Mexican Americans, 87, 614 Commission on Health MI. Read the entire page →
From page 755... ... 755 INDEX National Institutes of Health (NIH) Read the entire page →
From page 756... ... 756 INDEX Opioid supplies, availability of, 8 evidence of race-concordance Oral Health Initiative, 389 consequences for the Other, the, 609 communication process, 574 "Overcompensation," 134 implications for physician training and Overuse of clinical services, by white patient activation to improve patients, 139-140 patient-physician communications within culturally diverse populations, 575-577 P nature and consequences of broad normative expectations, bias, and Pacific Business Group on Health, 711 racial stereotyping by providers Pacific Islander, 34 and patients, 556-557 defined, 34, 522 needed research, 577-579 Page Act of 1875, 459 physician role obligations and Paired testing strategies, 188n medicine's unwritten social Pap smears, 194 contract, 556 Paperwork Reduction Act, 217 relationship between communication Participation, of racial and ethnic style and patient satisfaction and minorities in health professions health outcomes, 574-575 education, 120-123 role and impact of patient Participatory decision-making (PDM) , 132, sociodemographics on medical 559, 572-574 communication, 562-572 Paternalistic racism, 493 role of cross-cultural training for Patient- and system-level factors, 125-159 healthcare professionals, 579-580 Patient education programs, implementing, role of physician sociodemographic 19, 21, 198 characteristics on the medical Patient-level variables, 7-8, 131-140, 237 dialogue, 558-564 biological differences that may justify scope of topic, 553-555 differences in receipt of care, 138- Patient sociodemographics 139 age, 565-567 minority patient mistrust and gender, 565 experiences of discrimination, health status, 569-570 135-136 literacy, 570-572 minority patient preferences regarding race and ethnicity, 562-565 providers and racial concordance, social class, 567-569 132-135 Patients overuse of clinical services by white appearance, 399 patients, 139-140 cost sharing by, 706-711 patient refusal of recommended as discretionary actors, 128 treatment, 136-138 economic/insurance status, 399-400 patients' preferences, 131-135 education and empowerment, 18-19, 196 role of preferences, treatment refusal, 198 and the clinical appropriateness of perceptions, 71-74, 358-359 care, 7-8 preferences, 131-135 Patient-provider communication, 552-593 protecting, 14-15, 186-187 consequence of race concordance on refusal of recommended treatment, 136 patient reports of physician 138 participatory decision-making response by, 12, 174-175 (PDM) Read the entire page →
From page 757... ... 757 INDEX Patients and Healers in the Context of Culture, Practice arrangements, of minority 607 physicians, 621 PCP. See Pneumocystis carinii pneumonia Pre-Columbian and North American PDM. Read the entire page →
From page 758... ... 758 INDEX North American health and health populations with equal access to care, 466-469 healthcare, 4, 33 pre-Columbian and North American relationship of health status to, 35-36 development, 466-467 relationship to broader racial attitudes perceptions of violence, involuntary and discrimination, 101-102 commitment, and diagnosis of revised standards for the classification of schizophrenia, 616-618 federal data on race and ethnicity, Race-discordant dyads, 574 34 Racial and Ethnic Approaches to their documentation in the U.S., 487-489 Community Health (REACH) , Racial and ethnic minority groups 386-387 defined, 32-33 Racial and ethnic disparities in healthcare share of the elderly population, 671 assessing potential sources of, 7-12 Racial attitudes assumptions, 3-4, 30-35 discrimination in the United States, 6-7 background and history, 455-527 relations, 91-95 bias, stereotyping, prejudice, and clinical Racial categories for federal data uncertainty on part of healthcare American Indian or Alaska Native, 34 providers contributing to, 12, 19, Asian, 34 178 Black or African American, 34 civil rights dimension of, 626-663 Native Hawaiian or other Pacific culture of medicine and, 594-625 Islander, 34 data collection and monitoring, 21-22, White, 34 215-234, 460-464 Racial discrimination, 95-101 defining, 3-4 in criminal justice, 100-101 diagnosis and treatment of, 417-454 minority youth in the juvenile justice ethical analysis of when and how they system, 100-101 matter, 722-738 defined, 95-96 evidence of, 5-6, 38-77 in employment, 100 existence and unacceptability of, 6, 19, 79 in housing, 96-100 federal-level and other initiatives to in mortgage lending, 96 address, 235, 384-391 Racial groups focus group findings, 392-405 defined, 525 global problem, 441-442 hierarchies, 490-493 health disparities and Medicare and Racial models, as tools for analysis and Medicaid administration, 681-693 understanding, 493-495 healthcare environment and its relation Racial profiling, the importance of data to, 80-124 collection, 654-655 impact of cost containment efforts on, Racism, 491 699-721 aversive, 494 importance of, 36-38 competitive, 493 interventions to eliminate, 13-20 dominative, 494 many sources contributing to, 12, 19, 159 ideological, 523 minority patients more likely than white individual, 493 patients to refuse treatment, 8, 19, institutionalized, 494 179 internalized, 494, 524 occurring in the context of broader paternalistic, 493 historic and contemporary social personally mediated, 494, 524 and economic inequality, 6-7, 19, scientific, 501, 504, 525 123 societal, 493 patient-provider communication, 552- Racism in Medicine: An Agenda for Change, 593 441 Read the entire page →
From page 759... ... 759 INDEX Radiographic services, 71-74, 129, 360-361 implementing multidisciplinary RAND criteria, 45, 48, 57, 139, 143, 149 treatment and preventive care RAND Health Insurance Survey, 702, 707, teams, 18, 21, 196 709-710 implementing patient education Rationing of healthcare for American programs to increase patients' Indians/Alaska Natives, 528-551 knowledge of how to best access addressing health disparities, 548 care and participate in treatment changes in the healthcare arena, 534-535 decisions, 19, 21, 198 compacting/contracting and including measures of racial and ethnic improvement in quality of care, disparities in performance 543-545 measurement, 21-22, 233-234 effect of discrimination on quality of care increasing awareness of racial and ethnic for tribal members, 545-548 differences in healthcare among healthcare dollars, 536-537 healthcare providers, 6, 20, 124 history of health disparities among increasing awareness of racial and ethnic American Indians/Alaska differences in healthcare among Natives, 528-534 the general public and key interviews, 539 stakeholders, 6, 20, 124 quality of healthcare received by tribal increasing the proportion of communities, 539-543 underrepresented U.S. racial and tribal/consumer perspectives, 537-539 ethnic minorities among health Rawls, John, 726-728 professionals, 14, 20, 186 REACH 2010. Read the entire page →
From page 760... ... 760 INDEX Redlining, 642-643 healthcare disparities among nonReducing Health Care Disparities National African American minority Project, 388 groups, 240 Reductionism, defined, 525 identification of successful interventions Reductionist thinking, 496 and programs in medical and Referral patterns, access to specialty care, nursing education, 621 145-146 improving research on healthcare Refusal of service, 174-175 disparities, 242-243 Registered nurse population, distribution influence of healthcare systems and in geographic areas by racial/ settings on care for minority ethnic background, 117 patients, 237-239 Rehabilitative services, 66, 360-363 monitoring healthcare disparities, 241 Relevance of causal stories, 729-736 patient-level influences on care, 237 brute luck and social structural political economy of cultural practices in Egalitarian views of causality, medicine, 621 732-734 practice arrangements of minority Libertarian views of the relevance of physicians, 621 causal explanations, 730-732 roles of non-physician health relevance of individual causal professionals, 239-240 responsibility, 734-736 studies of DoD and VA systems, 238 Renaissance, 499 studies within healthcare plans, 237-238 Renal disease, 30, 435-437 types of hospital or clinic and racial and Renal transplantation, 58-60, 362-365, 435- ethnic disparities in care, 238-239 437 Respect, lack of, 396-397 Reporting data on healthcare access and Retrenchment era in healthcare, 507-508 utilization, by patient race, Revascularization, 74, 427 ethnicity, socioeconomic status, Revised standards for the classification of and primary language, 21-22, 233 federal data on race and ethnicity, Reporting racial and ethnic data by 34 federally defined categories, 21- Revolutionary War, 470, 489 22, 234 Robert Wood Johnson Foundation, 421, 620 Reporting racial and ethnic disparities Roman Empire, 498 using existing data sets, 231-232 Republican period, 501 S Research needed, 22-23, 235-243, 619-621 assessment of program successes Sacher, David, 611, 620 redressing imbalances in care, 621 St. Francis Hospital, 485 changes in the ethnicity and race of St. Read the entire page →
From page 761... ... 761 INDEX Scientific racism, 501, 504 Sources of medical care, those having no defined, 525 usual, 109 Search keywords, 40 Sources of racial and ethnic disparities in Segregation, contemporary de facto, 103-108 healthcare Sen, Amartya, 728 assessing potential, 7-12 Service use, 71-74, 364-377 clinical encounter, 160-179 SES. See Socioeconomic status clinical uncertainty, 9 Settings in which racial and ethnic healthcare provider prejudice or bias, 10 minorities receive healthcare, 108- 11 114 healthcare systems-level factors, 8-9 impact of community health centers on implicit nature of stereotypes, 10 healthcare in minority and medical decisions under time pressure medically underserved areas, 112, with limited information, 11-12 114 patient- and system-level factors, 125-159 primary care visits made to primary care patient-level variables, 7-8 delivery sites by health insurance patient response, 12 payer and race/ethnicity, 113 role of bias, stereotyping, and site of care in hospital settings, 110 uncertainty, 9-12 site of care in non-hospital facilities, 111 Southwest Native American Cardiology site of usual source of care, by health Program, 389 insurance payer and race/ Sowell, Thomas, 496 ethnicity, 111 Spanish heritage, 480-481, 564 those having no usual source of medical "Spanish Language and Cultural care, 109 Competence Curriculum," 209 Shalala, Donna, 626, 657, 659 Special Programs Development Branch, 391 SHIRE. Read the entire page →
From page 762... ... 762 INDEX STC. See Standards, Training and Community Action Grant Program, 390 Certification Committee pocket guide and desk reference, 390 Stereotypes Special Programs Development Branch, defined, 475, 525 391 effect of, 392-393 specialized HIV/AIDS outreach and healthcare disparities, 172-174 substance abuse treatment, 390 implicit nature of, 10 standards of mental healthcare for minority, defined, 524 Latinos, 390 Stinson, Nathan, 528 Summit Health Institute for Research and Stories about misdiagnosis or improper Education, Inc. Read the entire page →
From page 763... ... 763 INDEX Title VI, 157, 159, 188, 192, 221, 628-631, Understanding and Eliminating Minority 637-641, 668, 679. See also Civil Health Disparities Initiative, 386 Rights Act Unfulfilled potential of Title VI, 157-159 access to medical treatment, 645-647 United Hospital Fund, 658 discrimination concerns unique to United Network for Organ Sharing, 436 immigrant populations, 647-649 United States-United Kingdom enforcement history and the types of Collaborative Initiative on Racial discrimination, 638-649 and Ethnic Health, 441 intentional discrimination, 639-640 United States v. Read the entire page →
From page 764... ... 764 INDEX V Healthy People 2000, 226 HHS-wide initiatives, 384-385 Vaccination, 71-74, 374-375 Indian Health Service (IHS) , 389 Van Ryn, Michelle, 635 Minority HIV/AIDS initiative, 384-385 Veterans Administration (VA) Read the entire page →

From page 739...

... Index A African Moors, 498 Agassiz, Louis, 501 AAHP. See American Association of Health Age-adjusted death rates Plans for all causes of death by race and AAMC.