WASHINGTON, D.C., January 12, 2021 — More needs to be done to understand and address disparities and discrimination in health and health care that negatively impact racial, ethnic, religious and cultural communities and persons in the United States, says the American College of Physicians (ACP). In A Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care: A Policy Paper from the American College of Physicians, published in the Annals of Internal Medicine today, ACP laid out a framework that confronts the various, interconnected, and compounding aspects of U.S. society that contribute to poorer health outcomes for persons based on their race, ethnicity, religious, and/or cultural identities. In a related series of three companion papers, also released today, ACP further proposed specific policy recommendations to address the issue in education and the health care workforce, for specific populations, and in criminal justice practices.
“As a physician, I want every one of my patients to be in the best possible health that they can be,” said Jacqueline W. Fincher, MD, MACP, president, ACP. “Research shows us that many people experience inequities and disparities in health access and outcomes, simply because of their race, ethnicity, religion and cultural identities, and where they live. This is unacceptable. At ACP we are committed to good health care for all, poor health care for none.”
ACP’s policy framework includes recommendations that U.S. policymakers commit to understanding and addressing disparities in health and health care to enhance the quality and effectiveness of health care for all; and that policymakers comprehensively address the interconnected contributors to health and health care disparities including the role of racism, discrimination, lack of coverage and access to care, poverty, and other social drivers of health. The framework then lays out a series of 15 additional recommendations to reduce health disparities. Those recommendations discuss specific contributors to disparities and steps that could be taken to help improve them. The recommendations include things like steps that would help foster a diverse, equitable and inclusive health care workforce; the need to consider discrimination and hate as a public health crisis and to address social drivers of health, including the impact on Indigenous people and the disparities in maternal mortality rates for Black, Indigenous and other women; and the need to implement evidence-based solutions to systemic racism, discrimination, and violence in criminal justice and law enforcement policies and practices. The additional recommendations are explained in detail in the series of three additional papers.
- In Understanding and Addressing Disparities and Discrimination in Education and in the Physician Workforce, ACP offers recommendations to create safe, inclusive, and supportive educational and workplace environments; to promote the diverse medical school bodies and workforces; and to support, fund, and strengthen education at all levels.
- In Understanding and Addressing Disparities and Discrimination Affecting the Health and Health Care of Persons and Populations at Highest Risk, ACP makes recommendations to address disparities in coverage, access, and quality of care for racial and ethnic minorities, including expanding Medicaid and insurance marketplace subsidies, funding translation and patient navigator services, and supporting programs that place physicians in underserved communities. Specific recommendations are offered to address issues that disproportionately impact racial and ethnic minorities, such as maternal mortality rates and COVID-19.
- In Understanding and Addressing Disparities and Discrimination in Law Enforcement and Criminal Justice Affecting the Health of At-Risk Persons and Populations, ACP calls for changes to criminal justice and law enforcement policies and practices that result in racial and ethnic disparities in interactions, sentencing, and incarceration and disproportionate harm to these communities. This paper includes a review of the evidence finding that these policies can negatively impact the physical and mental health, and well-being of racial and ethnic minorities. The paper further contends that injury and loss of life at the hand of the state, whether in law enforcement encounters or through inequities in capital punishment sentencing, is a health issue.
“Too many Americans face discrimination and disparities that negatively impact their health,” continued Dr. Fincher. “As physicians, we have a moral imperative to help address this issue. Taken together, the recommendations in ACP’s papers would be a substantial step in reducing disparities and helping to increase health equity and improve health outcomes for our patients.”
About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 163,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook, and Instagram.
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