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No Matter the Doctor, Black Diabetics Fare Worse Than White Counterparts
Date:6/10/2008

f blood sugar levels) versus only 39 percent of blacks; 57 percent of whites had LDL ("bad") cholesterol levels in check, compared with 45 percent of blacks; and 30 percent of whites had their blood pressure in normal zones compared with 24 percent of blacks.

Socio-demographic factors, such as patient income and insurance explained some of the difference, in the order of about 20 percent to 30 percent, Sequist said. In other words, certain types of patients tended to cluster within certain providers.

Other diseases and conditions such as obesity or heart disease explained virtually none of the difference.

"Then you're still left with this big chunk of difference, and the question is why," Sequist said.

As it turned out, medication prescription rates tended to be lower among blacks, which might account for some of the discrepancy.

But the study was unable to explain why that might be. "We get all our data from charts and electronic medical records, so we don't have details about what discussions might have happened between physicians and patients that might have led to that lower rate," Sequist said. "Was counseling less effective among African-Americans? Were there differences in their ability to afford these medications and, if so, did the case provider decide not to order them? We don't have those types of differences."

"It's difficult to elucidate what exactly is the cause," pointed out Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center and Albert Einstein College of Medicine in New York City. "It's important to be aware of these disparities, and the issue will be to find out how to reduce them."

Sequist was also the lead author on a May 2008 study in the Journal of General Internal Medicine that found that 88 percent of primary-care clinicians agree that racial disparities in health care are a problem, but only 40 percent felt the disparities existe
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