Fixing health care disparities.(Guest Editorial)

We hear a great deal about "closing the gap" in health disparities in this country. To address these disparities, we must apply a multifaceted approach with leadership from the federal, educational, professional, financial, and business communities. Long-term and short-term strategies are needed.

While it's important to keep in mind that health care disparities are not isolated to race and ethnicity (and can relate to age, gender, disability status, sexual orientation, or other factors), I'd like to focus on health care disparities among racial and ethnic minorities.

The composition of our health care workforce does not reflect the composition of this nation. For patients, race and ethnicity play a role in the quality of care available to minority groups, according to the 2002 Institute of Medicine report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care."

I ask all of you to become knowledgeable about these issues. Fewer than half of U.S. medical schools offer courses in health disparities. I think that's a problem. Here are 10 steps to get us closer to solutions:

1. We need to continue the focus of federal, state, and professional groups on the increasing disparities in health care and research related to minority populations. There needs to be a national, broad-scale initiative to bring these concerns to the forefront. Repeated discussion of these issues will provide the many different constituents who will need to work together to address this national tragedy.

2. Support the 2003 Institute of Medicine report entitled. "Health Professions Education: A Bridge to Quality," which lists five core competencies: delivering patient-centered care; working as part of interdisciplinary teams; practicing evidence-based medicine; focusing on quality improvement: and using information technology. Patient-centered care includes identifying, respecting, and caring about patients' differences, values, preferences, and expressed needs.

We must continue to support and acknowledge the assistance of international medical graduates. That they fill a void in our medical care should be seen as a small part of the overall solution to this underlying problem of disparities.