Ideological shifts needed in primary care delivery: removing barriers through reform

Black Americans is one of the fastest growing segments of the population, yet the incidence of illness and mortality are higher and survival from the leading causes of death is poorer than for White Americans (Jaynes & Williams, 1989; U.S. Department of Health and Human Services [DHHS], 1990). In achieving the Year 2000 national health promotion and disease prevention objectives, health care systems must provide universal access to high quality, affordable, comprehensive, and coordinated primary health care services. It is crucial to initiate new approaches to health care delivery, including linking primary care providers (PCPs) in communities where people live and work to eliminate barriers and improve access to culturally-sensitive primary health care in Black communities. Nursing can play an important leadership role in redirecting the education of PCPs and shaping public policy to reflect the primary health care philosophy.