Racial and ethnic disparities in the use of health services: bias, preferences, or poor communication?
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.
Ashton
Carol M
CM
Baylor College of Medicine, Houston, Tex, USA. cashton@bcm.tmc.edu
Haidet
Paul
P
Paterniti
Debora A
DA
Collins
Tracie C
TC
Gordon
Howard S
HS
O'Malley
Kimberly
K
Petersen
Laura A
LA
Sharf
Barbara F
BF
Suarez-Almazor
Maria E
ME
Wray
Nelda P
NP
Street
Richard L
RL
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