ABSTRACT
Civil rights approaches need considerable discussion and clarification as they apply to health care issues. Adequate data are prerequisites to civil rights enforcement activities under present legal obligations and to the continuing process of definition of disparities that are to be regarded as unreasonable or illegitimate in terms of civil rights legislation. Discussion of social class differences is faintly un-American; race and handicapping conditions provide more urgent classifications, as reflected in civil rights concerns. The civil rights problem may be a structural one of institutional indifference or insensitivity to the concerns of racial or ethnic minorities or other constituencies not represented in the decision-making process. From this standpoint, perhaps the most effective regulatory action would be to require the decision-makers, in various health planning contexts at least, to assess the likely consequences of proposed actions on access to and utilization of health care services by racial and ethnic minorities or other disparate groups.
