Decoding Racial and Ethnic Disparities in Health Care
Health care disparities are among the most complex issues faced by the academic health services research community as well as the state and federal policymakers whose funding decisions define the limits of what the delivery system can potentially accomplish.
As part of its Penn Integrates Knowledge (PIK) program aimed at making such topics easier to understand, three of the University of Pennsylvania's top experts came together for an afternoon roundtable session that explored disparities through the prisms of health services research, genomics, the social sciences, and law.
The 12-year-old PIK program is specifically aimed at fostering and supporting the collaboration of Penn scholars from diverse disciplines in efforts to bring a broader array of insights to the study of real-world problems like this one.
In the four roundtable videos below, Penn Provost Wendell Pritchett along with PIK professors Karen Glanz, Sarah Tishkoff and Dorothy Roberts recap the latest knowledge from their fields that expand our understanding of the scope, operational dynamics and potential solutions to a broad range of health care inequities faced by members of the country's racial and ethnic minorities.
[2:00 minutes] Penn Provost Wendell Pritchett, JD, PhD, welcomes attendees and briefly introduces the day's topic and speakers.
[18 minutes] Social scientist and epidemiologist Karen Glanz, PhD, MPH, provided a 30,000 foot view of major population health issues involving minority inequities on a massive scale across the country. A professor at both Penn's Perelman School of Medicine and School Nursing, Glanz is also a Senior Fellow at Penn's Leonard Davis Institute of Health Economics (LDI). She pointed to some of the more serious differences among racial and ethnic groups, including infant mortality. For white women, it's 5.56 infant deaths per 100,000 births; for African American women it's 13.35 infant deaths per 100,000 births. Glanz also discussed the interventions that have been documented in the literature to work in reducing various sorts of health disparities.
[16 minutes] While specific gene-associated diseases and treatments have been the source of much excitement in recent years, less than 20% of all studies on genetic makeup have involved non-European ethnicities and only about 4% have involved people of African or Hispanic ancestry, Sarah Tishkoff noted in her presentation. Even the NIH study that sampled the genes of more than 2,000 people around the world only reached a portion of the genetically differentiated populations across Africa. Tishkoff, PhD, is a Professor of Genetics and Biology in both Penn's Perelman School of Medicine and School of Arts and Sciences. Her talk provided several surprising insights into African genetic variations and their potential implications for disparities in U.S. health care.
[20 minutes] The presentation of Dorothy Roberts, JD, a Professor at both Penn's Law School and School of Arts & Sciences, focused on the legal, sociological and political dimensions of health disparities. She pointed to a 2007 study showing that black women in Chicago had a lower rate of breast cancer than white women but a higher death rate from the disease. She noted that in 1980, the death rate of both Chicago groups was the same but diverged dramatically over the next two decades. Black women's death rate didn't increase; it was white women's death rate that dropped by half over that period. The conclusion is that white women generally received the advantages of advances in breast cancer diagnosis and treatment and black women didn't.