By
The Associated Press
CHICAGO - Running against the tide of previous research, a new study has found a racial disparity in medicine that actually favors blacks: Black patients at Veterans Affairs hospitals have lower death rates than whites.
The study of 36,509 patients treated at 147 VA hospitals compared 30-day death rates for six common ailments - pneumonia, diabetes, heart failure, angina, chronic lung disease and chronic kidney failure. For all six diagnoses, blacks were less likely than whites to die within 30 days of entering the hospital.
Numerous studies have suggested blacks fare worse than whites in many areas of health. They have higher rates of major ailments such as diabetes and high blood pressure, and higher death rates for cancer, heart disease and stroke.
"Most of the other studies that have found poorer outcomes have attributed the differences to poorer access to health care, such as lack of insurance," said Dr. Ashish K. Jha of the Veterans Affairs Medical Center in San Francisco and the University of California at San Francisco.
But Jha said the reverse disparity found in his study, published in today's Journal of the American Medical Association, is a mystery, since black and white veterans have equal access to VA hospital care, regardless of insurance status.
"It was heartening to see that they didn't do any worse, even though we can't explain why they did better," Jha said.
The study did not examine whether there were any differences in treatment that might explain the racial gap and did not look at the racial breakdown of doctors in the VA hospitals.
Blacks in the study were about 25 percent less likely to die within 30 days of entering the hospital and 20 percent less likely to die after six months.
An accompanying editorial said the study lacks key information that might explain the results, such as whether white patients were sicker or had other ailments that might have contributed to their deaths.
"Although blacks generally have worse health status than whites ... the same may not be true in the populations served by the Veterans Affairs medical system," wrote Dr. David Mark, a JAMA contributing editor.
Most veterans are entitled to lifelong VA care; as a result, many black veterans might receive better preventive care than other blacks.
Mark said closer study is needed.
