Determinants of racial and ethnic disparities in surgical care.

Racial and ethnic disparities are a pervasive and persistent problem in health care. This article has three main objectives: 1) To highlight key studies related to racial disparities in cardiovascular care and outcomes; 2) To explore determinants of disparities specifically related to access to renal transplantation as a model for understanding racial disparities in greater depth; and 3) To present promising approaches to eliminate racial disparities in care. Performance reports of the quality of medical and surgical care by race and ethnicity will be a crucial and expanding tool as more organizations ascertain complete data on their patients' race, ethnicity, language, and socioeconomic characteristics. Efforts to improve the quality of care and health outcomes of underserved racial and ethnic groups will also require effective coordination of care, patient-centered communication, and constructive engagement with communities to eliminate disparities in health care and health.