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‘Race Gap’ in Older Americans’ Health Still Exists

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‘Race Gap’ in Older Americans’ Health Still Exists

But blacks have made some gains, especially in the West

Older blacks in the United States still experience a “race gap” when it comes to managing diabetes and heart disease, according to a new study.

Researchers found that from 2006 to 2011, black Medicare patients were consistently less likely than whites to have their blood sugar, high blood pressure and cholesterol under control.

But there was good news: The racial divide in health care appears to have disappeared in western parts of the country.

“The disparity between African-American and white patients was eliminated,” said lead researcher John Ayanian, M.D., director of the Institute for Healthcare Policy and Innovation at the University of Michigan in Ann Arbor. “This offers hope that things can improve nationwide.”

What’s the West doing differently? Researchers point to Kaiser Permanente’s—a large, California-based insurer—programs for older adults. During the study period, Kaiser made greater use of electronic health records, initiated more email communication between doctors and patients and included changes to the list of blood pressure drugs offered as a standard benefit to members.

By the end of the study period, nearly 90 percent of patients of all races had reined in their blood sugar, 74 percent had their blood pressure under control and 70 percent had their LDL (bad) cholesterol down to healthy levels.

But we still have work to do to narrow racial health disparities. In an accompanying editorial published in the New England Journal of Medicine, Marshall Chin, M.D., associate chief of general internal medicine at the University of Chicago, wrote:

“There clearly are some success stories. We now know a fair amount about what works to help reduce disparities. But we need the will to widely implement those things.”

Changes in hospital procedures and health plan benefits don’t go far enough, according to Dr. Chin. To eliminate disparities fully, he said, health systems and individual doctors must study their records to see if there are disparities in how patients of different races fare. Lower-income minorities need help to find places to buy healthy food and safe places to exercise. And there needs to be more emphasis on prevention.

“The way that our health-care system is set up is that it rewards procedures,” Dr. Chin wrote, “but it does not reward prevention.”

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BHM Edit Staff