1) How do individual physicians contribute to health care disparities? Thinking about an area of health care of particular interest to you, what research do you think could be done to either understand the effect of individual physicians on health disparities, or to decrease this effect?
Receiving a diagnosis of Autism Spectrum Disorder (ASD) is the first and most crucial step at receiving early intervention services. Screening for ASD can be done as early as 18 months, when children fail to meet major milestones in social communication. Being identified early not only helps with the child’s immediate behaviors, but it can also improve the child’s trajectory for functional independence in the future. Physicians are the first contact that parents have regarding their child’s health and development. Thus, they play a major role in determining whether the child would be targeted for vital ASD services.
There is extensive research on disparities in ASD diagnoses across racial groups that place the blame on caregiver education and/or socio-economic status (Carr & Lord, 2013; Magana et al., 2012; Mandell et al., 2007; Mandell et al., 2002). These structural factors might determine access to quality healthcare and quality physicians, as well as competent parent communication regarding the child’s behavior impairments. However, this burden should not fall to the parents who are seeking care for their child. The physician and/or medical professional should take on the responsibility to adequately screen and evaluate children for ASD, regardless on caregiver racial and SES characteristics.
Research could intervene at the level of the medical facility and evaluate incentive-based interventions that aim to improve patient/doctor interactions. Several have delivered interventions to increase patient communication with their physicians (Harrington, Noble, & Newman, 2004). However, this review revealed an absence of racial considerations when interpreting treatment effects.
2) Structural issues within health care delivery are implicated in health care disparities. Please brainstorm 4 structural issues that might contribute to these disparities. Which of these are relevant to your particular area of research, and how?
Income, education, gender, and race are key structural issues
that influence disparities regarding a child receiving a diagnosis of ASD.
Income and education covary, with one contributing to the other. For example, resultant
low income given low education creates a variety of barriers to healthcare and quality
of treatment received. Gender might be the variable that dictates income regardless
of education, given that women’s reported income is typically lower than their
male counterparts. Finally, race, is the umbrella variable that influences both
education and income, as differential opportunities could be a result of institutional
racism.