Heart Study Finds That With Equal Quality of Care, Blacks Die of Heart Failure at a Lower Rate Than Whites

When quality of care is the same between blacks and whites, blacks have a lower mortality rate from heart failure, a Baylor College of Medicine study finds. The study, presented Nov. 14 at the American Heart Association's annual meeting, followed 17,000 white patients and 5,000 black patients between 1997 and 1999. Thirty days after they were admitted to the hospital, 6.4% of whites and 4.6% of blacks had died. One year after discharge, 23.9% of whites and 20.7% of blacks had died. Blacks in the study were more likely to have hypertension and kidney disease; whites were more likely to have coronary artery and chronic lung disease. Compared to blacks, whites were "more likely to receive comprehensive outpatient care." Blacks were more likely to use emergency room and urgent care facilities for outpatient care. For instance, blacks on average made two emergency room and urgent care facility visits per year after hospital discharge, compared with 1.6 visits for whites. Blacks made 8.6 visits to outpatient care providers, compared with 9.6 for whites. Dr. Anita Deswal, a Baylor professor of medicine and a Houston V.A. Hospital staff cardiologist, said, "This [study] suggests that when cost is taken out of the equation, African-Americans have a lower mortality rate than non-Hispanic whites. But it also suggests African-Americans are using hospital emergency rooms as a substitute for follow-up outpatient care." She added that the study researchers do not have an explanation for the different mortality rates. Dr. Lowell Jones, a University of Texas M.D. Anderson Cancer Center professor, said, "I might have guessed that races were equal after adjusting for equal quality of care but not that African-Americans would have a lower mortality rate. It suggests that a lot of popular ideas regarding minorities come from unfounded assumptions" (Ackerman, Houston Chronicle, 11/15).