Frontiers of Health Services Management - Spring 2014 - (Page 43)

A Historical Perspective on Disparities as Context for Our Work Ahead b ruce S iegel Bay l o r Hea l t h Ca r e System's laudable accomplishments in promot- Historical Backdrop to Current Equity Efforts That Baylor, a system situated in the once rigidly segregated South, has emerged as a leader in reducing care disparities is particularly noteworthy when we consider the long and troubled history of healthcare for minorities and other vulnerable populations in the United States. As with most aspects of life, medical care in the United States, and especially in the American South, was segregated by race prior to the civil rights era. Across much of the South, and even in northern cities with significant populations of African Americans, a separate system of hospitals served black patients and provided training and practice opportunities for black physicians. African Americans in the South largely received care at "blacks only" hospitals, and even those requiring emergency care often were turned away by white institutions (Zheng and Zhou 2008). That hospitals for black patients existed at all owes in part to the reaction of African American physicians to the terrible consequences that the lack of hospital care had on sick and injured blacks. Black physicians spearheaded efforts to establish these facilities after the Civil War and through the first half of the twentieth century-from about 40 in 1900 to about 370 by the early 1960s (Zheng and Zhou 2008). But in terms of health outcomes, Bruce Siegel, MD, is president and CEO of America's Essential Hospitals, based in Washington, D.C. B r uc e Sie g e l * 4 3 C O M M E N T A R Y ing care equity and Dr. Joseph Betancourt's analysis in this same issue illustrate how far we have come toward reducing disparities in care-and how far we still must go. For hospitals and health systems, historical context is important here, as the roots of disparities in the US healthcare system run deep and merit consideration as we push forward to improve how we serve society's most vulnerable people.

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2014

Frontiers of Health Services Management - Spring 2014
Contents
Editorial
Baylor Health Care System’s Journey to Provide Equitable Care
In Pursuit of High-Value Healthcare: The Case for Improving Quality and Acheiving Equity in a Time of Healthcare Transformation
Ending Healthcare Disparities: An Urgent Priority and a Growing Possibility
Expanding the Evidence Base for Health Equity
A Historical Perspective on Disparities as Context for Our Work Ahead

Frontiers of Health Services Management - Spring 2014