NCPA - National Center for Policy Analysis

THE PERSISTING RACE GAP IN HEALTH CARE

August 18, 2005

Black Americans still get far fewer operations, tests, medications and other life-saving treatments than whites, despite years of efforts to erase racial disparities in health care, according to three major studies being published today in the New England Journal of Medicine.

In the first study, researchers analyzed data collected on all 30 million patients enrolled in Medicare each year from 1992 to 2001, examining how often they got nine of the most common surgical procedures.

  • By 2001, the researchers found, the gap between whites and blacks had narrowed only for one operation for each sex: the repair of abdominal aortic aneurysm among men and angioplasties for women -- a disparity that disappeared entirely.
  • But the gap failed to narrow for heart bypasses and valve replacements, and it increased for back surgeries, stroke-preventing procedures called carotid endarterectomies, hip replacements, knee replacements and appendectomies.

In the second study, researchers studied the records of 598,911 patients treated for heart attacks at 658 hospitals from 1994 to 2002.

  • Blacks remained much less likely than whites to get basic diagnostic tests known as angiographies, as well as drugs or procedures, such as angioplasties, to reopen clogged arteries.
  • Women were also less likely to get appropriate care than men, with black women receiving the worst care of any group, the researchers found.

In the third study, researchers analyzed data on 1.5 million Medicare patients in 183 managed care plans from 1997 to 2003, examining whether women had mammograms, and whether heart disease and diabetes patients got basic tests and treatments. The quality of care overall improved significantly for both blacks and whites, with blacks narrowing the gap with whites on seven of nine measures; on five measures, the difference fell to less than two percentage points.

Source: Rob Stein, "Race Gap Persists In Health Care, Three Studies Say: Blacks Get Fewer Tests, Less Therapy and Medicine," Washington Post, August 18, 2005; based upon: Viola Vaccarino et al., "Sex and Racial Differences in the Management of Acute Myocardial Infarction, 1994 through 2002," New England Journal of Medicine, Vol. 353:671-682, No. 7, August 18, 2005; Ashish K. Jha et al., "Racial Trends in the Use of Major Procedures among the Elderly," New England Journal of Medicine, Vol. 353:671-682, No. 7, August 18, 2005; and Amal N. Trivedi et al., "Trends in the Quality of Care and Racial Disparities in Medicare Managed Care," New England Journal of Medicine, Vol. 353:671-682, No. 7, August 18, 2005.

For text (subscription required):

http://www.washingtonpost.com/wp-dyn/content/article/2005/08/17/AR2005081701437.html

For Vaccarino study (subscription required):

http://content.nejm.org/cgi/content/full/353/7/671

For Jha study (subscription required):

http://content.nejm.org/cgi/content/full/353/7/683

For Trivedi study (subscription required):

http://content.nejm.org/cgi/content/full/353/7/692

 

Browse more articles on Health Issues