Using facts to fight health disparities

The struggle against racism in the U.S. health system continues even in these terrible times of the Bush administration and the right-wing controlled Congress.

Standardized data collection is critical to understanding and eliminating racial and ethnic disparities in health care, according to the Institute of Medicine.

The IOM is an important quasi-governmental organization that brings together respected U.S. medical and public health professionals to analyze, discuss and issue reports that are supposed to affect public policy.

A few years ago they took on the goal of eliminating or curtailing the worst healthcare abuses of patients due to their race or ethnicity.

Now comes a major new study by the prestigious Commonwealth Fund, which says, “A critical barrier to eliminating disparities and improving the quality of patient care is the frequent lack of even the most basic data on race, ethnicity, and primary language of patients within health care organizations [mostly hospitals].”

The report is titled “Who, When and How: The Current State of Race, Ethnicity, and Primary Language Data Collection in Hospitals, May 2004.”



Importance of the law

In its 2002 report, the IOM found that far and away the most important reason hospitals collect race and ethnic data is that they are legally bound to. In their survey, 42 percent of these responding cited legal requirements as the reason they collected this data. In other words, to make sure this kind of data is collected, there must be a law requiring that collection.



U.S. Census categories not used

Incredible as it may sound, according to both the IOM and Commonwealth Fund, hospitals by and large did not use the most convenient categories for race and ethnicity, that is, the U.S. Census method.

The need for a standardized method of collecting national data would dictate the use of the Census methods.



Racism in health care

Black communities do not receive the level of physician and hospital care that the rest of a city or state receives. Combined with class issues, it is no wonder that mortality of infants and older Black Americans reflect a lower standard of health. Infant mortality for Black families is twice that of other families. Longevity of Black males is a woeful 61 years of age compared to 68 for white males. For white females, longevity is well in the upper 70s, while for Black females it is only about 68.



Recommendations

A new national administration in the White House and Congress would do well to make sure that qualified public officials are employed in data collection. The Commonwealth Fund recommends these officials not rely on the personal observations of intake personnel to determine race and ethnicity, a practice that takes place all too often, and that a standardized data collection system for all hospitals in the U.S. be established. The U.S. Census should be used as the basis of categories for race and ethnicity. Following these simple steps could make a big difference in the allocation of federal health dollars.



Attack on data collection

The recent rejection by voters in California of the racist proposal to drop all racial identifiers does not mean that the effort by the right wing will end. Racism is alive in the ultra-right and its think tanks. Correcting the delivery of health care by first making sure that Black, Latin and other racially and ethnically oppressed people get equal health care is the road to go.

Given the level of awareness, technology and need, this goal is achievable. But, it requires a change in the current administration and its biased way of making decisions.

The author can be reached at pww@pww.org.