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Biases Stop Blacks from Getting Pacemakers
Adding to the disease burden and shameful health disparities in America, new research has found that both African Americans and Hispanics with chronic heart failure are less likely than whites to be treated with a specialized pacemaker that prolongs survival and eases symptoms. Make no mistake about it this is a racial health disparity that is 1000% preventable.
The specific treatment at issue is called cardiac resynchronization therapy, and while more and more patients are getting it, the racial gaps remain, according to Dr. Zubin Eapen of Duke University School of Medicine in Durham, North Carolina. And per the American Heart Association, coronary heart disease (CHD) caused the deaths of 21,407 black males and 20,491 black females in 2008. And data from that same year showed non-Hispanic blacks age 20 and older, 7.9% of men and 7.6% of women also have CHD.
“New technologies tend to diffuse unevenly across racial and ethnic lines,” he said. “This is an example of underutilization of a recommended therapy in eligible patients.”
The new study, published by Eapen and his colleagues in the Journal of the American College of Cardiology, is the latest to point to healthcare disparities in the U.S.
More than five million Americans have chronic heart failure, which can cause pronounced fatigue and shortness of breath. In some people with this condition the two big chambers of the heart fail to contract in sync, further reducing the heart’s ability to pump out blood.
In cardiac resynchronization therapy with defibrillation, or CRT-D, a pacemaker-like device helps the two chambers pump properly. The units sell for tens of thousands of dollars. The most disturbing is that with the scope of existing disparities, researchers identified more; consider more than 100,000 patients eligible for CRT-D from a U.S. registry of heart devices known as implantable cardioverter-defibrillators. Between 2006 and 2010, the percentage of white patients receiving the therapy climbed from 81% to 84 percent.
For blacks, the number went from 78% to 81% and for Hispanics, from 77% to 79 percent. The disparities are significant because black males are disproportionately impacted by heart disease and could benefit from the lifesaving pacemaker.
Healthyblackmen.org would like to encourage patients to talk to their doctor, explicitly ask about new medical devices, treatment, and therapies. And when you are unsure about the standard of treatment you are receiving, get a second, and even third opinion if needed. It’s your health.
“Despite all the initiatives that we have had,” said Eapen, “we are still having the unequal diffusion across racial lines.”
The racial gap remained after accounting for a number of possible explanations, such as differences in age, gender, hospital region and other diseases between the groups. And they held up when looking only at Medicare beneficiaries, for whom cost should not be a factor. The reasons behind the disparity are unclear, but personal preferences, provider biases and access to care could all be at work, according to Eapen.
Really, hmmm. Be your own best advocate brothers and sisters.