Racial, Ethnic Inequities in Medicine to be Studied

Baylor College of Medicine's Department of Medicine, Health Services section and the Veterans Affairs Medical Center in Houston have been awarded a $7.8 million grant to conduct research on racial and ethnic variation in medicine.

The grant spans a five-year period, and is awarded by the Agency for Healthcare Research and Quality, an agency of the U.S. Public Health Service. The agency was formed to focus on the causes of disparities in health care and to identify interventions to reduce those inequities. This effort was initiated in response to the U.S. Department of Health and Human Services' Initiative on Eliminating Racial and Ethnic Disparities, and the U.S. Surgeon General's Healthy People 2010 goals to eliminate disparities in health by the year 2010.

The grant is co-funded by the National Institutes of Health's Office of Research on Minority Health.

In addition to Baylor and the VA, other grantees include the University of California at San Francisco, the University of California at Los Angeles, the University of Colorado, Mt. Sinai School of Medicine, the Medical University of South Carolina, the University of North Carolina, the Morehouse School of Medicine and the University of Pittsburgh.

The Houston program is led by Dr. Carol M. Ashton, professor of medicine at Baylor and director of the Houston VA Health Services Research & Development Center of Excellence.

"Members of different racial and ethnic groups use medical care at different rates, even when access to care, diagnosis and severity are the same," said Dr. Ashton. "Research indicates that social and societal factors, such as poverty and social class are strong influences on utilization of care. The effectiveness of doctor-patient communication skills during medical care interactions is also known to affect health outcomes, and the evidence suggests that doctors have poorer communication skills with minority patients."

The grant includes six research projects. Each of the six projects will focus on medical interactions between patients and health care providers, and address conditions that typically affect older adults. Project leaders are Dr. Paul Haidet, a VA clinician-educator and scholar in the Baylor College of Medicine Master Teachers' Fellowship Program; Dr. Debora A. Paterniti, a qualitative sociologist; Dr. Howard S. Gordon, a general internist and VA Research Career Development awardee; Dr. Tracie C. Collins, a general internist and Robert Wood Johnson Minority Faculty Development awardee; Dr. Maria Suarez-Almazor, a health services researcher and rheumatologist; and Dr. Laura A. Petersen, a general internist and VA Research Career Development awardee.

The overall program includes three support cores including a data core, led by Dr. Nelda P. Wray, chief of the Health Services Research section at Baylor College of Medicine; an administrative core, led by Dr. Ashton and Joyce McDaniel; and an Information Dissemination and Educational Academic Liaison, or IDEAL core, led by Frank Martin, a dissemination and health communication specialist and member of the Houston VA Minority Veterans Health Committee. Dr. Richard Street, professor and chair of the Department of Speech Communication at Texas A&M University, will conduct the analysis of doctor-patient communication for the program.

Improving medical interaction is becoming increasingly important, as medical and technological advances make it possible to prevent, detect, cure or relieve many conditions, Dr. Ashton said.

"This grant will help us to identify the aspects of doctor-patient communication that can be improved," she said, "so that patients and families can learn how to become more powerful communicators and obtain better health outcomes."

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©2006 Texas Medical Center

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