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

J Gen Intern Med. 2003 Feb;18(2):146-52. doi: 10.1046/j.1525-1497.2003.20532.x.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans
  • Communication*
  • Decision Making
  • European Continental Ancestry Group
  • Health Services / statistics & numerical data*
  • Hispanic Americans
  • Humans
  • Minority Groups*
  • Models, Theoretical
  • Patient Acceptance of Health Care / ethnology*
  • Physician-Patient Relations*