Disparities in health care based on racial bias is a problem and striving toward equity remains a challenge.
That was the theme of New Jersey native Dr. Tiffani Johnson’s keynote address at the New Jersey Health Care Quality Institute’s Annual Meeting & Spring All Council Conference in Trenton on May 21.
Johnson, a faculty member at PolicyLab at Children’s Hospital of Philadelphia (CHOP), said that disparities in health care and unequal treatment of patients based on race continues to grow.
“Racial and ethnic disparities in children’s health care are quite extensive, pervasive and persistent and individuals who report discrimination in health care are more likely to have emotional distress, depressive symptoms, stress and anxiety,” said Johnson.
Pediatric patients also demonstrated poor self-reported health status, hypertension, cardiovascular disease, high cortisol levels, poor glucose regulation, weakened immune system, and difficulties with memory and concentration.
Johnson, an assistant professor of pediatrics in the division of emergency medicine at CHOP, cited research indicating that a black woman is 22 percent more likely to die from heart disease, 71 percent more likely to die from cervical cancer and 243 percent more likely to have pregnancy and childbirth-related problems.
Reducing disparities based on social factors may improve health care quality more than marginal improvements in overall medical care.
She said that bias, stereotyping, prejudice and clinical uncertainty on the part of health care providers may contribute to racial and ethnic disparities in health care.
“Different populations need different resources in order to give them better access to those opportunities to achieve their highest level of health and well-being and health equity requires us to evaluate everyone equally in order to eliminate health care disparities.”
In addition, racial bias in pain assessment and treatment recommendations and false beliefs about biological differences between blacks and whites is not uncommon.
Johnson said that physicians with higher implicit bias demonstrate among other things: less interpersonal treatment, less supportive communication, and poorer patient ratings of satisfaction.
“Reducing disparities based on social factors may improve health care quality more than marginal improvements in overall medical care.”
Johnson recommended collecting data on race, ethnicity and preferred language and making sure that it is documented across the organization and making equity and disparity issues an integral component of quality improvement efforts.
She said that studies show that greater diversity in the medical student body was associated with the students endorsing health equity.
Johnson said that the goal of attaining the highest level of health for all requires valuing everyone equally; eliminating health and health care disparities; measuring health not only by lack of disease but also by access to opportunities.