Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger
Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients.
Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available.
Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.
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Creators
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Publisher
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Release date
December 11, 2015 -
Formats
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Kindle Book
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OverDrive Read
- ISBN: 9781479899630
- File size: 1489 KB
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EPUB ebook
- ISBN: 9781479899630
- File size: 1489 KB
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Languages
- English
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Reviews
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October 15, 2015
A densely written proposal for reducing discrimination by white physicians, nurses, and other health care personnel against minorities seeking medical services. Matthew (Law/Univ. of Colorado) opens with a shocking statistic: according to one estimate, nearly 84,000 more minority patients die annually "due to health care disparities" and "inferior medical treatment" compared to "their white counterparts." Drawing on social science studies, many of which are cited here, the author gathers evidence of implicit bias before, during, and after the clinical encounter, and she argues forcefully that this can and must be changed. A co-founder of the Colorado Health Equity Project, a medical legal partnership, Matthew tackles this important issue in disconcertingly repetitive prose filled with the jargon of the social sciences. Matthew presents a "Biased Care Model" with clunky charts of "physician and patient communication mechanisms" depicting how "physician's stored clinical and social knowledge of a patient's group" leads to "racially/ethnically disparate health outcomes." Quotes from various health care providers and excerpts from interviews with patients reinforce her message and lighten the sociolegal passages at times, but too often her presentation becomes discouragingly challenging for casual readers. Having presented a thorough picture of the problems facing minorities in the health care system, Matthew proposes a solution: reform of specific sections of the Civil Rights Act of 1964, which she claims would provide a legal and moral basis to hold liable those who unconsciously discriminate and would help to establish a new standard of care in medicine. Health care providers, hospital administrators, insurers, and those involved in civil rights law will find food for thought here; general readers will be better served by Damon Tweedy's Black Man in a White Coat: A Doctor's Reflections on Race and Medicine (2015).COPYRIGHT(2015) Kirkus Reviews, ALL RIGHTS RESERVED.
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