TY - JOUR
T1 - Patient and practitioner noncompliance
T2 - Rationing, therapeutic uncertainty, and the missing conversation
AU - Rouse, Carolyn
N1 - Funding Information:
The data for this ethnography took almost a decade to process, and so there are many people and organizations to thank. The author’s collegial interlocutors include Michael Oldani, Carol Zanca, Elizabeth Armstrong, Reyna Rapp, Faye Ginsburg, Emily Martin, Keith Wailoo, and Cheryl Mattingly. This research was also made possible through the financial support of The Woodrow Wilson Foundation, Wenner-Gren, Princeton University, and Maternal and Child Health. Research required hospital and university Institutional Review Board approvals.
PY - 2010/8
Y1 - 2010/8
N2 - Currently, the life expectancy of black Americans is about five years shorter than that of white Americans when factoring for gender. Poor patient compliance is often used as an explanation for why black people have worse health outcomes. The proof, however, is anecdotal and relies primarily on discourses about black people's general dysfunction. Black patients often respond in kind to problems they experience with health care access. They often conclude that the medical professionals they work with are racist. In most cases, neither of these explanations is correct. This paper argues that behavioral explanations for health care disparities shift attention away from structural issues, namely health care rationing and the limits of therapeutic medicine. The lack of an open discussion about the structural issues is part of the reason the goal initiated by the Clinton administration to end racial disparities by 2010, Healthy People 2010, largely failed.
AB - Currently, the life expectancy of black Americans is about five years shorter than that of white Americans when factoring for gender. Poor patient compliance is often used as an explanation for why black people have worse health outcomes. The proof, however, is anecdotal and relies primarily on discourses about black people's general dysfunction. Black patients often respond in kind to problems they experience with health care access. They often conclude that the medical professionals they work with are racist. In most cases, neither of these explanations is correct. This paper argues that behavioral explanations for health care disparities shift attention away from structural issues, namely health care rationing and the limits of therapeutic medicine. The lack of an open discussion about the structural issues is part of the reason the goal initiated by the Clinton administration to end racial disparities by 2010, Healthy People 2010, largely failed.
KW - explanatory models
KW - medical anthropology
KW - narratives
KW - race and medicine
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U2 - 10.1080/13648470.2010.493602
DO - 10.1080/13648470.2010.493602
M3 - Review article
C2 - 20721756
AN - SCOPUS:77955871494
SN - 1364-8470
VL - 17
SP - 187
EP - 200
JO - Anthropology and Medicine
JF - Anthropology and Medicine
IS - 2
ER -