Minority Health Archive

Race and healthcare disparities: overcoming vulnerablity.

Stone, John (2002) Race and healthcare disparities: overcoming vulnerablity. Theoretical medicine and bioethics, 23 (6). pp. 499-518. ISSN 1386-7415

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Abstract

The paper summarizes recently published data and recommendations about healthcare disparities experienced by African Americans who have Medicare or other healthcare coverage. Against this background the paper addresses the ethics of such disparities and how disadvantages of vulnerable populations like African Americans are typically maintained in decision making about how to respond to such disparities. Considering how to respond to disparities reveals much that vulnerable populations would bring to the policy-making table, if they can also be heard when they get there. The paper argues that vulnerable populations like African Americans need fair representation in bodies deciding what to do about such disparities and that fairness requires proportional representation at all levels of decisions that affect healthcare--a radical change. In this decision setting, how to provide adequate protection of minorities needs much further attention. The most attractive decision-making model is deliberative democracy. The paper shows that in deliberation, fair representation requires not only having a voice in decisions, but a fair hearing of those voices. Achieving a fair hearing requires changes in norms of communication and training of all to give importance to greetings and other measures of civility and trust building, and to be open to diverse forms of expression. Decisions about how to respond to healthcare disparities would include what programs to initiate for whom, how to evaluate the programs, and what to do in response to such evaluations. Conclusions are that achieving such goals will take a sea change in how healthcare institutions and providers do their business, and that social activism at every level will be needed to effect these changes. The discussion highlights many ethical issues that need much greater attention.


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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: African Americans - beneficence - communication - diversity - fair equality of opportunity - health disparities - healthcare disparities - justice - Institute of Medicine - racism - respect for persons - socioeconomic class - voice - vulnerable population
Subjects: Health > Health Equity > Access To Healthcare
Health > Health Equity > Bioethics
Health > Disparities
Health > Policy
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Depositing User: Users 141 not found.
Date Deposited: 28 Jul 2011 16:40
Last Modified: 28 Jul 2011 16:40
Link to this item (URI): http://health-equity.pitt.edu/id/eprint/2917

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