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Health Care Equality - Women and Minorities

Two reports published in medical journals last week suggest inequalities in health care outcomes for minorities and women.

At the 132nd Annual Meeting of the American Neurological Association, researchers presented data that indicated poorer outcomes for minorities and women following a stroke caused by a blood clot (an ischemic stroke). Both blacks and Hispanics were approximately 30% more likely to be readmitted to the hospital within one month than were whites. A separate study showed women more likely to die than men following post-stroke hospital discharge.

These results are not necessarily related to quality of health care while in the hospital. Alternative explanations include lack of appropriate support in the home or other setting, failure to comply with discharge instructions, other illnesses (co-morbidity), as well as genetic factors.

Further studies of the first population looked at differences according to race using mathematical models to remove the influence of demographics, past medical history, and co-morbidity. The total study group was 85% white, 10% black, 2% Hispanic, and 3% other races.

The University of Michigan School of Public Health reported in Cancer that black women with breast cancer receive adjuvant therapy less often than white women do. Dr. Mousumi Banerjee, who directed the study, noted that there are many issues involved, including socioeconomics, health insurance, and patient choices.

As reported previously, black women were more likely to have advanced-stage cancer and widespread tumors. They were also more likely to have co-morbid illnesses. However, when these factors were controlled, black women with localized cancers were just as likely as white women to undergo conservative surgeries and to receive tamoxifen and chemotherapy. Disparities showed in women with regional cancers in this group, white women were five times more likely to receive tamoxifen and three times more likely to receive other chemotherapy.

The study also revealed that women (regardless of race) with early-stage disease who had government insurance were more likely to receive radical mastectomy without radiation. Presumably the more extensive surgery is less expensive than breast-conserving surgery plus radiation.

What do these studies mean to us as women? I believe that exceptional health care should be available to all individuals, with no disparities according to gender, race, sources of insurance, or any other factor. It is evident that, at least in the settings studied, this goal is not being achieved. I hope you will give me your opinion by a personal comment or by a post in the forum. I look forward to hearing from you!

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