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Racial Discrimination Takes The Nobility Out Of Doctoring

Previous doubts about racial inequalities, even at the cost of lives, are turning out to be the ugly truth. A recent study finds that blacks are far less likely than whites to get specialized procedures, like angioplasty, after a heart attack, which leave them more vulnerable to future fatal attacks.

The study, published in the Journal of the American Medical Association, tracked 1.2 million Medicare patients at least 68 years old treated for a heart attack between January 2000 and June 2005 at 4,627 U.S. hospitals.

It found large differences in the way heart attacks are treated in black patients compared to white patients. Blacks were about 30 percent less likely to get procedures to open blood vessels such as angioplasty or open-heart surgery after a heart attack whether or not the hospital they checked into provided full invasive cardiac services.

Blacks were also 22 percent less likely to be transferred from a hospital that did not do such procedures to one that did, it found. And when they were, blacks were 23 percent less likely to get these operations than whites, the researchers said.

The results also found that in the first month after a heart attack, blacks were 9 percent less likely to die than whites, the researchers said, perhaps because whites were more likely to undergo specialized procedures that sometimes can be fatal.

But in the period from a month to a year after the heart attack, blacks were up to 26 percent more likely to die than whites, the study found.

I wished we knew what's going on, says lead researcher Dr. Ioana Popescu of the University of Iowa Carver College of Medicine and the VA Medical Center in Iowa City.

The study was not designed to find the reasons for the disparities. Popescu opines that though racial discrimination can not be ruled out, other factors may be at play including patient preferences for certain types of procedures and possible overuse of certain aggressive procedures in white patients.

Previous studies also have found differences in the way black and white U.S. patients are treated. This one is a large, nationwide study revealing that racial disparities apparently persist. Unfortunately we couldn't find significant progress, Popescu says. Medicare is the U.S. government health insurance program for the elderly and disabled.


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