Identifying Issues of Disparity

In 2003 the Institute of Medicine (IOM) was charged by Congress to examine racial and ethnic disparities in health care. Their landmark report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare,” brought the issue of health care disparities to national attention. The report concluded that “Racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities, even when access-related factors, such as patients’ insurance status and income, were controlled.” The report defined disparities as “racial or ethnic differences in the quality of healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention.” According to the U.S. Census Bureau, there are currently more than 300 million Americans: 65% white, 16% Hispanic, 13% black, 5% Asian, and 1% American Indian. Yet according to a report by the American Medical Association, only 6.4% of practicing physicians are Hispanic and 4.5% are black. Recognizing the changing patient demographics and the unchanging demographics of the physician workforce, the Association of American Medical Colleges (AAMC) Executive Council adopted a definition of underrepresented in medicine (URM) as “those racial and ethnic populations that are under-represented in the medical profession relative to their numbers in the general population.” Before this, the AAMC used the term “under-represented minority,” which specifically targeted African Americans, Mexican Americans, Native Americans, and mainland Puerto Ricans. A much broader definition of diversity includes race, ethnicity, socioeconomic status, sexual orientation, religion, disability, age, language, and geographic diversity.