MINNESOTA
MARCH 2017
PHYSICIAN
THE INDEPENDENT MEDICAL BUSINESS JOURNAL
Volume XXX, No. 12
Health equity Understanding institutional racism BY STEPHEN NELSON, MD
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Supporting patients with serious illness The LifeCourse model BY ERIC ANDERSON, MD
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rs. Olsen—your patient of 20 years—is back home after an admission for heart failure and COPD. She’s doing better now, partly because she is wearing oxygen all the time. She feels well enough to take care of her granddaughter two days a week while her daughter goes to work. When you ask, “Mrs. Olsen, how are you?” she answers, “I’m fine!” Has anyone talked with her about having a serious illness? Supporting patients with serious illness to page 104
t has been almost six years since I wrote about health equity in Minnesota Physician. As the French journalist Jean-Baptiste Alphonse Karr said, “plus ça change, plus c’est la même chose” (the more things change, the more they stay the same). Although we have seen some improvements in access to medical care with the Affordable Care Act, access and outcomes continue to be significantly worse for Americans of color. In fact, each annual National Healthcare Disparities Report (NHDR) since my last writing has shown inferior care for people of color in the U.S. In the most recent 2015 NHDR, Hispanics had worse access to care than whites for two-thirds of access measures while blacks had worse access to care than whites for approximately half of access measures. Blacks, Hispanics, and Native Americans received worse care than whites for about 40 percent of quality measures (http://www.ahrq.gov/research/ findings/nhqrdr/nhqdr15/index.html). Health equity to page 124