The men who least trusted. In the United States, black patients in particular have one of the worst health outcomes, and black men have the lowest life expectancy of any demographic group. A number of factors contribute to these health disparities, but one problem has been the lack of diversity among physicians. African Americans make up 13% of the U.
S., but only 4% of U. S. physicians and less than 7% of U. medical students are black.
A new NBER study looks at how changing this ratio could improve health outcomes and save lives. Researchers organized an experiment in which black male patients were randomly assigned to black or non-black male doctors, to see if having a doctor of their race affected patients' decisions about preventive care. They found that black men seen by black doctors accepted more, and more invasive, preventive services than those seen by non-black doctors. And this effect seemed to be driven by better communication and more trust. Coronavirus is infecting African Americans at a rate three times that of white Americans and is killing them twice as many times.
When patients have a choice, they are likely to choose a doctor of the same race or ethnicity and are more likely to be satisfied with their care, says a study in the New England Journal of Medicine. In addition, the 1982 analysis comparing early and later graduation cohorts suggests that the most recent graduates reported caring for or planning to care for a higher percentage of black patients than previous graduates. Patients who could choose their doctor were more likely to be of the same race as the doctor, compared to patients who could not choose. Black students also face a shortage of mentors who share similar life experiences; less than 3 percent of U. medical school faculty are black.
Still, reducing prejudice in healthcare requires fostering a more diverse medical community and providing more educational, financial, and mentoring resources for Black students can help make it happen. Connecting survey responses to people's results revealed that the same people who had experienced the most discrimination and were most concerned about experiencing it again were the same people who showed the greatest reduction in pain levels when consulted by a black doctor. And it has been argued that sharing a racial or cultural background with the doctor helps promote communication and trust. In the United States, black women are three to four times more likely to die from pregnancy-related causes than white women. But that's not the case in the United States, and a lack of diversity among doctors can mean the difference between life and death for black patients. For example, participants assigned to black doctors were more likely to have their blood pressure and BMI measured than those who saw non-black doctors. One way to reduce health disparities is to increase the likelihood that minorities will see doctors of their race or ethnicity, which I call racial and ethnic agreement between patient and provider. The authors suggest that patients choose a doctor of the same race because they feel more comfortable and confident with that doctor.
Many patients from racial and ethnic minorities seek doctors from the same background, but access is a problem. Last year, emergency physician Kimberly Collins '89 was working with a white colleague who had diagnosed dermatitis in a black patient, but Collins identified the rash as a condition called pityriasis rosea. The evidence suggests that having access to black doctors, especially for black patients, can lead to better health outcomes due to improved communication and trust between patient and provider. This could help reduce health disparities among minority populations by providing better access to quality healthcare.
