IOM Report on Racial Disparities Used ‘Flimsy’ Data, Op-Ed States

The Institute of Medicine's conclusion in a study last month that racial bias may result in disparities in health care is "weak," Dr. Sally Satel, a psychiatrist and American Enterprise Institute fellow, writes in a Wall Street Journal opinion piece (Satel, Wall Street Journal, 4/4). Based on a review of more than 100 studies conducted over the past decade, the IOM report found that minorities in America generally receive poorer health care than whites, even when income, insurance and medical conditions are similar (Kaiser Daily Health Policy Report, 3/21). But the study authors "hedged their bets" by saying that "some" of the findings "may ... suggest" that prejudice and stereotyping lead to unequal care, indicating that the "data are flimsy," Satel writes. She adds that while care based on race may indeed have played a role in health outcomes, the evidence cited in the IOM report "does not make the case." Although physicians do occasionally base treatment decisions on experience and statistical norms -- which are "sometimes influenced by race" -- Satel asserts that the IOM's elevation of that practice to "potential civil-rights violations" is "a large, questionable leap." She points to the "many unanswered questions" left by the study, including how often African Americans refused surgery, if they had higher rates of complications and how many were married (unmarried men generally fare worse than married men after surgery). Satel calls the "hype" surrounding the IOM report "disturbing" because it diverts attention from the "far more important causes of the health gap," such as access to care, health literacy and attitudes toward health. Satel concludes, "We can do much to improve the health of African Americans. Inciting their distrust of the medical profession with misleading claims about physician prejudice can only hurt" (Wall Street Journal, 4/4).