Patient and practitioner noncompliance: Rationing, therapeutic uncertainty, and the missing conversation

    Research output: Contribution to journalReview articlepeer-review

    17 Scopus citations

    Abstract

    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.

    Original languageEnglish (US)
    Pages (from-to)187-200
    Number of pages14
    JournalAnthropology and Medicine
    Volume17
    Issue number2
    DOIs
    StatePublished - Aug 2010

    All Science Journal Classification (ASJC) codes

    • Public Health, Environmental and Occupational Health
    • Anthropology
    • Arts and Humanities (miscellaneous)

    Keywords

    • explanatory models
    • medical anthropology
    • narratives
    • race and medicine

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