Second, some evidence suggests that medical care that is prevention oriented and seeks to address the social determinants of health along with the delivery of clinical services can play an important role in reducing disparities in health.161 Moreover, for at last some health status indicators, medical care may have a greater positive effect on socially disadvantaged populations than on their more advantaged counterparts.159 Research reveals that primary care is associated with better overall health and with smaller SES and racial disparities in health.162 Specifically, health is better in areas with more primary care physicians and for persons who have primary care physicians as their usual source of care. Blacks in the U.S. are two to three times more likely than whites to have diabetes-related lower extremity amputations, a disparity that is not evident in black-white comparisons in London. It has been suggested that the more primary care oriented British health system has eliminated this disparity.162
