Please note that the dates refer to the time we transferred the news topics to our archives
March 10, 2002A racial gap in the health-care system
Minority doctors seen facing hurdles
By Kimberly Atkins, Globe Correspondent ( 8/10/2001)
Black and Latino doctors have a harder time than white doctors getting hospital and specialty care for their patients, says a study released [on Aug. 9, 2001] - a disparity that researchers said reflects a growing racial gap in care. One in three black and Latino physicians reported having difficulty getting their patients admitted to hospitals, compared to one in four white physicians, according to the study by the Center for Studying Health System Change, a nonpartisan policy research organization.
Twelve percent of black doctors and 15 percent of Latino doctors reported difficulty getting specialty referrals for their patients, compared to 8 percent of white doctors.
The study was published [on Aug.9, 2001] in Medscape General Medicine, an online medical journal.
The difficulties that minority doctors face point to a bigger problem - the quality of health care received by minority patients, said Lee Hargraves, the study's lead researcher. That's because minority doctors are more likely to treat a larger percentage of patients with the same ethnic background.
Lack of access to quality health care can particularly affect blacks and Latinos, who are at higher risk for a number of illnesses including diabetes and heart disease, diseases that often require hospitalization and care by endocrinologists and cardiologists, Hargraves said.
The findings hit home for many physicians.
''This mirrors my experience in a lot of ways,'' said Dr. Joseph Betancourt, an internist at Massachusetts General Hospital who serves as director for multicultural education.
Betancourt, who is of Puerto Rican descent, said that in practice he often had a difficult time finding his patients specialists who could speak Spanish. He now teaches students at Harvard Medical School and residents at Massachusetts General Hospital how to take cultural issues into account when giving medical care.
The study validated a lot of what black doctors have been experiencing anecdotally for years, said Dr. Rodney G. Hood, former head of the National Medical Association and an internist practicing with three other black doctors in San Diego.
''We have long been saying that there is discrimination that has been institutionalized in the system,'' said Hood, who is from Roxbury.
He stressed, however, that it is not just minority doctors who have to be vigilant to ensure that minority patients are receiving quality care.
''Black doctors are more likely to treat black patients,'' he said. ''However, since there are so few black doctors, the majority of black patients are still being treated by white doctors.''
According to the study, less than 5 percent of physicians are black and less than 6 percent are Latino - although together blacks and Latinos make up about 25 percent of the general population.
Since most minority patients are being treated by white doctors, all doctors must be trained in what Betancourt calls cultural competency - the ability of doctors to recognize and meet the particular needs of their patients based on their cultural background.
''Medical facilities (and) medical groups need to have translators, and a bilingual staff,'' said Dr. Elena Rios, president of the National Hispanic Medical Association. ''They need to have ability to understand and provide a quality experience for their patients.''
This story ran on page A2 of the Boston Globe on 8/10/2001.
© 2001 Globe Newspaper Company.////////////////////\\\\\\\\\\\\\\\\\\\\
Prostate Cancer Survival Gap Between African Americans and Caucasians May be Closing
June 4, 2001
The survival gap may be narrowing between African Americans and Caucasians who have had prostate cancer and have been treated with radical prostatectomy, according to a new Wayne State University study.
Dr. Fernando Bianco, a WSU urologist at Harper University Hospital, and his colleagues conducted a study of 1,042 men who had radical prostatectomies between 1990 and 1999, about a third of whom were African American. The men were divided into two groups: those who had the procedure between 1990 and 1995 and those who had it between 1996 and 1999.
Although more Caucasian men than African-American men remained disease free between 1990 and 1995, the gap appeared to be closing between 1996 and 1999. Dr. Bianco believes the survival rate for African Americans improved because more cases were caught at an earlier stage and contained to the organ because of prostatic-specific-antigen (PSA) testing.African American men have lagged behind whites in access to the PSA (Prostate specific antigen) blood test and other tests for early detection of prostate cancer. They were estimated to be two to three times as likely to die of prostate cancer as white men. Poor medical care, late diagnosis and inferior treatment were the main culprits, according to Dr. Raymond Wynne, MD, a senior radiation oncologist at the University of Rochester.
Dr. Bianco says this is changing. "If you can catch it early enough, you can make a big difference, and I think that's the thing that's happening here," he said.
Source: PSA Rising Magazine
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New Study: A Disparity in VA Hospitals that favors Blacks
African Americans patients when treated at the VA hospitals seem to do better than whites, a new study said. They were found to have better survival rates for six common conditions. It is a well known fact that usually blacks fare less than whites in the whole American healthcare system.The reason for this disparity that seems this time to favor Black patients could not be clearly defined. One reviewer suggested though the data used may not have measured the sickness levels of the patients when they were admitted for treatment.
The authors of the study said the finding shows the benefits blacks have in treatment at a government program which offers equal access.
The study from the Veterans Affairs Medical Center and Department of Medicine, University of California, San Francisco, looked at the records of 28,934 white and 7,575 blacks, all male patients admitted for treatment at 147 VA hospitals in 1995 and 1996. They were treated for six common problems -- pneumonia, angina, congestive heart failure, chronic obstructive pulmonary disease, diabetes and kidney failure.
"We found that black patients had lower 30-day mortality compared with white patients after admission ... overall mortality at 30 days was 4.5 percent in black patients and 5.8 percent in white patients. Mortality was lower among blacks for each of the six medical diagnoses," the study said. The authors added that the findings were consistent across disease, age, financial status, length of stay and other lines, including geography.
"The survival advantage of black patients is not readily explained; however, the absence of a survival disadvantage for blacks may reflect the benefits of equal access to health care and the quality of inpatient treatment at VA medical centers," concluded the report, published in a recent issue of the Journal of the American Medical Association.
The study reiterated what several other health experts have said before: that in general racial differences are found in many aspects of U.S. health care delivery. Black patients are less likely to receive coronary angiography after a heart attack than white patients, it said, and after receiving coronary angiography, they are less likely to undergo revascularization. Doctors are more likely to delay referrals to a kidney specialist for black patients than for white patients, blacks are less likely to receive surgery for lung cancer and black women are less likely to undergo mammography than white women, the study said, referring to other information already written on the subject.
Ashish Jha, the main author of the study, said this new study "underscores how much progress the VA has made in bringing equal access and really good quality care for all patients ... and might hopefully provide some impetus for all of the health care organizations to look at what kind of care they provide minorities and other underserved populations, and make a concerted effort in some way to catch up to the kind of equal access that the VA provides."////////////////////\\\\\\\\\\\\\\\\\\\\