Diversity And Division In Medicine

The United States is rapidly transforming into one of the most racially and ethnically diverse nations in the world. Groups commonly referred to as minorities-including Asian Americans, Pacific Islanders, African Americans, Hispanics, American Indians, and Alaska Natives-are the fastest growing segments of the population and emerging as the nation's majority. Despite the rapid growth of racial and ethnic minority groups, their representation among the nation's health professionals has grown only modestly in the past 25 years. This alarming disparity has prompted the recent creation of initiatives to increase diversity in health professions. In the Nation's Compelling Interest considers the benefits of greater racial and ethnic diversity, and identifies institutional and policy-level mechanisms to garner broad support among health professions leaders, community members, and other key stakeholders to implement these strategies. Assessing the potential benefits of greater racial and ethnic diversity among health professionals will improve the access to and quality of healthcare for all Americans.

This is an innovative investigation of pluralism in health care. Using both extensive archival material and oral histories it examines relationships between indigenous healing, missionary medicine, and 'western' biomedicine. The book includes the different regions within South Africa although focusing in most detail on the Cape, the earliest area of white settlement. In a wide-ranging survey the division in medicine between 'western' and indigenous medicine is analysed through an exploration of the evolving practices of healers, missionaries, doctors and nurses. The book considers the extent to which there was a strategic crossing of boundaries in the construction of hybrid practices by these practitioners, and the extent to which patients pursued health by sampling diverse care options. Starting with missionary penetration during the early nineteenth century, the volume outlines interventions by the colonial state in medicine and public health, and the continued resilience of indigenous healing in the face of this. The book ends by relating past to present in scrutinising the legacy of historical structures - including those of the apartheid state - for current health care, and in briefly discussing the huge challenges that the HIV/Aids pandemic poses in impacting on them. The book thus provides an inclusive history of medicine for the 'New' South Africa.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

Even as the U.S. population becomes steadily more diverse, minorities and women remain underrepresented in clinical trials to develop new drugs and medical devices. Although progress in increasing minority participation in clinical trials has occurred, participation rates do not fully represent the overall population of minorities in the United States. This underrepresentation threatens the health of both these populations and the general population, since greater minority representation could reveal factors that affect health in all populations. Federal legislation has sought to increase the representation of minorities and women in clinical trials, but legislation by itself has not been sufficient to overcome the many barriers to greater participation. Only much broader changes will bring about the meaningful participation of all population groups in the clinical research needed to improve health. To examine the barriers to participation in clinical trials and ways of overcoming those barriers, the National Academies of Sciences, Engineering, and Medicine held a workshop in April 2015. This publication summarizes the presentations and discussions from the workshop.

Even as the U.S. population becomes steadily more diverse, minorities and women remain underrepresented in clinical trials to develop new drugs and medical devices. Although progress in increasing minority participation in clinical trials has occurred, participation rates do not fully represent the overall population of minorities in the United States. This underrepresentation threatens the health of both these populations and the general population, since greater minority representation could reveal factors that affect health in all populations. Federal legislation has sought to increase the representation of minorities and women in clinical trials, but legislation by itself has not been sufficient to overcome the many barriers to greater participation. Only much broader changes will bring about the meaningful participation of all population groups in the clinical research needed to improve health. To examine the barriers to participation in clinical trials and ways of overcoming those barriers, the National Academies of Sciences, Engineering, and Medicine held a workshop in April 2015. This publication summarizes the presentations and discussions from the workshop.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Despite the changing demographics of the nation and a growing appreciation for diversity and inclusion as drivers of excellence in science, engineering, and medicine, Black Americans are severely underrepresented in these fields. Racism and bias are significant reasons for this disparity, with detrimental implications on individuals, health care organizations, and the nation as a whole. The Roundtable on Black Men and Black Women in Science, Engineering, and Medicine was launched at the National Academies of Sciences, Engineering, and Medicine in 2019 to identify key levers, drivers, and disruptors in government, industry, health care, and higher education where actions can have the most impact on increasing the participation of Black men and Black women in science, medicine, and engineering. On April 16, 2020, the Roundtable convened a workshop to explore the context for their work; to surface key issues and questions that the Roundtable should address in its initial phase; and to reach key stakeholders and constituents. This proceedings provides a record of the workshop.

The underrepresentation of minorities in health and other professions has long cast a shadow over our nation's efforts to develop a more representative and productive society. Many programs have been developed to enlarge the presence of minorities in health careers, but these efforts have been unable to develop the infrastructure and momentum needed to produce and sustain an adequate number of minority professionals among the ranks of clinicians, researchers, and teachers. This book looks at the historical significance of this underrepresentation, presents data that define the problem, and identifies underlying factors that contribute to the failure to achieve fairness in opportunity. The volume examines programs that have made successful efforts to decrease underrepresentation and sets forth an action and research agenda for further enhancing the numbers of minorities in the health professions.