Health care minority access

In the U.S., race has been used as a proxy for a variety of physical, mental, and social dimensions. The legacy of racism still pervades society, including disparity in access to health care and in health care outcomes (see chapter by Nsiah-Jefferson, this volume). In attempting to eliminate these health disparities there have been efforts to include racial and ethnic minorities in research studies and to generate better data on racial and ethnic variations in health status. Although most policy makers and commentators believe that racial classifications in data collection and outcomes research are needed to eliminate health disparities, others believe that such policies prolong the use of a flawed concept and reify race as a pseudoscientific measure (Lee et al., 2001). 

An extensive literature documents persistent differences in health outcomes between ethnic minorities and white Americans. These disparities include differences in health care access and utilization as well as health status and outcomes. Wolinsky showed that differences in access and use of health services by various ethnic groups stems in part from their varying cultural traditions. Pharmacists can assist in closing this gap in health outcomes by providing culturally sensitive patient care. Information about patients cultural health care beliefs and practices is essential for devising interven-... 

The principle of justice requires that the burdens and benefits of participation in clinical trials are distributed evenly and fairly. Historically, populations that were easily and conveniently accessed by researchers, such as prison inmates, nursing home residents, and people with poor access to general health care, have been included in clinical trials when they should not have been. Vulnerable populations in which individuals may find it difficult to refuse participation in a study should not be deliberately chosen for participation in clinical trials when non-vulnerable populations would also be appropriate. The benefits of participation, such as access to potentially lifesaving new therapies, should be available to all, including those not historically well represented in the clinical research enterprise, such as women, children, and members of ethnic minorities. 

School-based health centers are uniquely positioned to provide services to students who are most in need. Most sbhcs are established in low-income communities with inadequate health care resources and many unmet health care needs. This is reflected in a 1998-1999 survey of sbhcs nationally two-thirds of the population served by the centers were members of a minority group (National Assembly on School-Based Health Care, 2000). Studies of children with special health care needs reveal that those who face the most serious problems in accessing health care are children who live at or below the federal poverty line, live in single-parent families, are uninsured, are older children and teens, or members of a racial or ethnic minority group, sbhcs are designed to provide easily accessible health care services to this population. 

These benefits not only accrue to the individual, but to society as well. The resource savings to the healthcare system through responsible self-medication allows better allocation of limited healthcare resources and physicians time to important issues beyond the scope of self-care. It is inconceivable to consider the tremendous economic strain it could impose on the healthcare system if every consumer chose to visit a physician for every minor illness. Health centers would be overwhelmed and would not be able to work efficiently as illustrated by the fact that on an average each American experiences one potential self-treatable health problem every 3 days. Additionally, approximately 90% of the Americans consider themselves in poor health at least one or more times each month. Approximately 70% of consumers self-medicate on a regular basis, and an estimated 40% of the U.S. population uses at least one non-prescription drug within any given 48-hr period.Hence, easy access to nonprescription products is likely to be a priority for the American consumer. 

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