Studies Find That Blacks Receive Lower Quality Health Care

November 8, 2006 -- A series of studies on race and health published in the Journal of the American Medical Association have shown that racial minorities regularly receive lower-quality health care than whites in the United States. They are less likely to undergo major surgeries at hospitals that specialize in those procedures. Among Medicare enrollees, black patients fared worse than white patients on several health measures regardless of the quality of their insurance plans. In addition, black women are less likely to survive breast cancer than their white counterparts.

Researchers examined who was using high-volume hospitals for 10 complex surgeries including coronary artery bypass grafting, esophageal cancer resection, and hip fracture repair in California over a five year period. Because high-volume hospitals perform many of these procedures, researchers believe that they produce better results. Blacks were 28 percent to 60 percent less likely than whites to receive surgical care at six out of 10 high-volume hospitals, even when medical plans and geographic area were taken into account.

The second study found that blacks in Medicare-managed insurance plans do not do as well as whites in terms of controlling long-term conditions such as high blood pressure, diabetes, or high cholesterol, regardless of their plan. Researchers examined 430,000 patients in 151 different Medicare plans.

Finally, in a 25-year study of more than 2,000 breast cancer patients in Houston, researchers found that black women had a lower survival rate than white or Hispanic women, and that black patients had more advanced cancer at the time of treatment.

A number of National Academies reports deal with disparities in health care. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care reveals how racial and ethnic minorities tend to receive lower-quality health care than whites do, even when insurance status, income, age, and severity of conditions are comparable.

Evidence indicates that diversity among health professionals is associated with improved access to care and greater choice and satisfaction for minority patients, among many other pluses. In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce examines the benefits of greater representation of racial and ethnic minority groups among these health care providers.

In addition, two reports examine various other factors that influence health. Critical Perspectives on Racial and Ethnic Differences in Health in Late Life and Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda discuss different reasons for why older blacks are even less healthy than whites, who tend to be in poorer health than Hispanics or Asian Americans. The report looks at differences in socioeconomic status, risk behavior, social relations, and geography as well as health care. America Becoming: Racial Trends and Their Consequences, Volume II looks at racial trends in the United States, including differences in health.

• Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (2003)
• In the Nation's Compelling Interest: Ensuring Diversity in the Health Care Workforce (2004)
• Critical Perspectives on Racial and Ethnic Differences in Health in Late Life (2004)
• Understanding Racial and Ethnic Differences in Health in Late Life: A Research Agenda (2004)
• America Becoming: Racial Trends and Their Consequences, Volume II (2001)

• CDC