Physician Beliefs Concerning Structural and Institutional Racism in Health Care

2021 ◽  
pp. 13-18
Author(s):  
William Ciurylo ◽  
Carol Brenner ◽  
Victoria Stacey Thieme
Keyword(s):  
Health Care ◽  
African Americans ◽  
New England ◽  
Health Care System ◽  
Perceived Discrimination ◽  
Perceived Quality Of Care ◽  
College Of Osteopathic Medicine ◽  
Systemic Health ◽  
The University ◽  
Care System

Perceived discrimination in medical settings remains prevalent within the U.S. health care system. However, the details of these experiences and their associations with perceived quality of care are not well understood. This study evaluates any potential difference in African Americans' systemic health care discrimination and Latinx perceived by African American and Latinx patients and physicians. The New England physician alumni from the University of New England College of Osteopathic Medicine were sent surveys. Two hundred fifty-one practicing physicians' responses to the 2018 study address their beliefs toward African Americans and Latinx' racism within the health care system. High scores indicate more significant perceived discrimination among these groups. Physicians have lower discriminatory belief scores across gender, patient racial distribution and specialty.

Should Screening Programs Be Perfect?

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 301-301
Author(s):  
PHILIP R. WYATT
Keyword(s):  
United States ◽  
Health Care ◽  
Early Detection ◽  
New England ◽  
Health Care System ◽  
The United States ◽  
Neonatal Hypothyroidism ◽  
Screening Programs ◽  
Care System

To the Editor.— The report of the New England Regional Screening Program1 on neonatal hypothyroidism is a stunning illustration of the vulnerability of screening programs. It is unfortunate that this experience will probably be used as an argument to minimize the input of screening programs in the health care system in the United States. The report illustrates that, in addition to the 2% of the screened population that eluded the program, 14 infants with hypothyroidism escaped the full benefits of early detection and treatment.

scholarly journals Are persons with a limited health literacy less satisfied with the German health care system?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Achstetter ◽  
J Köppen ◽  
M Blümel ◽  
R Busse
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Literacy ◽  
Health Care System ◽  
Medical Errors ◽  
Private Health Insurance ◽  
Perceived Discrimination ◽  
German Health Care System ◽  
German Health ◽  
Care System

Abstract Background Health literacy (HL) is the ability to find, understand, appraise and apply health information with the aim of using this information to make decisions affecting the own health. Previous studies showed limited HL in around 50% of the German population. The assessment of the German health care system from the perspective of persons with limited HL is subject of this study. Methods In 2018, a survey was conducted among 20,000 persons with private health insurance in Germany. Survey items were based on the intermediate and final goals of the WHO Health Systems Framework. Questions comprised, for example, satisfaction with the health care system, responsiveness (e.g. perceived discrimination), access (e.g. off-hour care), and safety (e.g. medical errors). HL was assessed with the HLS-EU-Q16 questionnaire. Descriptive statistics and Chi-square test were used to analyze the data and group differences. Results Overall, 3,601 participants (18.0%) completed the survey (58.6 years ± 14.6; 64.6% male). Limited HL was seen with 44.6% (8.5% inadequate & 36.1% problematic), whereas 55.4% did not report limited HL (43.4% sufficient & 12.0% excellent). Very satisfied with the German health care system were 6.5% of the persons with limited HL (vs. 14.3%). Perceived discrimination within the last 12 months was reported by 11.0% of the persons with limited HL (vs. 5.1%). To get medical care on weekends, holidays or evenings outside hospitals was rated as “very hard” by 34.6% of the persons with limited HL (vs. 23.6%). The feeling that they experienced medical errors was reported by 18.7% with limited HL (vs. 11.5%) and 5.9% were unsure (vs. 2.2%). All results were statistically significant (p < 0.001). Conclusions Persons with limited HL were less satisfied with the overall German health care system in comparison to persons with not limited HL and reported more often perceived discrimination. Strengthening HL could help to improve satisfaction with the health care system. Key messages Limited HL among persons with private health insurance in Germany was found in 44.6% of the survey’s participants. Persons with limited HL indicated to be less satisfied with the German health care system and perceived more often discrimination in their health care.

scholarly journals Examining the Role of Family History of US Enslavement in Health Care System Distrust Today

2021 ◽  
Vol 31 (3) ◽  
pp. 417-424
Author(s):  
Lorraine T. Dean ◽  
Genee S. Smith
Keyword(s):  
Health Care ◽  
African American ◽  
Family History ◽  
African Americans ◽  
Health Care System ◽  
The United States ◽  
Black African ◽  
The Us ◽  
History Of ◽  
Care System

Objective: Black/African American people have long reported high, albeit warranted, distrust of the US health care system (HCS); however, Blacks/African Americans are not a homogenous racial/ethnic group. Little in­formation is available on how the subgroup of Black Americans whose families suffered under US chattel slavery, here called De­scendants of Africans Enslaved in the United States (DAEUS), view health care institu­tions. We compared knowledge of unethical treatment and HCS distrust among DAEUS and non-DAEUS.Design and Setting: A cross-sectional random-digit dialing survey was adminis­tered in 2005 to Blacks/African Americans, aged 21-75 years, from the University of Pennsylvania Clinical Practices in Philadel­phia, Penn.Participants: Blacks/African Americans self-reported a family history of persons enslaved in the US (DAEUS) or no family history of persons enslaved in the US (non- DAEUS).Main Outcome Measures: HCS distrust was measured by a validated scale assessing perceptions of unethical experimentation and active or passive discrimination.Methods: We compared responses to the HCS distrust scale using Fisher’s exact and t-tests.Results: Of 89 respondents, 57% self-re­ported being DAEUS. A greater percentage of DAEUS reported knowledge of unethical treatment than non-DAEUS (56% vs 21%; P<.001), were significantly more likely to express distrust, and to endorse the pres­ence of covert (eg, insurance-based) than overt forms (eg, race-based) of discrimina­tion by the HCS.Conclusions: DAEUS express greater HCS distrust than non-DAEUS, patterned by awareness of unethical treatment and passive discrimination. Understanding how long-term exposure to US institutions influ­ences health is critical to resolving dispari­ties for all Black/African American groups. Rectifying past injustices through repara­tive institutional measures may improve DAEUS’ trust and engagement with the US HCS.Ethn Dis. 2021:31(3):417-424; doi:10.18865/ed.31.3.417

scholarly journals Ideology, change and conflict

2004 ◽  
Vol 28 (1) ◽  
pp. 110
Author(s):  
Colin Grant
Keyword(s):  
Health Care ◽  
Hong Kong ◽  
Health Care System ◽  
Source Book ◽  
Australian Health ◽  
South Wales ◽  
Long Time ◽  
Data Book ◽  
The University ◽  
Care System

Background ? or product disclaimer It is a long time since my very brief tenure as editor of Australian Health Review came to an end. Not, though, as long ago as I had thought! Swift recourse to an old c.v. shows it was in 1993 that I left the University of New South Wales to become a Visiting Fellow in Hong Kong and teach more or less the same sorts of health and management subjects which I had taught in Sydney, and compile, with Peter Yuen, a ground-breaking source book on the Hong Kong health care system that looks uncannily like the sort of data book that I was prone to write with the inestimable Helen Lapsley about our Australian system. Perhaps in making a charm-laden invitation to contribute something to AHR, Allan Hughes might have thought I would produce some dazzling synthesis of contrasts and comparisons between the two systems. But I doubt that he would have been even momentarily so unrealistic. My move to Hong Kong gave me the chance to extricate myself from following the tortuous development of our system. In turn my departure from that maddening, bustling and exciting city a couple of weeks after the Hand-over (Glorious Re-unification or Great Take-Away) left me rapidly out of touch with their health care system too.

Health consequences of alcohol abuse on the example of patients of the Emergency Department at the University Hospital in Bialystok

2020 ◽  
Vol 7 (4) ◽  
pp. 272-277
Author(s):  
Sylwia Jabłońska ◽  
Paulina Bakier ◽  
Mateusz Lech ◽  
Rafał Milewski ◽  
Jerzy Robert Ładny ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care System ◽  
Emergency Departments ◽  
Laboratory Tests ◽  
Alcohol Concentration ◽  
University Hospital ◽  
Blood Alcohol ◽  
The University ◽  
Care System

The aim: To assess patients admitted to the Emergency Department requiring hospitalization in whom the presence of alcohol has been stated in laboratory tests. Material and methods: The study was conducted on the basis of medical documentation analysis of 134 patients treated in Emergency Department in whom blood alcohol has been stated. The study included: sociodemographic data, blood alcohol concentration, the reason for hospitalization, the average duration of hospitalization and the patient’s future. Results: Retrospective study was based on medical records of134patients treated in the Emergency Department of the University Hospital in Bialystok from 01/01/2016 to 01/06/2016.The analysis took into account patients whose laboratory tests results showed an alcohol concentration above 0.004 ‰.The most common reason for hospitalization for examined patients was alcohol intoxicationa 26%.For 25% of examined patients, the cause of hospitalization was alcohol addiction syndrome, 19%drug poisoning,13% gastrointestinal bleeding. Almost 20% of patients was hospitalized in the Emergency Department with multiple injuries. Conclusions: The majority of patients hospitalized in Emergency Departments are patients under the influence of alcohol. Such patients are a cause of Emergency Departments overload, which are not efficient due to the number of patients who use the services of EDs instead primary healthcare facilities. Other causes of hospitalization of alcoholic patients are associated with constant exposure to alcohol. Such situation suggests changes in the health care system which would relieve EDs and involve other units of the health care system. The system should focus on education and treatment of patients by non-invasive methods, i.e. psychotherapy or other psychological help.

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