In the United States, many Black and Latino patients believe that the quality of healthcare they receive is influenced by their race or ethnicity. A 2000 study by Edward L. Hannan and others provides some empirical evidence supporting their belief.
Hannan studied the connection between (1) the use of coronary artery bypass graft (CABG) surgery among patients for whom CABG surgery is the appropriate or necessary treatment and (2) race and ethnicity.
The Design of the Study
The researchers selected a random sample of 4,905 post-angiography patients from eight New York hospitals between 1994 and 1996. The researchers then applied criteria developed by a third party, the RAND Corporation, to determine the appropriateness or necessity of CABG surgery for each of these patients. Of the 4,905 patients, CABG surgery was found to be appropriate for 1,261 of them. These patients were tracked for 3 months to determine whether they had undergone the surgery. After controlling for age, payer, number of vessels diseased, and presence of left main disease, the researchers arrived at an unfortunate conclusion.
The Results of the Study
The researchers found that Black and Latino patients were significantly less likely than white non-Latino patients to undergo CABG surgery. While 57% of white non-Latino patients for whom CABG surgery was appropriate underwent the surgery within 3 months of their angiography, the percentages of corresponding Black and white Latino patients who underwent CABG surgery within 3 months was, respectively, 45% and 46%.
The significant differences in access for Black and Latino patients was in large part due to the failure of a physician to recommend the treatment. The physician recommended surgery only 10% of the time that patients did not undergo “appropriate” CABG surgery.
When necessity was used as a criterion, instead of appropriateness, significant differences in access for Black patients remained. (CABG surgery was considered a necessity if it was appropriate and it was believed that a physician had an obligation to recommend the procedure because it was clearly the best option available to the patient.) While 63% of white non-Latino patients for whom CABG surgery was a necessity underwent the procedure within 3 months of their angiography, only 49% of corresponding Black patients underwent the surgery within 3 months.
It is important to point out the possible impact of not getting the surgery. Coronary artery disease, the condition that CABG surgery treats, is the leading cause of death in the US.
Unsurprisingly, Blacks with coronary artery disease experience higher rates of mortality than Whites.
What Can Be Done to Improve Health Outcomes for Blacks and Latinos in America
We can and should hold doctors accountable for the errors they make. All too often individuals who are injured by doctors never seek the help of a medical malpractice attorney. Suing a doctor for his or her negligence is not about putting the doctor out of business; it’s about putting justice into business.
Additionally, we should push
lawmakers–especially those in blue states–to fix medical malpractice laws. For
example, in Maryland, we should push lawmakers to lengthen the applicable
statute of limitations and to eliminate the cap on damages for pain and
suffering. It’s crucial to remember that when Black and Latino people receive
inferior healthcare due to racism, limiting their ability to sue and recover
substantial damages for the harm they suffer is a civil rights issue.
 Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease. Coronary artery disease is the narrowing of the coronary arteries–the blood vessels that supply oxygen and nutrients to the heart muscle.
 Angiography is a diagnostic procedure used to determine the extent of a patient’s coronary artery disease.