The Heart of the Matter: The Relationship between Communities, Cardiovascular Services and Racial and Ethnic Gaps in Care

Publication Date: October 2006

Publisher: Robert Wood Johnson Foundation; The George Washington University School of Public Health and Health Services Department of Health Policy

Author(s): Anthony. Lara; Holly. Mead; Marsha. Regenstein

Research Area: Health

Type: Report

Abstract:

Increasingly, the field of health policy has come to acknowledge that patients from certain racial and ethnic groups are more likely to receive a lower quality of health care than majority groups. These gaps in treatment between minority and majority populations, commonly referred to as racial and ethnic disparities, persist across a range of health care services used to treat different conditions. Evidence of disparities is particularly strong in the diagnosis and treatment of cardiovascular disease.

The reasons for these disparities are multidimensional. But doubtless some of the variation rests with the availability of services and service patterns within communities and health care markets. By the time a patient reaches a hospital bed, countless decisions have either explicitly or implicitly been made on that patient’s behalf. The choice of primary care or specialty physician, location of a physician’s office, and preference for hospitals are just some of the decision points that can influence minorities’ access to high quality services.

The Robert Wood Johnson Foundation (RWJF) has formulated a strategy to reduce racial and ethnic health care disparities, as part of its mission. This report, funded through RWJF's initiative Expecting Success: Excellence in Cardiac Care, reviews key decision-makers—plans, providers, purchasers, consumers and patients—to identify the factors that contribute to disparate care. Subsequent market assessment reports will explore the differentials in care for minorities who have coverage and/or access to a medical home.