African Americans with muscular dystrophy die 10 to 12 years younger than their white counterparts, according to research published in the Sept. 14 issue of Neurology, the medical journal of the American Academy of Neurology.
The black-white mortality gap, which was calculated on the basis of 20 years of data, is among the largest ever observed in the annals of research into racial disparities in health care, say Dr. Nicte Mejia and Dr. Rachel Nardin, co-authors of the editorial. "Furthermore," they write, "white patients with MD [muscular dystrophy] enjoy increasing survival, while survival of black patients with MD barely budges," leading to an ongoing widening of that gap.
Muscular dystrophy is a group of inherited muscle diseases that lead to early death due to respiratory or cardiac failure. Various types of MD affect about 50,000 Americans.
"Inequities in the health delivery system - and the multiple ways in which race constrains access to care - seem the most likely explanation for the observed MD black-white mortality gap," Mejia and Nardin write in their editorial. But they add that inadequate access to care due to lack of good quality health insurance may also be part of the picture.
"Nonelderly African Americans are 1.5 times more likely than whites to lack any type of insurance and about twice as likely to rely on Medicaid," they write, noting that lack of health insurance is linked to lack of access to care.
And while Medicaid, the public health program for the poor, compares favorably with private insurance in providing access to primary care, it falls short when it comes to providing access to the standard-of-care treatments needed to manage conditions like muscular dystrophy, they say.
These shortcomings of Medicaid coverage are "particularly worrisome because more than half of the new health coverage under the 2010 National Health Reform will be Medicaid."
In a separate comment made today, Nardin said, "Replacing the current U.S. health care financing system with a single-payer system that would ensure comprehensive insurance coverage for every American, regardless of race, would go a long way toward reducing this type of disparity."