Black Heart Attack Patients Living In Certain Areas Are More Likely Than Whites To Be Admitted To Hospitals With Higher Mortality Rates

Main Category: Cardiovascular / Cardiology
Also Included In: Public Health
Article Date: 05 Mar 2009 - 5:00 PDT

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Black heart attack patients living in racially segregated areas are 35% more likely than whites to be admitted to hospitals with higher mortality rates, even when hospitals that have better outcomes are geographically closer, according to a Health Affairs study released on Tuesday, CQ HealthBeat reports. For the study, Mary Vaughan Sarrazin, an assistant professor at the University of Iowa, and colleagues analyzed hospital admissions of Medicare beneficiaries for heart attacks in 118 health care markets between 2000 and 2005.

Researchers examined straight-line distances between the location of the patient and the hospital where they were admitted, finding that in areas with high levels of hospital segregation, 27% of black patients who lived closer to a hospital not classified as high mortality were admitted to a high-mortality hospital farther away, compared with 9% of white patients under the same circumstance.

Researchers could not determine a single factor behind the disparity but suggested that patient preference and physician referrals might be contributing factors. They also noted that blacks might feel more comfortable being seen by black physicians, who are more likely to be in hospitals with a majority of black patients.

According to CQ HealthBeat, the study has some limitations. It only looked at fee-for-service Medicare beneficiaries; distances between locations, rather than travel time; and areas primarily in the southern U.S. The researchers acknowledged some complexities in measuring racial segregation, as well as the study limitations, but said the findings are an "important step" toward understanding the causes of racial health care disparities.

Sarrazin said, "I think health services researchers are just beginning to understand the influence of culture and diversity on health services." She added, "This study really opens up some conversation about other factors that we had previously not measured" (Skotzko, CQ HealthBeat, 3/2).

The study is available online.

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