There have been recent practice and policy concerns over the “quality chasm,” or gap between the promise of evidence-based medicine and the realities of community practice1 with little variation by geographic and sociodemographic factors.2 Studies document disparities in access of care for particular conditions, and there is widespread concern about disparities in health status and health risk factors disadvantaging underserved ethnic minority and lower-socioeconomic status groups.3,4 Addressing quality gaps and health disparities will require implementation of programs to address social determinants of health and improve services delivery across diverse communities. Doing so for underserved communities may be especially challenging owing to resource constraints, underdevelopment of research, and historical distrust in research and health care in some groups.3,5
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 108
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
The Rational Clinical Examination
All results at
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.