Risa Lavizzo-Mourey

Gathering together and analyzing major scientific papers, the Institute of Medicine (IOM) released a report in March that documented significant health disparities between whites and minorities in the US. Risa Lavizzo-Mourey, a member of the committee that wrote the report, spoke to an HSPH audience on April 25 in Snyder Auditorium, after receiving the 2002 Alonzo Smythe Yerby Award.

The award honors the late Alonzo Smythe Yerby, best remembered for his life-long concerns about the nation’s health care system, which he believed provided inadequate health care to the poor. Yerby chaired the Department of Health Services Administration, the predecessor to the Department of Health Policy and Management, from 1966 to 1975, and was the school’s first African-American department chair.

In her lecture, Lavizzo-Mourey, senior vice president and director of the Health Care Group at the Robert Wood Johnson Foundation, described the planning, execution and findings of the IOM report, "Unequal Treatment: Confronting Racial and Ethnic Health Disparities."

The congressionally mandated report found that minorities tend to receive lower-quality health care than whites do, even when insurance status, income, age and severity of conditions are comparable. Some consequences of the unequal treatment include higher death rates for minorities, resulting in part from differences in treatments for heart disease, cancer and HIV infection, say the report’s authors.

	Alonzo Smythe Yerby

Evidence suggests that bias, prejudice and stereotyping by health care providers may contribute to differences in care. Lavizzo-Mourey, an African American, offered a supporting anecdote from her life. While living in Philadelphia, Lavizzo-Mourey, who has a medical degree from HMS, was forced to bring her sick daughter to an emergency room in the middle of the night. After a cursory examination, the resident dismissed Lavizzo-Mourey’s concerns, saying the girl was not sick. Lavizzo-Mourey pushed for more testing, asserting her medical training, and ultimately her daughter was diagnosed with pneumonia. Lavizzo-Mourey said the exchange represented some barriers patients may face in receiving health care: stereotyping, a dismissive attitude and a lack of engagement on the part of a health care provider.

The IOM committee that wrote the report has recommended that awareness about disparities be increased among the public, health care providers, insurance companies and policymakers. Consistency and equity of care should also be promoted through the use of "evidence-based" guidelines to help providers and health plans make decisions about which procedures to order or pay for based on the best available science, wrote the authors.

Other steps are outlined in the report, available at http://www.iom.edu/.