Question

In what ways were the racial and ethnic culture of America defined by the Civil Rights Act of 1964? What are the reasons for affirmative action?

Answer 1

In the United States, affirmative action was first created by Executive Order 10925, signed by President John F. Kennedy in 1961. It required that government employers "not discriminate against any employee or applicant for employment because of race, creed, c

• Affirmative action.
• Animal rights.
• Anti-discrimination law.
• Cultural assimilation.
• Cultural pluralism.
• Desegregation.
• Diversity training.
• Empowerment.

olor, or national origin."

The Civil Rights Act of 1964 banned discrimination and segregation on the basis of race, religion, national origin and gender in the workplace, schools, public accommodations and in federally assisted programs. ... The Civil Rights Act also had a profound effect on schools

It is hard to talk about race. Discussions about race in general and racial discrimination in particular are potentially unnerving, which explains in large measure why such conversations are so few and far between. In the health care context, discussions about race and racial discrimination are particularly rare.

But this is slowly beginning to change, and two primary forces have triggered the change. First, the Initiative to Eliminate Racial and Ethnic Disparities in Health has focused considerable attention on improving the health status of people of color in the United States. The disparities initiative was launched in 1998 by former President Clinton and Secretary of Health and Human Services Donna Shalala. Under this bipartisan initiative, President Clinton and Secretary Shalala committed the nation to the ambitious yet attainable goal of eliminating racial and ethnic disparities in six areas of health status while continuing the progress that has been made in improving the overall health of people in America. The six focus areas of this initiative are: (1) infant mortality; (2) cancer screening and management; (3) cardiovascular disease; (4) diabetes; (5) HIV infection/AIDS, and (6) immunizations. This Initiative enjoys the support of current HHS Secretary Tommy Thompson.

The second factor that has triggered a discussion about the role of discrimination in health care is the dramatic increase in immigrant populations in urban and rural settings across the United States. These major demographic shifts have forced health care providers, government officials, and communities to address the unique challenges confronting immigrants. The growing dialogue surrounding the need for a culturally competent health profession reflects the recognition of the changing face of America.

The disparities initiative and the rapid expansion of immigrant populations across America have focused the attention of health professionals, politicians, and policy makers on the critical question of why it is that communities of color and immigrant communities are lagging behind the rest of America in so many critical measures of health status.

Racial disparities in many areas of health status are well documented, disturbing, and preventable.² In order to eliminate health disparities, it is important first to understand the root causes. Until recently, the role of discrimination was largely ignored. Instead, disparities have been defined in other terms: economic -- poor people are more likely to have difficulty accessing quality health care;. geographic--those who live on the wrong side of the tracks and near the toxic waste dump are more likely to encounter health problems; and sometimes genetic--certain races or ethnicities may have a genetic predisposition to certain illnesses. Finally, disparities frequently have also been defined in terms of education or behavioral issues -- if we could simply teach better habits.

All of these explanations are undoubtedly true depending on the context, with some factors perhaps playing a larger role than others. However, another factor is rarely discussed-discrimination. This paper addresses the role that discrimination plays in explaining health disparities, and outlines a host of civil rights interventions that can be put into place to address these disparities. This paper is divided into four parts.

Part one addresses what specifically is meant by “discrimination” in the legal sense. Discrimination is an often misunderstood concept, and this section seeks to demystify and destigmatize discrimination by explaining what it means legally in the health care context. This section introduces Title VI of the Civil Rights Act of 1964, one of the principal tools used in addressing discrimination in the health care context.

Parts two and three explore whether discrimination is actually alive and well in the health care setting. Part two outlines research regarding the potential role of discrimination in explaining health disparities. This section is not intended as an exhaustive review of the literature, but it does outline noteworthy studies that have triggered further discussion about the role of discrimination in explaining disparities.

Part three discusses actual discrimination cases in the health care context. There are some respected experts who believe that discrimination is not a significant problem in health care.³ Regrettably, the evidence belies these assertions, and there is a substantial body of cases involving discrimination in a variety of health care settings, and this section discusses these cases. A generation ago, discrimination in health care was quite similar to discrimination in other settings. That is, hospitals, nursing homes and other health care facilities, like schools, were segregated and needed to be integrated. Thus, early discrimination cases in the health care context focused on issues such as equal access to medical facilities.

Today's civil rights challenges in health care generally are more subtle, but no less compelling. The six categories of cases discussed in section three are (1) intentional discrimination cases; (2) access to health care for people with limited English skills; (3) medical redlining in a variety of settings, including managed care and home health care; (4) other managed care issues, including physician participation; (5) discrimination in access to treatment; and (6) other unique challenges confronting immigrant population in addition to language access.

Parts two and three lay out the case that discrimination is a root cause of health disparities, and underscore that a comprehensive strategy to eliminate disparities must incorporate a strong civil rights component. Part four contains a series of recommendations for eliminating disparities that focus on the civil rights dimension of the disparities challenge. These recommendations include (1) promoting the collection of data related to race, ethnicity and primary language by federal, state and local governments and health care facilities; (2) enhancing the federal infrastructure for enforcing civil rights laws in the health care context; (3) expanding the capacity of private organizations to enforce civil rights laws in the health settings; (4) implementing a comprehensive language access agenda; (5) amending federal law to re-establish that private parties can enforce all provisions of the Title VI regulations; and (6) reviewing federal law and removing barriers to participation for legal immigrants in critical programs, such as Medicaid and the State Children's Health Insurance Program (SCHIP).