Racial Disparities

Study: ICU docs discuss end-of-life with blacks less often

Thu, 22 May 2008 06:59:54 -0400

New research from the Center for Reducing Health Disparities (CRHD) suggests that ICU physicians discuss prognoses and end-of-life issues less frequently with black patients and their families than they do with white patients. Researchers, who interviewed more than 1,200 ICU physicians caring for 9,105 seriously ill patients at five major medical centers, concluded that doctors discussed prognoses with 58 percent of white patients and 41 percent of black patients. In addition, only 43 percent of the ICU doctors reported feeling comfortable during these conversations with black patients. (It's worth noting, however, that the interviews were conducted between 1989 and 1994, which makes the data sufficiently dated.)

Previous data has shown that ICU physicians, when predicting the likelihood that a patient will survive, were less likely to predict that their African-American patients would do so, while in reality, such patients were statistically more likely to survive. Given this concern, as well as the fact that physician discussions can influence family decisions to take steps like pulling life support, it's critical that researchers better understand factors influencing ICU physicians' communication with blacks in the ICU, said Dr. J. Daryl Thornton of the CRHD.

To learn more about the study:
- read this HealthDay News piece

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Study: MDs who treat minorities face quality challenges

Wed, 23 Apr 2008 06:59:55 -0400

Doctors who treat minorities tend to face a unique set of quality and financial challenges, according to a new study appearing in Health Affairs. The researchers, who used data from the 2004-05 Community Tracking Study Physician Survey, concluded that 26 percent of physicians in high-minority practices disagreed that it was possible to provide high-quality care to all patients, while only 16 percent of low-minority practices agreed with this statement. What's more, high-minority practices were more likely to report that having too little time during office visits impacted their ability to provide high-quality care. This study was supported by The Commonwealth Fund.

To learn more about this study:
- read this Modern Physician article

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GA minorities suffer big health disparities

Mon, 21 Apr 2008 06:59:55 -0400

A new report concludes that Georgia's minorities suffer significantly worse health than non-minority citizens, with the report awarding an "F" to 16 Georgia counties on scores of minority care. The grades, which were issued by the state's Department of Community Health, reflect the serious differences found in death rates before age 75. (Another report, by the United health Foundation, ranked Georgia 40th in health status overall, with African-Americans there experiencing 44 percent more premature deaths than whites.)

The disparities come, in part, from structural problems faced by the state's healthcare system as a whole. Of the state's 159 counties, 118 are rural, and have roughly half as many doctors per capita as, say, metro Atlanta, in addition to major shortages of nurses, therapists and nutritionists, the report said. However, minorities generally seem to face bigger obstacles to getting care than non-minority citizens.

To learn more about Georgia's health disparities:
- read this Atlanta Journal-Constitution article
- read this Community Health press release

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Trend: Minority doctors scarce in California

Thu, 03 Apr 2008 07:59:54 -0400

A new study suggests that despite California's ethnically-diverse citizenry, there are comparatively fewer doctors of color to serve them. The study, which was conducted by the University of California San Francisco, concluded that of 62,000 practicing doctors in the state, only 5 percent are Latino, despite the fact that Latinos make up a whopping one-third of the state's total population. And only 3 percent of California physicians are black, compared with 7 percent of the state's overall population. In real number terms, fewer than 3,300 Latino physicians and about 2,000 African-American physicians are in active patient care, in a state with more than 35 million residents. Meanwhile, the state has a disproportionate number of Asian and white doctors, researchers found.

To learn more about the study:
- read this San Francisco Chronicle article

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Study: Ethnic bias not seen in care for same condition

Thu, 13 Mar 2008 07:59:54 -0400

As we've detailed here in the past, disparities in care between whites and ethnic minorities continue to exist throughout the U.S. However, there's at least one area where whites and minorities seem to fare equally in quality of care--though oddly enough, outcomes seem to be worse--according to a new study appearing in the March/April edition of the journal Health Affairs. It appears that when they're being treated in a hospital for the same condition, or getting the same procedure, care for whites and minorities is about equal.

The study drew on state patient discharge data from 13 states from 2000 to 2003, plus data from Pennsylvania and Texas public health authorities and the AHRQ's Healthcare Cost and Utilization project. When researchers crunched the numbers, they found that there were indeed racial disparities in the overall rates of mortality and adverse events for patients, but no major differences in the quality of care between whites and minorities.

To get more data from the study:
- read this Modern Healthcare piece (reg. req.)

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Study: Hispanics get lower-quality medical care

Wed, 12 Mar 2008 07:59:54 -0400

It's more discouraging news from the health disparity front: A new study suggests that elderly Hispanics tend to get inferior care. The study, which looked at Medicare data from 2004, found that hospitals with high percentages of Hispanic patients seem to have slightly lower quality ratings for heart attack, congestive heart failure and pneumonia care. This ties in with data from the past 20 years demonstrating that minorities get lower quality care in the U.S., even when the data is adjusted for age, patient acuity, income level and insurance status, said Dr. Ashish Jha of the Harvard School of Public Health, who led the study.

The study also noted that the disparity extends to where Hispanics are treated, as well what care they get. According to the research, more than half of African Americans and Hispanics get treated at only 5 percent of the nation's hospitals.

To learn more about this research:
- read this piece from The Miami Herald

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