Report Details Racial Disparities in Care

June 9, 2008 at 12:20 pm 1 comment

The Dartmouth Atlas Project has released a report titled Disparities in Health and Health Care Among Medicare Beneficiaries.  While disparities in care are generally associated with race and socioeconomic factors, the Dartmouth report reveals that geography also plays an important role.  The report examines geographic disparities in the rates of leg amputations (a complication of diabetes), screening for breast cancer and diabetes, the prevalence of primary care physicians, and ambulatory care vs. hospitalization rates. You can read a NY Times article on the report here.

The Robert Wood Johnson Foundation used the data in the report as a platform to announce $300 million in new grants to fight health disparities.

The Democrat and Chronicle reports on the Rochester numbers in the report (full article after the jump) and notes that that while progress has been made in areas such as immunizations and mammograms, disparities in diabetes care remain.  According to the most recent Monroe County Adult Health Survey, 20 percent of African Americans in the county have diabetes – more than twice the number of whites and Latinos.

The Democrat and Chronicle
June 8, 2008
Rochester-area health care suffers from racial disparity
Justina Wang

Black patients in the Rochester area have their legs amputated from complications with diabetes or vascular disease at a rate more than six times that of white people, a disparity that far exceeds the racial gaps in other parts of western New York, a study released last week found.

The discrepancy in leg amputation rates is indicative of differences in preventive care and a community’s socioeconomic problems, said Dr. David Goodman, co-author of the Dartmouth Atlas Project’s report on the health care of Medicare beneficiaries across the country. Though racial gaps in medical care have long been noted, the study shows vastly different levels of disparities in communities across the country.

The rate of white patients in the Rochester area who undergo leg amputations from complications falls below national averages, but local black patients have their legs amputated at significantly higher rates than across the state and country. More than five in every 1,000 African Americans in the Rochester area have amputations, according to the report.

In the Buffalo region, African Americans undergo leg amputations at less than twice the rate of white people, with 1.86 amputations for every 1,000 black patients. In the Syracuse region, the rate is about four and a half times higher for African Americans than white people, with 3.9 amputations for every 1,000 black patients.

“In Rochester, that’s a troubling and very high degree of disparity,” Goodman said.

The study, based on Medicare data and commissioned by the nonprofit Robert Wood Johnson Foundation, also found that black people with diabetes in the Rochester area were far less likely than white people to have annual eye examinations or blood lipid tests. Those racial disparities were again more pronounced in the Rochester area than in other parts of western New York and across the country.

Dr. Nancy Bennett, director of the University of Rochester’s Center for Community Health and the Monroe County’s deputy health commissioner, said the Rochester area has recently narrowed racial disparities in childhood immunizations and mammographies because of targeted efforts.

“What we’ve not been as successful in is addressing disparities as a whole, and I think that’s because there’s so many different factors,” she said. “It sounds like this data will point us in the direction where we need to work next.”

Along with higher rates of complications, more than twice as many African Americans as white people in Monroe County have diabetes, Bennett said. Health officials are now working on teaching diabetes and heart disease prevention in minority communities through the county’s Healthy Living Program, which is run through UR. “If we focus a great deal of attention on a particular area, we can have a major effect.”

In other measures of health care included in the study, the Rochester region fared better than national and western New York averages with higher percentages of both black and white people who have primary care physicians and annual mammographies.

Local patients of both races were also less likely to go to hospitals because of poorly managed chronic conditions such as diabetes.

In connection with the report, officials at the nonprofit Robert Wood Johnson Foundation announced $300 million in grants over the next three years to health programs targeting 14 communities across the country, including western New York.

The P2 Collaborative of Western New York, based in Williamsville, Erie County, will receive about $1 million to come up with public education campaigns on diabetes and health management, and consumer training programs to teach patients how to find good healthcare.

“Our collective goal is to close the gap between the quality of health care that people now receive and what we believe the health care system is capable of delivering,” said P2 Collaborative Executive Director Shelley Hirshberg.

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Entry filed under: Access to Health Care, Immunization, In the News, Overweight and Obesity, Physical Activity.

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