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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

View larger version (17K): [in a new window]   Figure 1 Evidence of racial/ethnic differences in cardiac care, 1984 to 2001. Source: Kaiser Family Foundation/American College of Cardiology Foundation. Racial/Ethnic Differences in Cardiac Care: The Weight of the Evidence (9).

View larger version (25K): [in a new window]   Figure 2 Evidence of racial/ethnic differences in cardiac care: methodologically strong and less strong studies, 1984 to 2001. Source: Kaiser Family Foundation/American College of Cardiology Foundation. Racial/Ethnic Differences in Cardiac Care: The Weight of the Evidence (9). CABG = coronary artery bypass graft; PTCA = percutaneous transluminal coronary angioplasty; THROM = thrombolytic therapy.

View larger version (24K): [in a new window]   Figure 3 Odds ratios for selected methodologically strong studies: coronary artery bypass graft surgery (African Americans/whites). *Odds ratio findings taken from Kressin N, Petersen L. Racial differences in the use of invasive cardiovascular procedures: review of the literature and prescription for future research. Ann Intern Med 2001;135:352–6. Study analyzes more than one procedure or treatment. Odds ratio: African Americans/whites 2.26 (0.42 to 12.11). The authors computed relative risks, which are comparable to odds ratios when the events are rare. Both measure the strength of an association between a factor and an outcome. Note: Studies selected for this figure were all methodologically strong studies that used odds ratios for analyzing statistical differences between African Americans and whites. An odds ratio of 1.0 means there is an equal likelihood of receiving the procedure or treatment. An odds ratio of <1.0 means African Americans are less likely to receive the procedure or treatment. Source: Kaiser Family Foundation/American College of Cardiology Foundation. Racial/Ethnic Differences in Cardiac Care: The Weight of the Evidence (9).

View larger version (30K): [in a new window]   Figure 4 The public's perceptions of quality of care others receive compared with whites. Black bars = lower quality; white bars = same quality; gray bars = higher quality. Source: Kaiser Family Foundation. Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences, October 1999 (conducted July to September 1999) (11).

View larger version (33K): [in a new window]   Figure 5 Perceptions of disparities in health care. Black bars = very often; white bars = somewhat often. Source: Kaiser Family Foundation. National Survey of Physicians, March 2002 (conducted March to October 2001) (11); Kaiser Family Foundation. Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences, October 1999 (conducted July to September 1999) (11).

View larger version (16K): [in a new window]   Figure 6 Physicians' perceptions on disparities in heart disease treatment. Black bars = those who agree; white bars = those who disagree. Source: Kaiser Family Foundation. National Survey of Physicians, March 2002 (conducted March to October 2001) (11); Kaiser Family Foundation. Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences, October 1999 (conducted July to September 1999) (11).