HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lillie-Blanton, M. Articles by Mensah, G. A. Search for Related Content PubMed PubMed Citation Articles by Lillie-Blanton, M. Articles by Mensah, G. A.

STATE-OF-THE-ART PAPER

Disparities in cardiac care: Rising to the challenge of healthy people 2010

Marsha Lillie-Blanton, DrPH^*,*, Thomas M. Maddox, MD, Osula Rushing, MS and George A. Mensah, MD, FACC

^* Henry J. Kaiser Family Foundation, Washington, DC, USA
Cardiovascular Institute, Mount Sinai Medical Center, New York, New York, USA
Grantmakers In Health, Washington, DC, USA
Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Manuscript received March 25, 2004; accepted April 6, 2004.

^* Reprint requests and correspondence: Dr. Marsha Lillie-Blanton, Henry J. Kaiser Family Foundation, 1330 G Street NW, Washington, DC 20005, USA.
mlillie-blanton{at}kff.org

Eliminating health disparities is one of two overarching goals of Healthy People 2010. Although the causes of health disparities are complex, they appear to be related, in part, to disparities in the quality of medical care. Two recent reviews of peer-reviewed research investigated the evidence on racial/ethnic differences in medical care. An Institute of Medicine summary of the literature concluded that in most studies, racial and ethnic disparities in health care remained even after adjustment for potentially confounding factors. A review focused specifically on cardiac care, conducted jointly by the Kaiser Family Foundation and the American College of Cardiology Foundation, reached a similar conclusion after examining the most rigorous studies investigating racial/ethnic differences in angiography, angioplasty, coronary artery bypass graft (CABG) surgery, and thrombolytic therapy. For example, African Americans were statistically less likely than whites to undergo CABG surgery in 21 of the 23 most rigorous studies that calculated odds ratios to compare CABG use. Although there is a convincing body of evidence that race continues to matter in the health system, a nationally representative survey of physicians revealed that the majority of physicians do not view a patient's race/ethnicity as a factor in obtaining care, but do believe insurance coverage matters. Increasing physicians' awareness of the evidence for the role that race/ethnicity plays in health care is important because they are in a good position to directly and indirectly affect changes in clinical practice or patient behavior that could reduce disparities in care.

Abbreviations and Acronyms   ACCF = American College of Cardiology Foundation   CABG = coronary artery bypass graft   IOM = Institute of Medicine   KFF = Kaiser Family Foundation   OR = odds ratio

This article has been cited by other articles:

				K. Bibbins-Domingo and A. Fernandez BiDil for Heart Failure in Black Patients: Implications of the U.S. Food and Drug Administration Approval Ann Intern Med, January 2, 2007; 146(1): 52 - 56. [Abstract] [Full Text] [PDF]

				D. H. Thom and M. D. Tirado Development and validation of a patient-reported measure of physician cultural competency. Med Care Res Rev, October 1, 2006; 63(5): 636 - 655. [Abstract] [PDF]

				K. J. Lancaster, S. O. Watts, and L. B. Dixon Dietary Intake and Risk of Coronary Heart Disease Differ among Ethnic Subgroups of Black Americans J. Nutr., February 1, 2006; 136(2): 446 - 451. [Abstract] [Full Text] [PDF]

				A. N. Trivedi, T. D. Sequist, and J. Z. Ayanian Impact of Hospital Volume on Racial Disparities in Cardiovascular Procedure Mortality J. Am. Coll. Cardiol., January 17, 2006; 47(2): 417 - 424. [Abstract] [Full Text] [PDF]

				L. Goldman Cost-Effectiveness in a Flat World -- Can ICDs Help the United States Get Rhythm? N. Engl. J. Med., October 6, 2005; 353(14): 1513 - 1515. [Full Text] [PDF]

				G. de Simone Left Ventricular Hypertrophy in Blacks and Whites: Different Genes or Different Exposure? Hypertension, July 1, 2005; 46(1): 23 - 24. [Full Text] [PDF]

				K.-H. Mak Bridging the practice chasm Eur. Heart J., May 2, 2005; 26(10): 949 - 950. [Full Text] [PDF]

				G. A. Mensah, A. H. Mokdad, E. S. Ford, K. J. Greenlund, and J. B. Croft State of Disparities in Cardiovascular Health in the United States Circulation, March 15, 2005; 111(10): 1233 - 1241. [Abstract] [Full Text] [PDF]

				G. A. Mensah Eliminating Disparities in Cardiovascular Health: Six Strategic Imperatives and a Framework for Action Circulation, March 15, 2005; 111(10): 1332 - 1336. [Abstract] [Full Text] [PDF]