title: Racial and Ethnic Disparities in the Quality of Health Care.
abstract: The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities.
authors.affiliation: Departments of Family Medicine and Public Health Sciences, University of Rochester Medical Center, Rochester, New York 14620; email: Kevin_Fiscella@urmc.rochester.edu.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.affiliation: Departments of Family Medicine and Public Health Sciences, University of Rochester Medical Center, Rochester, New York 14620; email: Kevin_Fiscella@urmc.rochester.edu.
authors.forename: Mechelle R
authors.initials: MR
authors.lastname: Sanders
mesh_terms: D002908:Chronic Disease / Q000208:ethnology / Q000517:prevention & control; D005006:Ethnicity; D006297:Health Services Accessibility; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006760:Hospitalization / Q000331:legislation & jurisprudence; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000458:organization & administration; D011315:Preventive Medicine / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D044469:Racial Groups; D063505:Racism; D012959:Socioeconomic Factors
keywords: ethnicity; health care disparities; health care quality; public health; race