Challenges To Reducing Discrimination And Health Inequity Through Existing Civil Rights Laws
Challenges To Reducing Discrimination And Health Inequity Through Existing Civil Rights Laws
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DOI：
10.1377/hlthaff.2016.1091
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发表时间：
2017-06-01
期刊：
影响因子：
9.7
通讯作者：
Malani, Anup
中科院分区：
文献类型：
--
作者：
Chandra, Amitabh;Frakes, Michael;Malani, Anup
在1964年民权法案通过50多年后，美国少数种族和族裔的医疗保健在许多方面仍然是分离和不平等的。此外，改善少数群体保健的努力面临的挑战与法律上隔离期间面临的挑战不同。我们回顾这些挑战，并研究是否更有力地执行现有的民权立法可以帮助克服这些挑战。我们的结论是，更有力地执行现有的法律，例如，通过行政命令，以加强执法的法律和国会的行动，让个人对供应商提起诉讼谁可能从事歧视，将改善少数民族的医疗保健，但这种方法是有限的，它可以实现。在法律的竞技场之外的补充方法，如质量改进努力和直接向少数民族服务提供者转移资金--那些看到少数民族病人相对于他们在人口中所占比例不成比例的人--可能被证明更有效。
More than fifty years after the passage of the Civil Rights Act of 1964, health care for racial and ethnic minorities remains in many ways separate and unequal in the United States. Moreover, efforts to improve minority health care face challenges that differ from those confronted during de jure segregation. We review these challenges and examine whether stronger enforcement of existing civil rights legislation could help overcome them. We conclude that stronger enforcement of existing laws-for example, through executive orders to strengthen enforcement of the laws and congressional action to allow private individuals to bring lawsuits against providers who might have engaged in discrimination-would improve minority health care, but this approach is limited in what it can achieve. Complementary approaches outside the legal arena, such as quality improvement efforts and direct transfers of money to minority-serving providers-those seeing a disproportionate number of minority patients relative to their share of the population-might prove to be more effective.