Skip to Content

Neurology Study Reveals What We Already Know: People of Color Get Worse Healthcare

Maybe one day we’ll spend more energy addressing racism instead of continuing to prove it exists

 

In the most recent issue of Neurology, Dr. Altaf Saadi and colleagues reveal the disheartening news that African Americans and Hispanic Americans receive lower quality neurologic care than their white counterparts.

Analyzing data from the Medical Expenditure Panel Survey from 2006-2013, they found that Black patients were 30% less likely to see an outpatient neurologist even after adjusting for social factors such as insurance coverage. Hispanic patients were 40% less likely.

They looked at neurologic diseases such as stroke, headache, multiple sclerosis, Parkinson’s disease, and epilepsy. According to the CDC, strokes kill over 130,000 Americans each year, about 5% of deaths. Strokes are also the leading cause of long-term disability. Furthermore, the risk of stroke is nearly twice as high for Black Americans as opposed to whites. Yet, despite higher rates of stroke, Black Americans are seeing neurologists, the experts on strokes, less.

The authors postulate that there are likely simultaneous factors. The first factor they cite is low health literacy. Not only are patients unaware of all the possible follow up care that can prevent another stroke or minimize the impact of a recent one, folks might not even recognize the symptoms of stroke, multiple sclerosis, or Parkinson’s disease to begin with.

Folks of color are more likely to have their care across more than one healthcare system making it difficult for the primary care doctor, the emergency room doctor, the neurologist, and the hospital doctor to coordinate their care. If you live in the Southeastern United States, the number of neurologic specialists is far lower than anywhere else in the country.

And finally, the impact of implicit bias and stereotyping cannot be underestimated. Though most doctors are well intentioned and would like to be “color-blind” study after study has shown that we have also absorbed the subtle messages that society sends us that folks of color are inferior or less deserving of care. As this study points out, even at high volume specialty sites, Black and Hispanic patients get delayed care compared to whites.

But perhaps the most distressing part of this article is that time and resources were put towards it at all. We already know that Black Americans, Hispanic Americans, Asian Americans, get lower quality care and that they die younger because of it. David Hatcher, former Surgeon General reports that from 1991-2000, 880,000 excess deaths could have been averted had the health of Black Americans matched that of whites.

In fact, we’ve known this for almost 15 years. In 2003 the Institute of Medicine published a 764-page report that reviewed hundreds of studies. In the report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, they found that even when controlling for factors outside of the hospital system (insurance coverage, location, severity of disease, socioeconomic status etc), disparities remain. The bottom-line? Not only does racism on a societal level cause people of color to have worse health outcomes, so do the unconscious biases of those working in the healthcare system.

In fact, Unequal Treatment already looked at stroke outcomes.



story | by Dr. Radut