Racial disparities are not just an isolated public health concern, based on a national study that consistently found differences in health outcomes by race and income, regardless of hospital performance or neighborhood.
Published in JAMA Network Open, this study looked at whether racial health disparities vary between different hospitals. The goal was to determine whether health disparities are influenced by certain areas or if it’s a reflection of issues with the health system as a whole.
Health disparities occur when certain groups of people carry greater burdens of disease or face poorer outcomes than other individuals. In the U.S., it’s well established that minorities and low-income individuals tend to have poorer health than whites and individuals with higher levels of income and education.
To further explore, researchers analyzed Medicare data from patients 65 years or older who were treated at U.S. hospitals between 2009 and 2011. Eligible participants were treated for heart attack, heart failure or pneumonia, which are among the top causes of hospital visits. Researchers tracked hospitalizations and survival rates a month after hospital admission.
Depending on the type of visit analyzed, the study included as many as 703,324 patients and up to 1,265 hospitals. Authors note that most hospitals were large teaching hospitals, many of which were located in the South.
Interestingly, researchers found that 30-day mortality rates from heart attack, heart failure and pneumonia were slightly lower in black patients than in whites. However, black patients were more likely to be re-hospitalized in the following month for these conditions, indicating poorer outcomes.
Researchers note that these differences were similar across all hospitals included in the study. Overall, hospitals generally delivered consistent quality of care to patients, regardless of race.
What findings suggest, according to authors, is that health disparities are largely caused by issues with the health care system as a whole. Initially, authors wondered whether disparities could be due to minorities and low-income patients receiving poorer care or seeking care at lower quality hospitals. However, this study disproved that theory, as quality of care at hospitals was similar across the board.
According to authors, there are many factors that influence health disparities, such as income, education, and access to care. With better education and changes to policy, experts hope to tackle these underlying causes and help improve health and outcomes for minority and low-income populations.