Spectre of racism in health and health care: lessons from history and the United States

Inequalities in health and health care in relation to race and ethnicity pose ethical problems of which racism is the most disquieting. One controversial inequality is the poor health of African Americans—their life expectancy in 1993 was 7.1 years less than that of white Americans. La Veist et al have shown that the disparity has increased over this century. The deficit arises from excess mortality in relation to many causes of death, and is partly explained by differences in income.