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Commentary
JAMA. 2008;299(7):814-816. doi: 10.1001/jama.299.7.814

Who Is Accountable for Racial Equity in Health Care?

  1. Jan Blustein, MD, PhD
  1. Author Affiliations: Wagner Graduate School, New York University and Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, New York.

Since this article does not have an abstract, we have provided the first 150 words of the full text.

Racial disparities are a ubiquitous feature of the US medical landscape, with health care delivery substantially segregated by race/ethnicity. Recent evidence from hospitals,1,2,3 nursing homes,4,5 and physicians' offices6 suggests that those caring for minority patients do not perform as well as those who care for nonminority patients, on average. This evidence is troubling but hardly surprising because the limited resources of those who care for the poor have helped to create and sustain racial disparities. As the United States enters an era of accountability in health care, it is time to consider these familiar circumstances from a new perspective.

De Facto Racial Segregation in US Health Care

De facto racial segregation is a remarkably prevalent feature of US health care delivery. A national study of Medicare beneficiaries hospitalized with acute myocardial infarction in 1994 and 1995 showed that the majority of facilities in the United States admitted no black …

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