Study examines racial disparities in hospitalization for white and black adults with preventable conditions

Receiving prompt treatment for common health problems like diabetes, pneumonia and high blood pressure can save patients trips to the hospital and thousands of dollars in medical care costs.

However, African-Americans with preventable conditions often fail to get adequate care, resulting in hospitalizations years earlier than whites with the same conditions, results from a new study suggest.

"Blacks were hospitalized, on average, five years younger than whites for health conditions that could be prevented with adequate ambulatory care," said senior study author Jeannette Ickovics, Ph.D., director of social and behavioral sciences at the Yale University School of Public Health.

The study, which appears online and in the January issue of the American Journal of Preventive Medicine, examined racial disparities in hospitalization for 6,815 white and black adults with a variety of preventable acute and chronic conditions.

"Good primary care and a good strategy centering on prevention and health promotion would help to avoid these hospitalizations," said Brian Smedley, Ph.D., vice president and director of the Health Policy Institute of the Joint Center for Political and Economic Studies in Washington, D.C. He was not affiliated with the study.

For all health conditions combined, African-Americans needed hospitalization an average nine years earlier than whites. After taking insurance status and other factors into account, researchers found African-Americans entered the hospital at a significantly younger age — an average of five and a half years younger — than whites with the same conditions.

"For the individual, quality of life is greatly reduced when hospitalization is required. For the family, the social and economic costs can be profound when a family member — and possible wage earner or caregiver — is hospitalized at younger ages," Ickovics said.

There was a 12-year difference in the age at hospitalization for blacks with diabetes compared to whites. Blacks with bacterial pneumonia required hospitalization seven and a half years earlier.

"While the younger age at hospitalization was not necessarily surprising, the magnitude of the difference was indeed surprising," Ickovics said.

Significant racial disparities also existed for hospitalization with chronic obstructive pulmonary disease, high blood pressure, congestive heart failure and dehydration.

Smedley, who described the study as "very important," said that the results "point to structural inequities in our health care system, even at the same level of insurance."

"These are problems experienced more deeply by racial and ethnic minorities than they are by whites," Smedley said. "It tells us our health care system is failing African-Americans."

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