In the begining of Disparities 2

      Today we continue our historical look back to the origins of Healthcare Disparities. The last blog discussed the international origins. Today's blog will focus on the US recognition.
      In the United States, scientific evidence from several lines of inquiry examining outcomes and patterns of health care began to converge in the late 1970's and early 1980's to suggest differential health outcomes across patient groups and the importance of "nonbiologic" social, environmental and cultural factors in determining health outcomes. Medical researchers demonstrated that large variability in services provided and patient outcomes existed between clinical practices in different parts of the country, despite treating clinically similar patients. Prior to this, it was largely assumed by some that all practices provided essentially the same care to patients with similar illnesses. As public awareness grew, the US government released a report documenting that, while the overall health of the nation was relatively good, major differences existed in “the burden of death and illness experienced by blacks and other minority Americans as compared with the nation's population as a whole.
      The secretary of the Department of Health and Human Services then established a task force on black and minority health—the first time that the US government formed a group of experts to conduct a comprehensive study of minority health problems. In 1985, release of the report of the task force significantly raised awareness of the disparate health of the country’s minority groups as compared to the white majority population. In addition large epidemiologic studies like the Harvard Medical Practice Study emerged, documenting that a significant portion of practice variability could be classified as substandard care and that there was a correlation between substandard care and hospitals treating substantial numbers of poor and minority patients. By the late 1990s, the scientific evidence seemed to indicate that issues of disparity, practice variation, substandard care, and socioenvironmental determinants of health may all be related to the quality of health care experienced by patients.
      Health Disparities are generally defined as population differences in environmental exposures, health care access, utilization, or quality, health status, or health outcomes. Within the US health care system these differences have most convincingly been demonstrated across racial and ethnic lines (whites vs. minorities); however, disparities based on other categorizations have also been described, including geography, gender, socioeconomic status and age. Health disparities are generally thought to be related to the health care system and other social factors. To help bring clarity to these issues, the Institute of Medicine released the first of several reports highlighting and summarizing the scientific evidence concerning issues of differential health status, culture, behavior, communication, substandard care/medical errors, and health care quality. The work of the IOM on disparity issues culminated with the 2003 release of a report entitled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” which found that, within the United States, even among individuals with access to healthcare, significant racial and ethnic disparities indeed existed and were related to historic and contemporary social and economic inequality, discrimination, and a fragmented US system of health care. Portions of this blog were taken from the article entitled eHealth Solutions for healthcare disparities by MC Gibbons.