In reply
The comments by Dr Stevens are thoughtful and important, in that they highlight the interconnection between the quality of and disparities in health care. A growing body of literature shows that, among adults, disparities can be reduced by improving the quality of care for all patients.1,2 This is being demonstrated through a collaborative effort among community health clinics sponsored by the Institute for Healthcare Improvement and the Bureau of Primary Health Care that focuses on improving the quality of health care for minority patients with chronic diseases (http://ihi.org/collaboratives/hdc.asp). Unfortunately, we have yet to conduct similar studies and demonstration projects for children and adolescents.