While the 14th amendment to the U.S. constitution guarantees all citizens “equal treatment under the law,” subtle forms of unequal treatment remain prevalent in American life. A landmark 2002 report by the Institute of Medicine showed that racial and ethnic disparities in health and health care are significant, with black and Hispanic Americans receiving a lower quality of health care than their white counterparts. This translates into higher mortality rates among minority patients. Social and economic inequalities account for many of the observed differences in health and access to care, but the gap persists even when controlling for insurance status and income level. The factors that contribute to this unequal treatment include a lack of linguistic interpretation services, institutional bias, and insufficient awareness of ethnic disparities among both the general public and health care providers.
To address this issue, the Foundation has provided support for Mary-Jo Delvecchio Good of Harvard University to study “culturally specific” clinics: those where more than 50 percent of the patients are from a particular ethnic group, medical care is offered in the primary language of this group, and the clinic is formally identified as specializing in the care of members of a particular ethnic group. Good and her research team will conduct ethnographies of ten such clinics in the Boston area, interviewing administrative staff, clinicians, and community members to get an understanding of how the clinics are run, and what areas and groups of patients they serve. Then, Good’s team will interview fifty patient-clinician pairs to see how care is administered in these settings and to understand if and how culture makes a difference in the delivery of health care. The results of this project will be published in a number of medical and psychiatric anthropology journals, an edited collection of papers, and a monograph.