Race (still) Matters: Innovation needed to tackle health disparities

A recent posting looked at a new study of health technology being overused in breast cancer care.  Another study presented this month at the American Association for Cancer Research Conference sheds light on the importance that race plays in health outcomes, regardless of insurance status.

Assistant Professor Heather Hoffman and colleagues from George Washington University's School of Public Health performed a retrospective analysis of 983 women who underwent breast cancer examinations at six hospitals in Washington D.C. They measured diagnostic delay, the span of time between the detection of a breast abnormality and a definitive diagnosis, for women who were white, African American, or Hispanic, stratified by whether they were insured or not. Their findings:

-Among women with private insurance, average diagnostic delay was 15.9 days for whites, 27.1 days for African Americans, and 51.4 days for Hispanics.

-For those with government insurance, it was 11.9 days for whites, 39.4 for African Americans, and 70.8 for Hispanics.

-For the uninsured, it was 44.5 days for whites, 59.7 days for African Americans, and 66.5 for Hispanics.

While we don't know the definitive cause, the assumption is not that racism is at play. What seems clear is that breast cancer awareness messages skewed in their cultural delivery. And providing more health insurance wouldn't appear to be the answer either. But the extreme force that race plays in dictating care is stunning; why are uninsured white women better off by this measure than Hispanic women with private or government insurance?

Are there other socio-cultural factors creating this disparity? Are women being triaged by race into health care facilities providing different standards of care? What about innovations in care delivery that could remediate these unacceptable variations in diagnostic timing?

Photo Credit: the author