More needs to be done to understand and address disparities and discrimination in health and health care that negatively impact racial, ethnic, religious, and cultural communities and people in the United States, ACP stated in a policy paper.
ACP's policy paper was published Jan. 12 by Annals of Internal Medicine and includes recommendations that U.S. policymakers address disparities in health and health care to enhance the quality and effectiveness of health care for all. Policymakers should comprehensively address the interconnected contributors to such disparities, including the role of racism, discrimination, lack of coverage and access to care, poverty, and other social drivers of health, the paper stated. Clinicians and medical students also have a role in using patient-centered and culturally appropriate approaches to create a trusted health care system, according to the paper.
A series of 15 additional recommendations discuss specific contributors to disparities and steps that could be taken to help improve them, including the following.
- Public policy must support efforts to acknowledge, address, and manage preconceived perceptions and implicit biases by physicians and other clinicians.
- Health care facilities and medical schools and their clinicians and students should use patient-centered and culturally appropriate approaches to create a trusted health care system free of unjust and discriminatory practices.
- Policymakers must strengthen U.S. education to improve health, health literacy, and diversity in medical education and in the physician workforce. Policies should address the disproportionate adverse effect of discrimination and inequitable financing in education on specific communities.
- Policymakers should consider discrimination and hate against any person on the basis of personal characteristics as a public health crisis.
- Policymakers should address the effect of social drivers of health, like poverty, on the health and health care of those affected, while addressing disparities associated with personal characteristics independent of, or in addition to, socioeconomic status.
ACP further proposed specific policy recommendations to address the issue in education and the health care workforce, for specific populations, and in criminal justice practices in a related series of three position papers published on ACPOnline.org. “Understanding and Addressing Disparities and Discrimination in Education and in the Physician Workforce: A Policy Paper From the American College of Physicians” offers recommendations to create safe, inclusive, and supportive educational and workplace environments.
“Understanding and Addressing Disparities and Discrimination Affecting the Health and Health Care of Persons and Populations at Highest Risk: A Policy Paper From the American College of Physicians” makes recommendations to address disparities in coverage, access, and quality of care for racial and ethnic minorities.
“Understanding and Addressing Disparities and Discrimination in Law Enforcement and Criminal Justice Affecting the Health of At-Risk Persons and Populations: A Policy Paper From the American College of Physicians” calls for changes to criminal justice and law enforcement policies and practices that result in racial and ethnic disparities in interactions, sentencing, and incarceration as well as disproportionate harm to these communities.
“We believe that, taken together, these 4 papers provide a comprehensive and interconnected set of policies to address some of the most pressing issues throughout society that contribute to health disparities based on race, ethnicity, religion, and cultural characteristics and identities,” the position paper stated.