Insights in the Economics of Aging
Chandra A, Hoppenfeld T, Skinner J
There is a vast literature documenting the presence of pervasive racial disparities in U.S. health care (IOM, 2002). More recently, researchers have studied changes over time in the extent of racial and socioeconomic disparities, to test whether the public focus on disparities in health care has led to fundamental changes in practice styles, improved sensitivity by health care providers to different cultural norms, and less biased treatment and outcome decisions. In many cases, there has been a notable reduction in the magnitude of disparities in treatment and the use of “effective” care (Trivedi et al., 2005; Trivedi et al., 2011; Jha et al., 2005). There is less progress, however, with respect to racial disparities in overall health outcomes (e.g. Cutler and Meara, 2008).
How can this puzzle be explained? Many efforts to address disparities have focused on how physicians treat patients of different races and ethnicities. For example, the public knowledge that stenting rates for Black patients are so much lower than those for white patients could lead to cardiologists at the margin to question their decisions not to provide stents to their Black patients. An increasing share of minority health professionals could also lead to a decline in the extent of disparities in treatments of diverse patient populations. Over a sufficiently lengthy period of time, we might expect to see a convergence in treatment patterns as a result of efforts to reduce both implicit and explicit biases in health care within the hospital.