title: Racial and ethnic disparities in the use of health services: bias, preferences, or poor communication?
abstract: African Americans and Latinos use services that require a doctor's order at lower rates than do whites. Racial bias and patient preferences contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and health behaviors. Research has shown that doctors have poorer communication with minority patients than with others, but problems in doctor-patient communication have received little attention as a potential cause, a remediable one, of health disparities. We evaluate the evidence that poor communication is a cause of disparities and propose some remedies drawn from the communication sciences.
authors.affiliation: Baylor College of Medicine, Houston, Tex, USA. cashton@bcm.tmc.edu
authors.forename: Carol M
authors.initials: CM
authors.lastname: Ashton
authors.forename: Paul
authors.initials: P
authors.lastname: Haidet
authors.forename: Debora A
authors.initials: DA
authors.lastname: Paterniti
authors.forename: Tracie C
authors.initials: TC
authors.lastname: Collins
authors.forename: Howard S
authors.initials: HS
authors.lastname: Gordon
authors.forename: Kimberly
authors.initials: K
authors.lastname: O'Malley
authors.forename: Laura A
authors.initials: LA
authors.lastname: Petersen
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Sharf
authors.forename: Maria E
authors.initials: ME
authors.lastname: Suarez-Almazor
authors.forename: Nelda P
authors.initials: NP
authors.lastname: Wray
authors.forename: Richard L
authors.initials: RL
authors.lastname: Street
mesh_terms: D001741:Black or African American; D003142:Communication; D003657:Decision Making; D006296:Health Services / Q000706:statistics & numerical data*; D006630:Hispanic or Latino; D006801:Humans; D008913:Minority Groups; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010817:Physician-Patient Relations; D044465:White People