Unfortunate Racial Bias
There is mounting evidence that there is a racial bias. People with heart failure that are Black are less likely than White patients to receive modern medicine.
A study was published on Wednesday in the journal Circulation: Heart Failure. White people were twice as likely as Black people to have a heart transplant or a mechanical heart pump called a ventricular assist device. It is used for patients with end-stage heart failure.
In a news release from Dr. Thomas Cascino, the study’s lead author and a clinical instructor in the Division of Cardiovascular Disease at the University of Michigan at Ann Arbor, “the body of evidence implies that we as heart failure providers are perpetuating current inequities. Recognizing discrepancies, though, isn’t sufficient. In our capacity as medical professionals, we must devise strategies for bringing about fair change.”
Between July 2015 and June 2016, the researchers examined data on 377 adults in the United States. They were receiving treatment for heart failure, of whom 27% identified as Black.
Data shows that 11% of Black patients underwent a heart transplant or received a ventricular assist device, compared to 22% of White patients, even though both groups’ mortality rates were equal at 18% for Black patients and 13% for White patients.
The patients’ preferences for ventricular assist devices, heart transplantation, or other therapy had no bearing on the outcomes, according to the researchers.
Researchers stated that “this residual imbalance may be a result of institutional racism. As well as discrimination or provider prejudice influencing decision-making.” Specialists in the field state that the results provide validation of what physicians have been observing for years.
Studies
Dr. Jaimin Trivedi, an associate professor at the University of Louisville School of Medicine who has investigated racial disparities among heart patients, said, “I cannot say I’m surprised.” He wasn’t a part of the recent investigation.
Trivedi advises taking an active role in your own health journey in order to receive cardiovascular care. Also heavily involved should be your family or other close friends.
Additionally, Dr. Dave Montgomery, a cardiologist at Piedmont Healthcare in Atlanta, did not find the new findings unexpected.
Montgomery, who was also not involved in the new study says, “the study validates what has been known for too long. Namely that black heart failure patients have worse results. That part of the explanation for the lower outcomes is a gradient in the quality of care received.”
While the findings of this study do not surprise me, the fresh data it offers gives me hope. These findings disprove the notion that variations in heart failure outcomes are related to patient preferences. Among other things, he stated. “The issue is not vague and intractable, as we may have previously thought. Instead, it demonstrates the clear progress toward better treating everyone.
Welcome To America
Dr. Bessie Young, head of the Office of Health Care Equity at UW Medicine says, people should learn how to speak up for themselves and inquire about choices they may not be aware of, like the ventricular assist device.
“There’s just difficulty for certain groups of people to get some of these really life-saving procedures and transplants,” she added.
Young, a health equity researcher, not involved in the study, thinks it demonstrates that social determinants, such as access and education, rather than biological drivers, are to blame for the gap.
Regarding the study’s implications for healthcare professionals, she stated, “Since these resources are so scarce, there should be equity among those who receive them. And it’s at that point that you need to ensure that people are considering utilizing an equity lens when evaluating those who are in need of a device or transplant.
Written By Lance Santoyo
Sources:
Silive: Black adults less likely to receive life-saving heart failure treatment, devices, says study
Healio: Racial bias in pulse oximetry present in patients with acute hypoxemic respiratory failure
CNN: Black heart failure patients less likely to get devices and transplants they need, study finds
Top and Featured Image Courtesy of Cristian Ramírez Flickr Page – Creative Commons License
Inset Image Courtesy of Ben Dracup Flickr Page – Creative Commons License
