Healthcare industry changes alone won't eliminate racial disparities of care outcomes, life expectancy

Although it's vital that the healthcare industry continue its efforts to eliminate racial disparities, those initiatives alone will not rid the inequalities of health outcomes, according to a post at Harvard Business Review.

John Z. Avanian, M.D., director of the Institute for Healthcare Policy and Innovation and the Alice Hamilton Professor of Medicine at the University of Michigan, writes that in order to truly eliminate racial disparity in life expectancy, the nation needs broad policies and collaborations so that community health through racial equity is also considered through education, employment, housing and the judicial system.

"Better integration of these approaches to reduce racial disparities in healthcare and community health will sustain and accelerate progress in narrowing the racial gap in life expectancy, and it will enhance the economic value that comes with better health and longevity," he writes.

In the general population, African-Americans experience higher mortality than their white peers, a problem that research attributes in part to lower socioeconomic status, reduced access to care and genetics. But a new study finds that if all patients get the exact same treatment, African Americans may actually fare better than whites.

The study, published this month in the American Heart Association journal Circulation, reviewed the records of roughly 3 million patients from the U.S. Department of Veterans Affairs--a system that provides equal care for all according to the research team--and recorded the mortality rates of more than 2.5 million whites and 547,000 blacks over an eight-year period.  

After making adjustments for factors like age, gender, income, education, medications and body mass index, they found that black men and women were 37 percent less likely than whites to develop heart disease--the leading cause of death in America.

"We thought we were going to show they do the same if the same care is offered to both groups," Kamyar Kalantar-Zadeh, M.D., a nephrologist and epidemiologist at UC Irvine, told the Los Angeles Times. "But we found blacks do even better. This is a paradox within a paradox."

The findings suggest that a healthcare system without barriers to access, like the VA system, could dramatically improve health outcomes in minorities, Csaba Kovesdy, M.D., director of the Clinical Outcomes and Clinical Trials Program in Nephrology at the University of Tennessee Health Science Center, told CBS News.

Study authors said that the reason for the unexpected results might be due to genetic characteristics that may make blacks healthier than whites in some ways.

The research findings were published in the wake of an article from NPR that explored the role unconscious bias played into the disparities in health outcomes. Providers often respond to African-American patient's complaints of pain with less urgency than white patents and refer them for advanced cardiac care less often. As a result, many medical schools now train students to consider their own preconceived prejudices.

To learn more:
- read the HBR post
- here's the study abstract
- check out the LA Times article
- read the CBS News article

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