WASHINGTON -- Unconscious racism is so entrenched in the US medical system that the only way to eliminate disparities is to change the rules, according to a new report released yesterday.
But allowing communities to take control of their own healthcare helped in many cases, and also seemed to encourage healthy behavior above and beyond getting checkups and taking the right medicine, the report found.
''The healthcare system as a whole provides vastly unequal access and treatment based on race, language, and ethnicity," said Will Pittz, an organizer at the Northwest Federation of Community Organizations in Seattle who was lead author of the report.
''Racism within the health system is literally making people of color sick."
Several studies released this year have supported this claim.
In March, studies published in the journal Circulation showed that blacks tend to get older heart drugs, are less likely to have surgery, and got less effective treatment for heart problems overall than whites.
Dr. David Satcher, former US surgeon general, found that more than 80,000 black Americans die every year because of continuing disparities in healthcare.
In 2002, the Institute of Medicine, an independent group, reported that members of racial and ethnic minorities are given lower quality healthcare than whites even when they make as much money and carry the same insurance.
In January, the US Centers for Disease Control and Prevention reported that blacks are far more likely than whites to die from strokes, diabetes, and other diseases.
''I think in most situations it isn't conscious -- 'I prefer to serve white people rather than black people' or 'I don't believe this person deserves good healthcare,' " said Rinku Sen, a spokeswoman for the Applied Research Center, which also helped write the report.
''It's not just that we need policies, but that policies need to be implemented to address individual behavior. The combination of the lack of enforcement and unequal funding means that we can't hold healthcare providers accountable for discriminatory treatment," Sen added in an interview.
The report highlights some successful attempts to overcome the disparities. St. Thomas Health Services in New Orleans is one example.
''Located in a predominantly African American neighborhood, St. Thomas offers patients a full range of primary care services in an environment that is welcoming and respectful," the report reads.
Tohono O'odham Community Action in Sells, Arizona, a Native American reservation with the lowest per capita income in the country, fights the community's 50 percent diabetes rate by encouraging people to eat traditional foods such as beans and cactus instead of processed foods.
''Elders notice younger people dying ahead of us," tribal elder Danny Lopez is quoted in the report as saying. ''There must be something wrong and part of that is the way we are living."
Last September, the Sullivan Commission on Diversity in the Health Workforce found that while blacks, Hispanics, and Native Americans make up more than 25 percent of the US population, they represent only 9 percent of the nation's nurses, 6 percent of doctors, and 5 percent of dentists.