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Blacks Continue to Lose the Health Care Battle Better Health Insurance Doesn't Mean Better Care for Blacks, ABC News, Oct. 24, 2006
Blacks receive poorer health care than whites do.
Studies have shown this time and time again.
Research now suggests that that these health care
disparities do not stem from differences in
access to care or the quality of health
insurance, as some experts thought previously.
Researchers at Harvard and Brown universities say
a racial gap persists in health care regardless
of what health insurance plans people have,
according to a study published in today's Journal
of the American Medical Association.
Blacks still experience diminished health care
when compared with whites, even when blacks are
enrolled in "high-quality" health plans, plans in
which a larger percentage of patients demonstrate signs of good
health.
Poor health care often translates into poor
health outcomes. But that cannot change until
experts understand what's behind the disparities, experts say.
Inside Medicare Medical Care
The Harvard/Brown researchers analyzed the blood
sugar, cholesterol and blood pressure levels of
more than 300,000 black and white patients. All
were enrolled in one of 151 Medicare health plans in 38 states.
These weren't necessarily healthy patients -- they needed medical
care.
At the start of the study, each patient had
diabetes, high blood pressure or had suffered a
cardiac problem, such as a heart attack or stroke.
Diabetes, high blood pressure and heart attacks
can lead to stroke, kidney disease, heart attacks
or death if not properly treated.
Proper treatment means keeping an eye on these
high-risk patients to help them control their
health problems. But black patients in the study
were 6 to 14 percent more likely than white
patients to have uncontrolled blood sugar,
cholesterol and blood pressure levels.
Same Plan, Different Care
Researchers found countless cases in which whites
and blacks received different levels of care.
Seventy percent of the time, those disparities
occurred among white and black patients enrolled in the same
Medicare plan.
"We saw that over two-thirds of the disparities
were found within health plans and not between
health plans," says Dr. John Ayanian, an author
of the study and associate professor of medicine
and health care policy at Harvard Medical School.
So these differences in quality of care have
little to do with insurance and health care availability.
"Even when everyone is insured and in the same
plan, we still find racial disparities," says Dr.
Amal Trivedi, lead study author and assistant
professor in the department of community health at Brown Medical
School.
Widespread Implications
Experts say this study is important because "it
pinpoints the problem," says Dr. Ross Isaacs,
associate professor of medicine at the Center on
Health Disparities at the University of Virginia.
"These disparities ... should not be underestimated."
Researchers hope their study findings will
encourage health care organizations to start
collecting data on race and ethnicity.
"There are no public reports of equity of health
care. Many health care plans don't collect
information on race and ethnicity," says Trivedi,
which makes it difficult for health care plans to
know when racial disparities exist.
With an increased awareness about racial
disparities, heath care plans could then "monitor
the quality of care their patients are receiving
and have programs to improve this care when
needed," says Ayanian, adding that the quality
and the racial fairness of a given health plan
should be taken into account when patients select a health plan |
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