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Am J Public Health. 2003 Feb;93(2):248-55.

Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health?

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  • 1Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, MN 55417, USA.


There is extensive evidence of racial/ethnic disparities in receipt of health care. The potential contribution of provider behavior to such disparities has remained largely unexplored. Do health and human service providers behave in ways that contribute to systematic inequities in care and outcomes? If so, why does this occur? The authors build on existing evidence to provide an integrated, coherent, and sound approach to research on providers' contributions to racial/ethnic disparities. They review the evidence regarding provider contributions to disparities in outcomes and describe a causal model representing an integrated set of hypothesized mechanisms through which health care providers' behaviors may contribute to these disparities.

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