ABSTRACT
There is a large and growing body of literature documenting disparities in health and health care between racial groups. Blacks are less likely than whites to receive preventive services, diagnostic testing, and a wide range of interventions (1). These disparities in health care have been linked with higher levels of mortality from cancer and heart disease. For example, blacks with obstructive coronary disease or acute myocardial infarction are less likely to undergo bypass surgery than whites (2), and they have a higher 5-yr mortality (2). Blacks with lung cancer have lower surgical resection rates and higher 5-yr mortality than whites (3). These findings have sparked a broad reassessment of how health care is delivered (4), bringing increased attention to issues of trust (5, 6), cultural competence, and communication skills (7–9) and a commitment on the part of the federal government to eliminate racial disparities by the year 2010 (10).
