The Racial Segregation of Health Care in the United States: Assessing the Legacy, Impact and Remedies

Award Year:
David Smith
Race and Health
This project ties together the history of racial segregation and discrimination in health care and efforts to end it through litigation and regulation. A history of racial segregation in health care and insights into the impacts of discrimination on discrepancies in access and outcomes is presented. Dr. Smith provides two illustrative case studies. One describes the patterns of use of maternity services in a metropolitan area. Another describes the problems in assuring nursing home compliance with the Civil Rights Act. Dr. Smith assesses current organizational, methodological and data gaps associated with enforcing compliance with Title VI of the Civil Rights Act through the courts and regulatory agencies. He also addresses possible approaches, through regulatory and health care reform, for responding to continuing discrepancies and segregation in more subtle forms. Results focus on the need for policy interventions to monitor bias and ensure that changes in the delivery system do not institutionalize patterns of discrimination.