WASHINGTON (AP) - Whether it's a heart bypass, cancer surgery or pain management, minorities do not get as good health care as whites, the Institute of Medicine concludes.

"We weren't unaware of disparities, but we were surprised at the depth and breadth of the evidence," Dr. Alan Nelson, chairman of the committee that did the study, said Wednesday.

"Disparities in the health care delivered to racial and ethnic minorities are real and are associated with worse outcomes in many cases, which is unacceptable," he said.

The report was welcomed by Dr. Lucille Perez, president of the National Medical Association, which represents minority physicians.

"It validates what many of us in the NMA have been saying for so long — that racism is a major culprit in the mix of health disparities and has had a devastating impact on African-Americans," she said.

To Dr. David R. Williams of the University of Michigan, the report was "a wake-up call for every health care professional. We have a health care system that is the pride of the world, but this report documents that the playing field is not even."

Nelson, a retired physician and current consultant to the American College of Physicians-American Society of Internal Medicine in Washington, said the challenge now is finding ways to eliminate these differences.

Claude Allen, deputy secretary at the Department of Health and Human Services, said the Bush administration was seeking to address the disparities through a variety of initiatives, including increasing spending for community health centers and on research focused on the health of minorities.

The report, prepared at the request of Congress, is not the first study to reach this conclusion. As recently as January, the Centers for Disease Control and Prevention reported that, while Americans made advances in the 1990s against a broad range of diseases, racial and ethnic disparities remain.

Among the examples in the new report:

_A study of nearly 11,000 patients with lung cancer found that 76 percent of whites and 64 percent of blacks had surgery. After five years the survival rate was 26 percent for blacks and 34 percent for whites.

_A report on more than 13,000 heart patients found that for every 100 white patients who had a procedure to clear the heart artery, only 74 blacks did.

_Among 15,578 people who sought care in an urban emergency room, blacks were 1.5 times more likely to be denied authorization by their managed-care providers.

The report said the differences exist even when insurance, income, age and the severity of the disease are the same for both groups.

The committee recommended changing health insurance programs to reduce disparities among economic groups and setting up education programs to increase health care providers' awareness of the problem.

Other recommendations included recruiting more minorities into health care, expanding patient education programs and improving enforcement of laws against discrimination.

The National Academy of Sciences is an independent organization chartered by Congress to provide advice to the government on scientific topics.

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On the Net:

National Academy of Sciences: http://www.nas.edu

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