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Improvement of Minority Health Subject of Hearing

A bill (H.R. 3250) aimed at improving the quality of health care for minorities was the focus of a hearing held on May 11 by the House Commerce Subcommittee on Health and the Environment. Sponsored by Rep. Bennie Thompson (D-MS), the Health Care Fairness Act would:

  • establish a National Center for Research on Minority Health and Health Disparities at the National Institutes of Health (NIH);
  • establish a National Center for Excellence Research Education on Health Disparities and Training at the NIH;
  • require the Agency for Health Research and Quality to conduct research on how to improve the quality and outcomes of health care services for minority populations and the causes of health disparities;
  • require the National Academy of Sciences to study the data collection systems of the Department of Health and Human Services (HHS) with respect to race and ethnicity.

The hearing’s witnesses were supportive of the bill. Surgeon General David Satcher commented on national health statistics, saying, “Despite notable progress in the overall health of the nation, there are continuing disparities in the burden of illness and death experienced by African-Americans, Hispanics, American Indians, Alaska Natives, and Asian Pacific Islanders, compared to the U.S. population as a whole.”

Dr. Satcher emphasized the role of the HHS Office for Civil Rights (OCR), saying that addressing racial health disparities “is both a civil rights and a public health challenge.” He referred to several recent OCR cases, saying they “illustrate that discrimination regrettably is alive and well in the health care setting.”

Dr. Louis Sullivan of the Morehouse School of Medicine—and former Secretary of HHS—referred to a study by the Institute of Medicine, which revealed “that the culture, the structure, and programs of NIH as a whole serve the majority population well, but fall short in addressing the needs of our nation’s minority populations.” He praised H.R. 3250, saying, “Anything less than these improvements will once again leave us wringing our hands over the widening gap in the health status of a segment of our population that, in a few decades, will comprise the majority of people in this country.”

Dr. Kevin Schulman described a study he conducted with some colleagues, which was published last year in the New England Journal of Medicine. Among other findings, he said, the study “found that for identical patients, physicians were less likely to refer blacks compared to whites, and women compared to men, for cardiac catheterization; the lowest referral rates were for black women.” He added: “In this carefully controlled experiment, we were able to demonstrate that patients’ characteristics influence physicians’ recommendations for cardiac catheterization.” He cited several other studies with similar conclusions.