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Understanding Disparities

Understanding healthcare disparities begins with understanding the prevalence. Following are some U.S. statistics:

African Americans

  • African Americans are 13% less likely to have coronary angioplasty and 33% less likely to have bypass surgery than whites.1
  • African American Medicare patients with congestive heart failure or pneumonia received poorer quality care than whites.2 
  • African Americans are less likely than patients of other races to receive an ICD.3

Asian Americans

  • A study of cardiovascular risk factors in Southeast Asian Americans found that hypertension was the most commonly defined risk factor among the sampled population of Cambodian, Hmong, Laotian, and Vietnamese immigrants: 27% had a moderate to high risk, and 14% had a high risk.4
  • Cardiovascular disease is one of the two leading causes of death for Asian Americans.5
  • Native Hawaiians, Japanese and Filipino adults living in Hawaii were about two times more likely to have been diagnosed with diabetes as compared to White residents.6

Hispanic-Latino Americans

  • Hispanic Americans have a higher prevalence of diabetes than non-Hispanic people, yet only 1 in 4 Hispanic/Latinos with diabetes know they are at risk for heart disease.7
  • Hispanic respondents in the AHA Women’s Awareness Study were the least aware of heart disease risk factors among all ethnic groups.8
  • A study of Medicare beneficiaries examining ethnic disparities in quality of HF care reported that compared with non-Hispanic whites and African Americans, Hispanics were least likely to have an assessment of LV ejection fraction and to be discharged on angiotensin-converting enzyme inhibitor treatment.9

South Asian Americans

  • South Asian immigrants in the United States have premature heart disease at three to four times the rate of other Americans.10
  • Compared to other Americans, South Asians have twice the risk of developing heart disease even when there is a lower or equal occurrence of traditional risk factors such as smoking, hypertension, high cholesterol, and obesity.10
  • Serious forms of CAD (left main) and three vessel disease are twice as common among Indians as in whites, and even more common among Indian women.11

Women

  • More women than men die of cardiovascular disease yet women receive only 33% of angioplasties, stents and bypass surgeries and 35% of open-heart surgeries.12
  • Four times as many men as women receive device therapy for sudden cardiac arrest prevention.13,14
  • Four times as many men as women receive cardiac resynchronization therapy to treat heart failure, yet the prevalence of the condition is higher among women.15,16

For more information, email: rs.everypatientfirst@medtronic.com

References

  1. Physicians for Human Rights Report "The Right to Equal Treatment," 2003
  2. Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (Washington, D.C.: National Academy of Sciences, 2003).
  3. Gauri, Davis, Hong, et al. Disparities in the Use of Primary Prevention & Defibrillator Therapy among Blacks and Women, The American Journal of Medicine, 2006.
  4. http://erc.msh.org/provider/informatic/AAPI_CVD_Incidence.pdf
  5. http://www.aahiinfo.org/english/index.php
  6. http://minorityhealth.hhs.gov/templates/content.aspx?ID=2139
  7. www.ndep.nih.gov, National Diabetes Education Program
  8. Tracking Women's Awareness of Heart Disease – AHA National Study; Circulation 2004;109:573-579
  9. R. Correa-de-Araujo, B. Stevens, E. Moy, D. Nilasena, F. Chesley and K. McDermott, Gender differences across racial and ethnic groups in the quality of care for acute myocardial infarction and heart failure associated with comorbidities, Womens Health Issues 16 (2006), pp. 44-55.
  10. http://www.southasianhealth.org/default.aspx, South Asian Health Project
  11. Reports of the National Commission on Macroeconomics and Health. Ministry of Health and Family Welfare, India 2005
  12. National Heart, Lung, and Blood Institute: Addressing Cardiovascular Health in Asian Americans and Pacific Islanders. Publication Number 00-3647
  13. Adapted from American Heart Association, the Nurse's Health Study. WISE and Acute Coronary Syndromes Without Chest Pain: Insights from GRACE.
  14. American Heart Association's 2006 Statistical Update Report and web site (www.americanheart.org).
  15. Agency for Healthcare Research and Quality (AHRQ), HCUP Net Database of Hospital Discharges for 2003.
  16. American Heart Association Heart Disease and Stroke Statistics 2007.
Last updated: 22 Sep 2010

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