Healthcare Disparities at the Crossroads with Healthcare Reform

Article excerpt

Healthcare Disparities at the Crossroads with Healthcare Reform. Richard Allen Williams (ed.). New York, N.Y.: Springer Publishing Co. 2011. 445 pp. $79.95.

The need and drive to eliminate health disparities continue to be major priorities in public health and health care. Despite being a goal of Healthy People 2010 for the 10 years leading up to 2010, disparities in health outcomes remain a major concern for public health professionals. The book, Healthcare Disparities at the Crossroads with Healthcare Reform, takes a closer look at the issues causing disparities within the health care system. The book presents an in-depth history of the disparities and treatment of underrepresented minorities, offers compelling data on health disparities, and provides examples of ways to eliminate health disparities in the U.S. health care system.

In "Part I: Underlying Causes of Healthcare Disparities," chapter authors give an overview of the epidemiological data and demographics of race and ethnic health disparities in the United States. Issues covered include life expectancy disparities, leading causes of death, and historical perspectives on race and racism dating back to the time of slavery in the United States. Throughout these chapters there are references to the Institute of Medicine's Report on Health Disparities and Healthy People 2010. Overall, these chapters present a review of data and situations described in a myriad of other places.

The chapter authors investigate the underlying causes of health disparities in "Part II: Current Problems." Issues addressed and described include patient-provider communications, differences in medical management, patients' perceptions of discrimination by health care workers, the disparity of underrepresented minorities in the health care workforce, and the near absence of minorities in clinical trial research. These last two issues, the authors point out, have a direct impact on racial and ethnic health disparities because without full representation in the workforce or in clinical trials, minority patients are not comfortable seeking care nor are treatments designed specifically for them.

The final section, "Part III: Approaches to Correcting the Problem," includes the most number of chapters and the book's most current and interesting information. The authors of these chapters attempt to address all of the challenges described earlier by elucidating the problem of health care disparities. This section presents novel ideas to eliminate disparities. Chapter 10, written by the book's editor, Richard Allen Williams, discusses the Patient Protection and Affordable Care Act in one of the most complete ways yet in the literature. The chapter outlines specific ACA provisions that relate to opportunities to increase health equity, such as increasing health literacy, provisions for American Indians/Alaskan Natives, and a greater focus on minority health. …