Inner-City Health Care
Journal: Annals of Internal Medicine (1997)

Position Papers15 March 1997Inner-City Health CareAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-6-199703150-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail AbstractThe fundamental problems that beset the U.S. health care system-cost, quality, and access-differ in scope and intensity in inner cities. Current trends in health care are systemwide but are more difficult to accommodate in inner cities because of scarce resources and stresses to the health care system. In this position paper, the American College of Physicians seeks to highlight directions and innovations in public policy for inner-city health care with renewed determination that health care problems in the United States must be solved, especially in cities, where they are most extreme.Many persons in inner cities experience an urban health penalty because of the concentration of economic decline, job loss, and major health problems.Because the problems originate in a complex interaction of socioeconomic factors, behavior, environment, and disease that is related to race and ethnicity, multifaceted approaches that extend beyond the medical model are needed to improve health status. The College argues for tackling health problems of the inner city in the context of a comprehensive urban policy that addresses the root causes of poverty. In addition, this position paper contains more specific recommendations to improve health care delivery to inner cities. The College calls for a comprehensive urban partnership initiative to address all aspects of the urban penalty-social, economic, and health-related-and recommends solutions through public and private collaborations that can be adapted to the circumstances of each community. In addition, policy recommendations address health care coverage, providers, public health initiatives, community involvement, and short-term improvements to such existing programs as Medicaid.References1. Wolff EN. Top heavy: a study of the increasing inequality of wealth in America. A Twentieth Century Fund Report. New York: New Pr; 1996. Google Scholar2. Andrulis DP. The Urban Health Penalty: New Dimensions and Directions in Inner-City Health Care. In: Inner City Health Care. Philadelphia: American Coll Physicians; 1997: no. 1. Google Scholar3. American College of Physicians. Rural primary care. Ann Intern Med. 1995; 122:380-90. Google Scholar4. Adler NE, Boyce WT, Chesney MA, Folkman S, Syme SL. 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Cantor JC, Miles EL, Baker LC, Barker DC. Physician service to the underserved: implications for affirmative action in medical education. Inquiry. 1996; 33:167-80. Google Scholar18. American College of Physicians. The Impact of Managed Care on Medical Education and Physician Workforce. Philadelphia: American Coll Physicians; 1996. Google Scholar19. Volunteer Trustees Foundation for Research and Education. State Attorneys General's Authority to Police the Sale and Conversion of Not-For-Profit Hospitals and HMOs. Washington, DC; 1995. Google Scholar20. Urban Institute. Potential Effects of Congressional Welfare Reform Legislation on Family Incomes. Washington, DC; 1996. Google Scholar Author, Article, and Disclosure InformationAffiliations: Acknowledgment: The inspiration for this position statement came from Gerald E. Thomson, MD, President, American College of Physicians, 1995-1996.Corresponding Author: Elizabeth Prewitt, MA, 700 13th Street, NW, Suite 250, Washington, DC 20005. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPrimary Care Issues in Inner-City America and InternationallyPrimary Care Issues in Inner-City America and InternationallyBarriers to Effective Palliative Care for Low-Income Patients in Late Stages of Cancer: Report of a Study and Strategies for Defining and Conquering the BarriersHealth Through the Urban LensRacial and Ethnic Disparities in Low Birthweight Among Urban Unmarried MothersInner-City Health CareClinical Implications of Household Food Security: Definitions, Monitoring, and PolicyL'« exceptionnel » système de santé américainHospital Participation in Community Partnerships to Improve Health 15 March 1997Volume 126, Issue 6Page: 485-490KeywordsDeath ratesHIV infectionsHealth careHealth care policyHealth care providersHealth economicsLegislationMotivationPrevention, policy, and public healthRacial and ethnic issues ePublished: 15 August 2000 Issue Published: 15 March 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. 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