• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Study: Racial Gap Persists in Some Medical Treatment

Posted on: Thursday, 18 August 2005, 18:00 CDT

Aug. 18--Despite wide-ranging efforts over the past decade to reduce health disparities, whites are still far more likely to receive important medical treatments than blacks, according to a study being published today in the New England Journal of Medicine.

The findings, from one of the largest studies of its kind, underscore the need for politicians and health care advocates to make disparities a higher priority, said Dr. Ashish Jha, a Harvard University medical school researcher who helped lead the study. The nation has not been educated enough about health care inequities, Jha said Wednesday.

Since the mid-1990s, there has been a boost in funding for federal, state and local agencies to reduce health disparities, he noted. At least 34 states, including Virginia, have established offices of minority health, for example.

"We set out to do this with the hopes of finding some success stories to point to and learn from," Jha said. "Clearly, it was disheartening to not be able to do that. These differences are unacceptable.

"While well-intentioned, these programs are clearly ineffective."

A major reason for concern is that blacks tend to die earlier than whites. According to the national Centers for Disease Control and Prevention, the life expectancy of black males is about 69 years, six years less than their white counterparts. For black women, it's 76 years, four years less than white women.

The study, funded by the Robert Wood Johnson Foundation, examined data for Medicare patients -- about 30 million a year -- between 1992 and 2001.

Blacks edged closer to whites in the rate of usage for only one of the nine types of surgeries studied -- angioplasty, a procedure to open blocked or narrowed blood vessels of the heart. For five surgeries, the gap increased significantly. The disparity rate did not change for three procedures.

For several of the surgeries, the study found, white men were two to three times as likely as their black counterparts to undergo the treatments. The disparities were somewhat smaller between white women and black women.

Information from local areas was not published in the New England Journal. But researchers made some data available separately on Wednesday. In Medicare's Norfolk region, which includes South Hampton Roads, for example, elderly white men were more than twice as likely to receive a coronary artery bypass graft as their black counterparts during the 1999-2001 period.

The researchers also found that local white men in the same age group -- 65 and older -- were more than 50 percent more likely to receive a hip replacement than same-aged black men during that period.

Elderly white women in the local region were more than twice as likely as elderly black women to undergo surgery to remove plaque from the carotid artery, a procedure to reduce stroke risks.

Jha was joined by several other researchers -- from Harvard, Dartmouth Medical School and two other institutions -- in the study, one of three on racial disparities published in today's New England Journal.

They spent more than two years examining the Medicare data. They found that not one of the 306 Medicare regions they studied has been able to eliminate racial disparities.

Dr. Bruce Siegel, a professor of health policy at George Washington University in Washington, called the findings "outrageous."

In recent years, reducing medical errors has been the main focus of those pushing for improvement in care, Siegel said.

But, he asked, "How are we going to improve the quality of care in America if half of our citizens are not getting life-saving treatments?" He noted demographic trends indicating that today's minority groups will, together, constitute a majority of the U.S. population within a few decades.

Just as they have in recent years disclosed more information on the quality of their care, hospitals and other health providers should begin disseminating data on their treatment of minorities, Siegel said.

"There is evidence that if people start measuring these issues, then we can create solutions," he said.

Statewide and locally, no one questioned about the study was surprised by its findings.

Disparities have slowly become a major issue for health care providers in the state.

"Disparities is the No. 2 request for our agency to speak about," said Rene Cabral-Daniels, who runs the state Office of Health Policy and Planning.

Annette Holmes, a director at the nonprofit Virginia Health Quality Center in Richmond, said reducing disparities takes time.

Eight years ago, the center created a program to decrease the rate of black women dying from breast cancer. The rate was significantly higher for black women than for white women. It took four years before the efforts began paying off.

The center will soon begin to offer doctors and other health providers classes on the cultural differences between ethnic groups. "By understanding culture, doctors and nurses will be able to communicate better with their patients," Holmes said.

Bennie Marshall, the chair of Norfol k State University's nursing department, said disparities is a complex issue involving people's socioeconomic status and psychological factors.

There is bias among some providers who control access to medical procedures, Marshall said. But some patients refuse certain procedures out of fear and a lack of education, she said.

Marshall said she thinks her mother should get a knee replacement. She said her mother is afraid to have the operation.

"It's going to take persistence and good education to address disparities," Marshall said. "You can't change set patterns right away. You just can't."

In the end, patients are going to have to demand more from their doctors and nurses, Jha said. Bringing awareness to the problem is a start, he said.

-----

To see more of the The Virginian-Pilot, or to subscribe to the newspaper, go to http://www.pilotonline.com.

Copyright (c) 2005, The Virginian-Pilot, Norfolk, Va.

Distributed by Knight Ridder/Tribune Business News.

For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail reprints@krtinfo.com.

Source: The Virginian-Pilot

More News in this Category