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The Pediatric Forum |

Race Not Always Useful in Final Analysis—Reply

Frederick P. Rivara, MD, MPH; Laurence Finberg, MD
Arch Pediatr Adolesc Med. 2001;155(8):973. doi:10.1001/archpedi.155.8.972.
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We appreciate the thoughtful comments of Drs Moore, Laws, and Davis and colleagues on our recent editorial. We, as Dr Laws, hope that our editorial will not be misinterpreted. We agree that the issue of racial and ethnic disparities in health and health care is a major problem and support the efforts of the federal government1 and others to address these concerns. We welcome research reports that specifically examine disparities in health and health care and use sophisticated methods to explore the reasons for these disparities. We view medicine and patient care as resting on science but influenced by many variables as the letters point out. While we fully agree that cultural lifestyle and discrimination affect health and access to health care, these factors are not based on genetic determinants implied when using the term "race." Likewise, ethnicity is frequently used interchangeably with culture but in a very imprecise way. We also agree that health is affected by social, economic, and cultural determinants. We believe, as do Dr Davis and his colleagues, that sophisticated tools are needed to better measure the cultural and social factors that affect health and health care and ultimately reduce the disparities in these areas that still exist in this country.

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