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Patient preferences play role in racial disparities in rheumatoid arthritis treatment
Date:4/7/2009

in either health care providers or the health care system. This is because research on health care disparities has largely focused on access to care, lack of insurance, quality of care due to unconscious practitioner bias and social factors.

Although the Institute of Medicine's model of health disparities includes an acknowledgement that these may be due in part to differences in preferences of care, few studies have tested this notion and racial/cultural differences in risk/benefit perception remain an under-researched field.

"Our study is important because, to the best of our knowledge, this is the first study to formally assess whether risk preference for therapy is one of the potential explanations of the lower use among African Americans of more effective, although more risky, therapy for a chronic disabling disease," the authors state. They point out that disparate models of health and illness may lead to disparate patient preferences, as well as limited communication during clinical visits.

The study showed that African Americans were significantly more risk averse than their white counterparts, which the authors theorize may be due to "cultural risk aversion for gains." This type of risk aversion is based on a learned distrust or low expectations of the healthcare system that arise when a subgroup observes significant gains in lifespan, economic prosperity and power of the larger culture, but does not experience these gains even though they live in the same country or culture.

The authors conclude: "Given these results, physicians should confirm that patients have accurate expectations regarding the natural history and treatment of their disease, and ensure that patient preferences are based on an informed assessment of the pros and cons related to available treatment options."


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Contact: Sean Wagner
medicalnews@bos.blackwellpublishing.com
781-388-8550
Wiley-Blackwell
Source:Eurekalert

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