Racial stereotyping in the medical field

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I have located an excellent article by Griger (2001) in the Canadian Medical Association Journal (CMAJ) Available [On-line]http://collection.nlc-bnc.ca/100/201/300/cdn_medical_association/cmaj/vol-164/issue-12/1699.asp
which discusses the implications of racial stereotyping in the medical field:

Racial stereotyping and medicine: the need for cultural competence
H. Jack Geiger

In almost every nation in the world, increased burdens of morbidity and mortality afflict racial and ethnic minorities and new immigrant populations. In the United States, inferior health status has been documented for African-Americans, people of Hispanic origin, American Indians and some groups of Asian origin;1 in the United Kingdom, for people of Indian, Pakistani and West Indian origin; in France, for people of North African origin; in Germany, for Turkish residents and in Turkey for Kurds; and in Israel, for Jews of Ethiopian, North African and Russian origin. In Canada, the health status of the Aboriginal population2 and of a number of immigrant groups3 is equal cause for concern. If good public health data were also available for every developing nation, it would be easy to demonstrate that this is a global phenomenon.

Although the poorer health status of these populations is primarily attributable to poverty and related environmental factors - social, physical, biological, economic and political - as well as lack of access to health care, a significant contribution may be made by racial and ethnic disparities in the quality of medical care, specifically, by differences in the diagnostic work-up and treatment of minority patients already in the health care system. Recent reviews of the relevant peer-reviewed literature in the United States4,5 have provided overwhelming evidence that African-Americans, people of Hispanic origin and American Indians are strikingly less likely to receive coronary artery angioplasty or bypass surgery,6,7,8 advanced cancer treatment, renal transplantation or surgery for lung cancer9 compared with white patients matched for insurance status, income or education, severity of disease, comorbidity, age, hospital type and other possible confounders. Even more disturbingly, these differentials were also found in basic elements of clinical care such as the adequacy of physical examinations, history-taking and laboratory tests10,11 - even the adequacy of medication for pain12 - and across the whole spectrum of disease. There is evidence in some studies that the patients who were denied appropriate or necessary care included some who were at greatest risk, and who suffered accelerated mortality in consequence.13

These are issues of an ethical as well as a practical nature, because such systematic disparities in treatment conflict with our fundamental professional commitment to equitable care and concern for every patient. We know far too little about the causes of these differentials, but they are surely complex. A few have been attributed to ...