RACIAL CONCORDANCE, AUTONOMY, AND JUSTICE: EVIDENCE FOR THE ETHICAL NEED OF DIVERSITY IN MEDICINE

Abstract

Racial and ethnic minorities in the United States experience health disparities and poor health outcomes at a disproportionate rate in comparison to other groups. One of the many social determinants of health that contributes to these poor health outcomes is mistrust in the medical community. Mistrust is a consequence of a too-long history of unethical experimentation in African American and Latino communities, and has resulted in decreased use of preventive services and screening tools, lack of adherence to medical treatments, and minimal participation in clinical trials. These patterns of minimal utilization of healthcare services have resulted in poor outcomes for numerous health conditions, poor understanding of different diseases and their impact on minority groups, as well as a lack of evidence-based treatments which will benefit these populations. The purpose of this thesis is first to address the historical origins and contemporary consequences of mistrust in medicine within the African American and Latino communities. Second, I address the ameliorating impact that patient-physician racial and language concordance has on both trust and clinical outcomes. Throughout, I reference the ethical principles which warrant the need for greater patient-physician race and language concordance, and I present pipeline programs as a tool to increase the diversity in the medical field, all with the ultimate goal of improving health outcomes in the African American and Latino community.