Racial and ethnic disparities in the use of health services: Bias, preferences, or poor communication?

Carol M. Ashton, Paul Haidet, Debora A Paterniti, Tracie C. Collins, Howard S. Gordon, Kimberly O'Malley, Laura A. Petersen, Barbara F. Sharf, Maria E. Suarez-Almazor, Nelda P. Wray, Richard L. Street

Research output: Contribution to journalArticlepeer-review

359 Scopus citations


African Americans and Latinos use services that require a doctor's order at lower rates than do whites. Racial bias and patient preferences contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and health behaviors. Research has shown that doctors have poorer communication with minority patients than with others, but problems in doctor-patient communication have received little attention as a potential cause, a remediable one, of health disparities. We evaluate the evidence that poor communication is a cause of disparities and propose some remedies drawn from the communication sciences.

Original languageEnglish (US)
Pages (from-to)146-152
Number of pages7
JournalJournal of General Internal Medicine
Issue number2
StatePublished - Feb 1 2003
Externally publishedYes


  • Communication
  • Health care utilization
  • Race
  • Racial disparities

ASJC Scopus subject areas

  • Internal Medicine


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