African Americans have 5 times higher amput...( CHICAGO The overall amputation rate...),Health

CHICAGO The overall amputation rate in northern Illinois is declining due to improved care for diabetes and peripheral vascular disease, new research shows.

But not everyone is reaping the benefits.

A new study from Northwestern University's Feinberg School of Medicine has found people in African American communities on Chicagos South and West Side have a five times higher rate of lower limb amputations than people in the predominantly white suburbs and exurbs.

Amputations are the canary in the coal mine for quality of care," said Joe Feinglass, lead author and research professor of medicine at the Feinberg School. Many amputations are preventable. This means the primary care for minority people may not be very good. "

Feinglass said the high rate of amputations means people are not being closely monitored. "They come in with gangrene or a skin ulcer that comes to the attention of a doctor really late and nothing can be done," he said. "They have to take their leg off.

This is the first longitudinal study -- nationally or locally -- to examine amputation trends over nearly 20 years. Most studies of amputation rates look at one point in time.

The study will be published in the May issue of the Journal of Vascular Surgery.

The high amputation rate for minorities in Chicago likely reflects other racial disparities in healthcare, Feinglass said. "Diabetes is a condition that is highly susceptible to quality of care. Amputation rates give you a basic idea of how the system is performing."

It was known in the late 1990s that African Americans were more likely to have an amputation than whites. But as the national trend of amputations declined in the early 2000's, Feinglass wanted to see if the gap closed or at least narrowed.

The study examined hospital discharge data from the Illinois Department of Public Health for nine counties in northern Illinois encompassing more than eight
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