Skip to main content
PMC home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 1992 Jul;84(7):569–575.

Quality of care and black American patients.

W H Weddington 1, L L Gabel 1, G M Peet 1, S O Stewart 1
PMCID: PMC2571696  PMID: 1629920

Abstract

Even with major advancements in medical knowledge and significant improvements in health sciences technology, evidence still exists that blacks do not enjoy as full a measure of health as do other racial and ethnic groups. To attempt a better understanding of this situation, literature was reviewed to consider relationships between being black and issues related to quality of health care. It was determined that these relationships have not been studied to any great extent, either in quantity or quality. When such studies have been undertaken, they have been limited to mostly qualitative designs, and appropriate controls for confounding variables have been minimal. The psychiatric literature reports most of the studies with very few studies found in the literature of other specialties. A conceptual model is presented regarding race-related research. It is argued that a first step might be to study whether the quality of care differs when the physician and the patient are members of different racial groups compared with when the physician and patient are members of the same racial group. In all race-related research, it is necessary to carefully consider specific variables that may confound results, eg, diagnostic errors, age, sex, socioeconomic status, level of education, geographic locale, and method of payment for health-care services.

Full text

PDF
569

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adebimpe V. R., Gigandet J., Harris E. MMPI diagnosis of black psychiatric patients. Am J Psychiatry. 1979 Jan;136(1):85–87. doi: 10.1176/ajp.136.1.85. [DOI] [PubMed] [Google Scholar]
  2. Bahn A. K., Gardner E. A., Alltop L., Knatterud G. L., Solomon M. Admission and prevalence rates for psychiatric facilites in four register areas. Am J Public Health Nations Health. 1966 Dec;56(12):2033–2051. doi: 10.2105/ajph.56.12.2033. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chien C. Transcultural psychopharmacology. Summary of the symposium. Psychopharmacol Bull. 1978 Oct;14(4):89–91. [PubMed] [Google Scholar]
  4. Cohen A. I. Treating the black patient: transference questions. Am J Psychother. 1974 Jan;28(1):137–143. doi: 10.1176/appi.psychotherapy.1974.28.1.137. [DOI] [PubMed] [Google Scholar]
  5. Davis W. E., Beck S. J., Ryan T. S. Race-related and educationally-related MMPI profile differences among hospitalized schizophrenics. J Clin Psychol. 1973 Oct;29(4):478–479. doi: 10.1002/1097-4679(197310)29:4<478::aid-jclp2270290423>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  6. De Hoyos A., De Hoyos G. Symptomatology differentials between Negro and white schizophrenics. Int J Soc Psychiatry. 1965 Autumn;11(4):245–255. doi: 10.1177/002076406501100401. [DOI] [PubMed] [Google Scholar]
  7. Egbert L. D., Rothman I. L. Relation between the race and economic status of patients and who performs their surgery. N Engl J Med. 1977 Jul 14;297(2):90–91. doi: 10.1056/NEJM197707142970205. [DOI] [PubMed] [Google Scholar]
  8. Fischer N. An interracial analysis: transference and countertransference significance. J Am Psychoanal Assoc. 1971 Oct;19(4):736–745. doi: 10.1177/000306517101900407. [DOI] [PubMed] [Google Scholar]
  9. Gemson D. H., Elinson J., Messeri P. Differences in physician prevention practice patterns for white and minority patients. J Community Health. 1988 Spring;13(1):53–64. doi: 10.1007/BF01321480. [DOI] [PubMed] [Google Scholar]
  10. Gross H. S., Herbert M. R., Knatterud G. L., Donner L. The effect of race and sex on the variation of diagnosis and disposition in a psychiatric emergency room. J Nerv Ment Dis. 1969 Jun;148(6):638–642. doi: 10.1097/00005053-196906000-00007. [DOI] [PubMed] [Google Scholar]
  11. Gynther M. D. White norms and black MMPIs: a prescription for discrimination? Psychol Bull. 1972 Nov;78(5):386–402. doi: 10.1037/h0033555. [DOI] [PubMed] [Google Scholar]
  12. Halper I. S. The counterpoint of racial and oedipal themes in the psychotherapy of a Negro patient. Psychoanal Rev. 1970;57(2):169–180. [PubMed] [Google Scholar]
  13. Hamadeh G. Religion, magic, and medicine. J Fam Pract. 1987 Dec;25(6):561–568. [PubMed] [Google Scholar]
  14. Jones B. E., Gray B. A. Black and white psychiatrists: therapy with blacks. J Natl Med Assoc. 1985 Jan;77(1):19–25. [PMC free article] [PubMed] [Google Scholar]
  15. Jones E. Social class and psychotherapy: a critical review of research. Psychiatry. 1974 Nov;37(4):307–320. doi: 10.1080/00332747.1974.11023817. [DOI] [PubMed] [Google Scholar]
  16. Kalow W. Race and therapeutic drug response. N Engl J Med. 1989 Mar 2;320(9):588–590. doi: 10.1056/NEJM198903023200909. [DOI] [PubMed] [Google Scholar]
  17. Krebs R. L. Some effects of a white institution on black psychiatric outpatients. Am J Orthopsychiatry. 1971 Jul;41(4):589–596. doi: 10.1111/j.1939-0025.1971.tb03217.x. [DOI] [PubMed] [Google Scholar]
  18. Mayer W. J., McWhorter W. P. Black/white differences in non-treatment of bladder cancer patients and implications for survival. Am J Public Health. 1989 Jun;79(6):772–775. doi: 10.2105/ajph.79.6.772. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Penchansky R., Fox D. Frequency of referral and patient characteristics in group practice. Med Care. 1970 Sep-Oct;8(5):368–385. doi: 10.1097/00005650-197009000-00004. [DOI] [PubMed] [Google Scholar]
  20. Perkoff G. T., Anderson M. Relationship between demographic characteristics, patient's chief complaint, and medical care destination in an emergency room. Med Care. 1970 Jul-Aug;8(4):309–323. doi: 10.1097/00005650-197008040-00007. [DOI] [PubMed] [Google Scholar]
  21. Raskin A., Crood T. H., Herman K. D. Psychiatric history and symptom difference in black and white depressed inpatients. J Consult Clin Psychol. 1975 Feb;43(1):73–80. doi: 10.1037/h0076322. [DOI] [PubMed] [Google Scholar]
  22. Reed B. D., Lutz L. J., Zazove P., Ratcliffe S. D. Compliance with acute otitis media treatment. J Fam Pract. 1984 Nov;19(5):627–632. [PubMed] [Google Scholar]
  23. Rubenstein L. V., Calkins D. R., Young R. T., Cleary P. D., Fink A., Kosecoff J., Jette A. M., Davies A. R., Delbanco T. L., Brook R. H. Improving patient function: a randomized trial of functional disability screening. Ann Intern Med. 1989 Nov 15;111(10):836–842. doi: 10.7326/0003-4819-111-10-836. [DOI] [PubMed] [Google Scholar]
  24. Schachter J. S., Butts H. F. Transference and countertransference in interracial analyses. J Am Psychoanal Assoc. 1968 Oct;16(4):792–808. doi: 10.1177/000306516801600407. [DOI] [PubMed] [Google Scholar]
  25. Simon R. J., Fleiss J. L., Gurland B. J., Stiller P. R., Sharpe L. Depression and schizophrenia in hospitalized black and white mental patients. Arch Gen Psychiatry. 1973 Apr;28(4):509–512. doi: 10.1001/archpsyc.1973.01750340047007. [DOI] [PubMed] [Google Scholar]
  26. Steinberg M. D., Pardes H., Bjork D., Sporty L. Demographic and clinical characteristics of black psychiatric patients in a private general hospital. Hosp Community Psychiatry. 1977 Feb;28(2):128–132. doi: 10.1176/ps.28.2.128. [DOI] [PubMed] [Google Scholar]
  27. Tinling D. C. Voodoo, root work, and medicine. Psychosom Med. 1967 Sep-Oct;29(5):483–490. doi: 10.1097/00006842-196709000-00007. [DOI] [PubMed] [Google Scholar]
  28. Trotter R. T., 2nd Folk medicine in the Southwest. Myths and medical facts. Postgrad Med. 1985 Dec;78(8):167-70, 173-6, 179. doi: 10.1080/00325481.1985.11699228. [DOI] [PubMed] [Google Scholar]
  29. Weddington W. H., Gabel L. L. Racial differences in physicians and patients in relationship to quality of care. J Natl Med Assoc. 1991 Jul;83(7):569–572. [PMC free article] [PubMed] [Google Scholar]
  30. Welner A., Liss J. L., Robins E. Psychiatric symptoms in white and black inpatients. II. Follow-up study. Compr Psychiatry. 1973 Nov-Dec;14(6):483–488. doi: 10.1016/0010-440x(73)90033-3. [DOI] [PubMed] [Google Scholar]
  31. Winston A., Pardes H., Papernik D. S. Inpatient treatment of blacks and whites. Arch Gen Psychiatry. 1972 May;26(5):405–409. doi: 10.1001/archpsyc.1972.01750230015003. [DOI] [PubMed] [Google Scholar]
  32. Yamamoto J., Dixon F., Bloombaum M. White therapists and negro patients. J Natl Med Assoc. 1972 Jul;64(4):312–316. [PMC free article] [PubMed] [Google Scholar]
  33. Yamamoto J., James Q. C., Bloombaum M., Hattem J. Racial factors in patient selection. Am J Psychiatry. 1967 Nov;124(5):630–636. doi: 10.1176/ajp.124.5.630. [DOI] [PubMed] [Google Scholar]
  34. Yamamoto J., James Q. C., Palley N. Cultural problems in psychiatric therapy. Arch Gen Psychiatry. 1968 Jul;19(1):45–49. doi: 10.1001/archpsyc.1968.01740070047007. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES