Rationing of healthcare

Racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities, even when access-related factors, such as patients’ insurance status and income, are controlled. The sources of these disparities are complex, are rooted in historic and contemporary inequities, and involve many participants at several levels, including health systems, their administrative and bureaucratic processes, utilization managers, healthcare professionals, and patients.

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I would like to thank those with whom I have worked both at the University of Bristol and at the University of East Anglia for their friend- ship, encouragement and advice in the years leading up to the publication of this book. Particular thanks are due to Caroline Ball, Dave Cowan, James Davey, Bronwen Morgan, Jill Morgan, Tony Prosser, Oliver Quick, Mike Radford, Claudina Richards and Mark Stallworthy.

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As the global epidemic of diabetes continues to expand, the prevalence of type 2 diabetes is predicted to double in the next 20 years. Continued population growth, increasing age, and worldwide globalization leading to changes in diet and patterns of physical inactivity have resulted in staggering numbers of individuals affected by the disease. A haphazard approach to treatment for a problem of this magnitude could easily overburden the healthcare system, particularly in areas of the world with limited resources.

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