While the health care reform debate in the United States has been dominated on lowering the cost of health insurance, other health care activists and experts are working behind the scenes to lower barriers to quality health care for African-Americans and Hispanics. One well-respected figure says the key is bringing more minorities into the profession.
Numerous studies indicate African-Americans and Hispanics receive a poorer quality of health care than non-Hispanic whites, even when they have the same levels of income and health insurance coverage. Researchers say the reasons for this disparity include stereotyping of patients by health care providers, and a severe shortage of minority health care professionals.
Dr. Louis Sullivan says minority health care professionals fill a key role in serving ethnic communities. "There are studies that have shown that African American physicians and Hispanic American physicians are three to five times more likely to establish their practices in African American or Hispanic American communities," he said.
Sullivan, who once served as secretary of the U.S. Department of Health and Human Services, says minority physicians see a higher percentage of patients with either no insurance, or covered by Medicaid, the government insurance program for low-income Americans.
He says these factors improve the chances for providing quality health care, because of the shared identity between doctor and patient.
"What happens with the health outcome, depends upon good communication, the trust and credibility between the health professional and the individual seeking care, and an understanding of the patient's culture, value system, so that one can develop, hopefully, a strong relationship or interaction between the health professional and the individual," Dr. Sullivan explained. "Otherwise what we see resulting are a lack of compliance, people not returning for appointments, not filling prescriptions, not doing a number of things they should be doing as part of the health exchange.
Consideration of a minority patient's language, customs and beliefs by virtue of their heritage is a concept known as cultural competency. Sullivan, who also served as dean of the historically African-American Morehouse College School of Medicine, says medical schools are beginning to incorporate this concept in educating and training the next generation of health care professionals, regardless of their race.
"It will be decades before our health care system truly mirrors the makeup of our general population," Dr. Sullivan said. "So yes, we want all of our physicians, white, African American, Latino, what have you, to be culturally competent."
Dr. Sullivan says there will be a chronic shortage of doctors in the country as a whole, as more medical schools transform from training and education, into medical research.