Studies find racial differences in US health care
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Racial disparities still exist in U.S. medical care despite years of attempts to reduce them, with black women typically being the least likely to get the care they need, research published on Wednesday shows.
“For most of the areas studied, disparities between white patients and black patients have not substantially improved during the past decade or so,” said Nicole Lurie in an editorial in The New England Journal of Medicine, where the findings appear.
Lurie of the Rand Corp. said there was hope for improvement because the leaders of insurance plans covering 90 million people “now understand that in order to make further improvement in the quality of health care and respond to a more demographically diverse marketplace, they need to make progress in racial disparities.”
A study led by Amal Trivedi of Brigham and Women’s Hospital in Boston contained a glimmer of good news, showing that racial disparities for patients in managed care plans had declined in seven out of nine categories from 1997 to 2003.
“When you have programs that provide more consistency for everyone, that seems to have some effect on racial disparities,” Ashish Jha of the Harvard School of Public Health, author of one of the other studies, told Reuters.
But the other study findings were less encouraging.
The Jha team found that the racial disparities for five procedures, such as surgery to replace a hip, knee or heart valve, actually increased between 1992 and 2001.
The gap in care for blacks narrowed for only one of the nine procedures studied.
“When we started our study two years ago, we did it with the hope that we would find a few procedures where the gap was narrowing, or a few regions around the country where the gap truly got eliminated so we could try to extrapolate that to the rest of the country,” Jha said. “We couldn’t find any place in the country, or any set of procedures, where we could consistently see the gap narrowing.”
“It’s a little shocking,” he said.
The third study came to a similar conclusion.
Using data from a national Heart attack registry, researchers found that between 1994 and 2002, for every 100 white men who needed and received treatment to have their narrowed heart arteries reopened, the same care was received by 97 white women, 91 black men and 89 black women.
Similar trends were found for both the likelihood of receiving coronary angiography, where doctors locate specific blockages in the heart, and the risk of death in hospital following a heart attack.
There was “no evidence that the differences have narrowed in recent years,” said Viola Vaccarino of Emory University School of Medicine. “We could not determine the reasons for the differences,” Vaccarino said.
However, the disparities were not seen across the board. Blacks and whites were just as likely to receive aspirin and beta-blocker drugs for their heart disease, for example.
More than 600 studies in the medical literature have shown over the years that the quality of care varies according to a person’s racial or ethnic background.
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