Public Health Reports: The human face of health disparities - Photo Essay
Public Health Reports: The human face of health disparities - Photo Essay: "AFRICAN AMERICANS, CARDIOVASCULAR DISEASE, NO CARDIAC CATHETERIZATION
According to the American Heart Association, African Americans are 28% more likely to die of cardiovascular disease than white Americans. (1) Despite this disease disparity, by the early 1990s several studies had demonstrated quite clearly that African Americans were referred less frequently for cardiac catheterization for coronary artery disease than their white counterparts. (2) Many investigators felt that most or all of this discrepancy could be explained by African American patients preferring less invasive management. But subsequent studies have shown that differences in patient preference account to only a minor extent for the disparities seen in cardiac catheterization and other aspects of health care. (3,4) Communication barriers, problems in the doctor-patient relationship, and bias have been proposed as more important explanations of the differences measured. (5,6) It remains to be seen to what extent patient preference itself is based on a lack of trust in a health care system that has historically treated African Americans unfairly.
AFRICAN AMERICANS AND RENAL TRANSPLANT
While disparities in cardiovascular disease have been extensively studied, disparities in renal disease and especially renal transplantation are arguably the most compelling examples of differential treatment. The risk of an African American developing end-stage renal disease requiring dialysis is four times the risk for a white American. (7) Once on dialysis, African American patients are only about 70% as likely to be referred for evaluation to a renal transplantation center. (4) While much of the former difference may be explained by patient factors such as disease predisposition or access to car"
According to the American Heart Association, African Americans are 28% more likely to die of cardiovascular disease than white Americans. (1) Despite this disease disparity, by the early 1990s several studies had demonstrated quite clearly that African Americans were referred less frequently for cardiac catheterization for coronary artery disease than their white counterparts. (2) Many investigators felt that most or all of this discrepancy could be explained by African American patients preferring less invasive management. But subsequent studies have shown that differences in patient preference account to only a minor extent for the disparities seen in cardiac catheterization and other aspects of health care. (3,4) Communication barriers, problems in the doctor-patient relationship, and bias have been proposed as more important explanations of the differences measured. (5,6) It remains to be seen to what extent patient preference itself is based on a lack of trust in a health care system that has historically treated African Americans unfairly.
AFRICAN AMERICANS AND RENAL TRANSPLANT
While disparities in cardiovascular disease have been extensively studied, disparities in renal disease and especially renal transplantation are arguably the most compelling examples of differential treatment. The risk of an African American developing end-stage renal disease requiring dialysis is four times the risk for a white American. (7) Once on dialysis, African American patients are only about 70% as likely to be referred for evaluation to a renal transplantation center. (4) While much of the former difference may be explained by patient factors such as disease predisposition or access to car"
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