Black elderly more likely than whites to die after intestinal surgery

Black senior citizens who need surgery for the intestinal disorder diverticulitis are significantly more likely to die in the hospital than their equally ill white counterparts, even when each racial group carries the same health insurance, new Johns Hopkins research suggests.

While all of the patients in the study required surgery, were 26 percent more likely than white patients to undergo riskier and more expensive emergency diverticulitis surgery rather than "elective" scheduled surgery for their condition, the Hopkins researchers found. The results emerged in a study of data from , the government health insurance for senior citizens.

Black seniors also spent more time in the hospital recovering from their operations and the costs of their stays averaged nearly $30,000 more than those of comparable white patients.

Publishing in the November issue of the medical journal , the researchers say that while lack of insurance is often a major driver of in health care, their analysis shows that even with equal access to a doctor, race-based differences in outcomes persist.

"Even if everyone has coverage, black patients are doing worse, so we need to find out what else is going on," says study leader Eric B. Schneider, Ph.D., an at the Johns Hopkins Center for Surgical Trials and Outcomes Research. "Maybe then we can make a difference."

Schneider and his team analyzed data from more than 50,000 who underwent surgery — removal of part of the colon with or without or a colostomy procedure — between 2004 and 2007 in the United States. The researchers, adjusting for age, gender and other underlying illnesses, found that being black was associated with a 28 percent increase in in-hospital mortality, regardless of whether the patient underwent emergency or pre-planned surgery.

Diverticular disease is a common gastrointestinal condition, affecting up to 25 percent of the elderly. In severe cases, it is treated with surgery.

Previous research has found higher rates of mortality, complication and readmission among black surgical patients when compared to white patients undergoing similar procedures. Schneider says the conventional wisdom is that black patients' poorer outcomes can largely be accounted for by differences in socioeconomic status, including coverage and greater underlying comorbidity. The new research contradicts that hypothesis, he says.

Schneider says past research has shown that even when they have insurance, black patients are less likely to go to the doctor than white patients, even for routine preventive services such as vaccination. Black patients may also have more undetected or undiagnosed illnesses than white patients, as research shows black patients are less likely to undergo diagnostic evaluations than white patients.

One study, says Schneider, suggested that under-utilization of health care resources by blacks may be related to a higher level of distrust of the medical establishment.

If black seniors were encouraged to see doctors more quickly when they are sick, an illness like could be treated earlier, potentially obviating the need for surgery, or at least allowing for a less-risky, pre-planned operation.

"It may be an access issue. It may be a cultural issue," he says. "Whites are more likely to have a family practitioner and that may be a factor."

More information: Arch Surg. 2011;146[11]:1272-1276

Provided by Johns Hopkins Medical Institutions

4 /5 (1 vote)

Related Stories

Race and insurance status associated with death from trauma

Oct 20, 2008

African American and Hispanic patients are more likely to die following trauma than white patients, and uninsured patients have a higher death risk when compared with those who have health insurance, according to a report ...

Recommended for you

What are the chances that your dad isn't your dad?

Apr 16, 2014

How confident are you that the man you call dad is really your biological father? If you believe some of the most commonly-quoted figures, you could be forgiven for not being very confident at all. But how ...

New technology that is revealing the science of chewing

Apr 15, 2014

CSIRO's 3D mastication modelling, demonstrated for the first time in Melbourne today, is starting to provide researchers with new understanding of how to reduce salt, sugar and fat in food products, as well ...

After skin cancer, removable model replaces real ear

Apr 11, 2014

(HealthDay)—During his 10-year struggle with basal cell carcinoma, Henry Fiorentini emerged minus his right ear, and minus the hearing that goes with it. The good news: Today, the 56-year-old IT programmer ...

Italy scraps ban on donor-assisted reproduction

Apr 09, 2014

Italy's Constitutional Court on Wednesday struck down a Catholic Church-backed ban against assisted reproduction with sperm or egg donors that has forced thousands of sterile couples to seek help abroad.

User comments