Racial Disparities in Health Care, Missing Cultural Needs

A study released Monday in The Archives of Internal Medicine, reported by The New York Times, examined the electronic medical records of 6,814 patients with diabetes in eastern Massachusetts between 2005 and 2007. The study found racial disparities in their treatment, even when it was by the same doctor.

The lead author of the study said in an interview that he attributed the differences less to overt racism than to a systemic failure to tailor treatments to patients’ cultural norms. The problem, said the author, Dr. Thomas D. Sequist, an assistant professor of health care policy at Harvard Medical School, may be that physicians do not discriminate in the way they counsel patients.

“It isn’t that providers are doing different things for different patients,” Dr. Sequist said. “It’s that we’re doing the same thing for every patient and not accounting for individual needs. Our one-size-fits-all approach may leave minority patients with needs that aren’t being met.”

For instance, he said, counseling black or Latino patients with diabetes to lower their carbohydrate intake by cutting rice from their diets may not be a realistic strategy if rice is a family staple.

“We may be listing fruits and vegetables that are part of one person’s culture but not another,” Dr. Sequist said. “We’re not really giving them information they can use.”

The study authors advise that doctors, and other members of the health care system, learn more about the minority communities they serve.