The challenges of eliminating racial and ethnic health disparities: inescapable realities? Perplexing science? Ineffective policy?

Abstract

Despite the accomplishments of American medical science and the impressive array of healthcare facilities and service delivery models available in this country, the existence of significant health disparities is a matter of urgent national and state health policy priority. Policies to address these issues should address fundamental problems having to do with access to care (such as health insurance coverage and the availability and the geographic and culturally-appropriate accessibility of personal health services), the educational preparation of healthcare professionals for the challenge of caring for the increasing diversity of patients in a truly "patient-centered" healthcare system of the future, efforts to deal with widespread problems of health literacy that reduce the likely impact and effectiveness of healthcare, and a more aggressive effort to assure that future medial science continues to include minorities and women (and they continue to participate) as subjects in clinical trials of innovative therapeutic interventions. The policy agenda to address these issues is both broad and demanding, as would be expected of any set of problems which is so widespread and complex. But, America is no stranger to challenges, and few are more worthy of the effort than this.