Social class, race, and ethnicity all influence health care
disparities for many health care services and illnesses, such as
heart disease and stroke, cancer, diabetes, chronic kidney disease,
and maternal and child health care. Public health scholars have
advanced numerous reasons for these disparities, including
physician biases, patients' fatalistic attitudes, cultural
patterns, lack of health insurance, and institutional racism.
Communication plays a critical role in conveying, reinforcing, and
helping to reduce health care inequities. The eight articles in the
February 2006 issue of American Behavioral Scientist explore how
racial disparities in health care outcomes are related to
communication issues. Article highlights include: Focusing on
cancer-related health outcomes, the factors that contribute to
racial disparities in health care and how various types of
communication can both exacerbate problems and /or contribute to
high-quality health care (Kreps). A discussion of tailored
interventions in public health and insights from studies of
multi-level, multi-component interventions designed to promote
healthy eating and exercise among rural African-Americans (Kramish
Campbell and Quintiliani). Using examples from campaigns designed
to increase mammography use and the intake of fruits and vegetables
among lower-income African-American women, how subtle culturally
sensitive variations in tailoring communications directed at
minority audiences can influence health promotion behavior (Kreuter
and Haughton). Applying prospect theory and framing concepts to
health communications directed at medically underserved populations
and the complexities that arise from intersections of message
framing with program goals and cultural targeting (Schneider).
Insights from 15 years of research on an interactive cancer
communication program, the Comprehensive Health Enhancement Support
System (CHESS), and the consistently positive effects on low-income
African-American women's health information competence (Shaw,
Gustafson, Hawkins, McTavish, McDowell, Pingree, and Ballard). Two
papers that posit that doctors and minority patients frequently
miss the mark due to physician perceptions, language barriers, and
self-fulfilling prophecy spirals. The first paper includes an
integrative perspective on doctor-patient communication and
cultural competency. (Perloff, Bonder, Ray, Berlin Ray, and
Siminoff); the second paper offers an incisive review of
patient-centered communication and patient communication skills
training (Cegala and Post). The empirical and moral assumptions
surrounding segmentation campaigns designed to reduce racial
disparities, including different strategies to build racial
segmentation into campaigns, ethical and political quandaries, and
contexts in which segmentation may not be the best approach (Hornik
and Ramirez).
Taken together, these eight articles provide new directions for
research on communication and racial disparities. They also provide
thoughtful suggestions for campaign practitioners. This incisive
issue of American Behavioral Scientist should be in the library of
everyone interested in health communication, health disparities,
health promotion, minority health, cultural competency training,
doctor-patient communication, and public health.
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