CHOPR’s Multi-layered history of racial and ethnic disparities research helps identify factors of nursing that influence minority patient outcomes
In January 1989, Dr. Linda H. Aiken co-authored a landmark paper published in the Journal of the American Medical Association that highlighted a disturbing lack of healthcare equality for black Americans. In the years that followed CHOPR scientists continued to explore whether additional investments in nursing could contribute to reducing racial and ethnic disparities in health care delivery.
It would be another decade before full attention was brought to bear on the issue, however. In 2002, the Institute of Medicine’s report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care documented differences in the care, treatment, and outcomes for black patients compared to white patients. Then in 2008, The Dartmouth Atlas Health Care Project also confirmed stark differences in the care and treatment received by minorities, prompting the study’s sponsor, the Robert Wood Johnson Foundation, to create an initiative aimed at narrowing health care disparities across lines of race and geography. At the forefront, CHOPR sought to further investigate hospital characteristics that underlie care inequalities.
Drs. Eileen Lake, Douglas Sloane, Matthew McHugh, Ann Kutney Lee, and Margo Brooks Carthon, together and separately, developed research projects that could help identify potential interventions that could reverse what has been described as a “major area of concern for U.S. Health Policy.”
In 2008, Dr. Eileen Lake was funded by the NIH to continue to study nursing interventions to reduce disparities in hospital outcomes. Lake focused on disparities in maternal and infant health that are linked to nursing factors, including education and hospital resources. In 2017, she compared missed nursing care for infants in neonatal intensive care units (NICUs) across hospitals with a predominantly-black versus non-black patient population and found that NICUs with high-black infant populations had significantly higher patient-to-nurse ratios.
With funding from the Robert Wood Johnson Foundation (RWJF), Nurse Faculty Scholars Program, Dr. Matthew D. McHugh worked to identify potential interventions that could reverse disparities. During the three-year project, he successfully disseminated his findings in top-tier journals and well known media outlets including NPR, The Philadelphia Inquirer, American Nurse Today, and Advance for Nurses.Today. Today, McHugh is studying the impact of nursing on racial disparities in surgical outcomes supported by the National Institute of Minority Health and Health Disparities. The CHOPR team is closely examining the relationship between nursing and disparities in specific procedure and patient groups.
Dr. J. Margo Brooks Carthon’s doctoral dissertation focused on health disparities during the early 20th century. As a Nurse Practitioner, she saw countless patients that had difficulty accessing healthcare due to minority inequalities and was able to bring her unique perspective to study the vital role nurses play in the healthcare system. Dr. Brooks Carthon said, “Seeing evidence of the power of nurses historically and in my own clinical practice prompted my interest in studying the role of nurses in more contemporary settings.” She was the first to establish empirical data suggesting that nursing delivery system strategies were associated with better nurse staffing and care environments and were positively linked to minority outcomes.
Over the last decade, Dr. Ann Kutney Lee has partnered with Dr. Brooks Carthon to author several papers in high impact journals. Today, Brooks Carthon is studying the relationship between the organization and delivery of nursing care in-hospital cardiac arrest outcomes among black patients with funding from the National Institute on Minority Health and Health Disparities. She is also co-investigator on Kutney Lee’s VA Merit Award looking at racial disparities in quality of end-of-life care among veterans. Together, they are currently working on a new proposal to study the effects of electronic health record adoption and usability on minority health outcomes - a true intersection of their work to date.
- Sample list of CHOPR papers on disparities research
- Archived new stories from 1989 Blendon et al. paper: USA Today, Herald Examiner, and Los Angeles Times