In 2002 the Institute of Medicine reported in Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care that a consistent body of research demonstrates significant variation in the rates of medical procedures by race, even when insurance status, income, age and severity of condition are comparable. This research indicates that racial and ethnic minorities in the United States are less likely to receive even routine medical procedures and experience a lower quality of health services.

RWJF-funded studies of the effect of race and ethnicity on health and health care produced the following findings:

• Persistent disparities exist. A review of health care disparities literature conducted in 2000 found that there is widespread evidence of significant and persistent disparities in the treatment of African-American and Hispanic patients. There are substantially fewer studies documenting similar findings for Native Americans and those from Asian subgroups, but the same patterns are apparent. (See Program Results on ID# 033373.)
• Minorities have been less likely to have a regular health care provider. Research in 1999 revealed that African Americans and Hispanics were not only less likely to have a regular source of medical care than non-Hispanic Whites, but were also seen less often by the same provider even if they had a regular source of care. African Americans and Hispanics were also less likely to purchase private health insurance. (See Program Results on ID# 036332.)
• Americans receive only half the recommended medical care, according to research conducted by the RAND Corp. in 2006. Differences in care based on patient characteristics such as race and ethnicity were small compared to the larger gap between the care that all Americans receive and the care they should receive. (See Research Highlight.)
• Citizenship status affects access to care. RWJF-sponsored research found that while the main reason U.S. residents (both citizens and non-citizens) are uninsured is the cost of health insurance, children who are non-citizens or with immigrant parents are less likely to have health insurance than citizen children. (See Program Results on ID# 026855.) A study of undocumented immigrants in El Paso, Texas, found that excluding undocumented Latinos from receiving government-funded health care services is unlikely to reduce the level of immigration and may affect the well-being of citizen children living in immigrant households. (See Program Results on ID# 026618.)
• Managed care organizations have been no better than other insurers at addressing disparities, according to researchers at the University of Rochester. This finding was the result of a study conducted in 2000. (See Program Results on ID# 038088.)
• Medical students say that minorities receive poorer quality of care. A majority of American medical students believe that the U.S. health care system treats people unfairly based on their racial or ethnic background, insurance status, income and native language. (See Program Results on ID# 042706.)

Results from other research and data collection efforts supported by RWJF:

• A historical analysis of health disparities in light of historical racial discrimination concluded, "a divided health system persists, both exacerbating and distorting racial disparities." (See Program Results on ID# 026426.)
• In December 2003, the journal Health Services Research published a supplemental issue designed to educate researchers on a range of social and other non-medical factors that influence health, including social and economic status, ethnicity and race. Among the topics addressed in the supplement were socioeconomic status and low birthweight; social determinants of tooth loss; income inequality and depression; and racial differences in aftercare following colorectal cancer surgery. (See Program Results on ID# 044195.)