A recent study of over 1.5 million hospital procedures in the United States has highlighted the substantial disparity in post-surgery mortality rates among Black and Hispanic patients compared to white patients. The analysis revealed that the likelihood of death within 30 days after surgery is 42 percent higher for Black patients and 21 percent higher for Hispanic patients. Minority Americans have worse health outcomes for a number of conditions, including diabetes and heart disease, leading to an estimated 12,000 deaths over the past two decades that could have been avoided if there were no racial and ethnic disparities among Americans having surgery.
The lead study author, Christian Mpody, MD, an assistant professor of anesthesiology and pediatrics at the Ohio State University College of Medicine in Columbus, stated that although post-surgery mortality rates have declined for all groups, persistent disparities in surgical health in the United States continue to result in avoidable deaths. The investigation reviewed data from about 1.5 million surgical procedures among adults between 2000 and 2020, performed at approximately 8,000 hospitals across the US. The study found that three-quarters of the patients were white, 14% were Hispanic, and 11% were Black, with the Northeast and West regions showing higher deaths among Black people and Hispanic people, respectively.
What’s Behind the Differences in Post-Surgery Outcomes
The Annals of Surgery Open is set to publish a study in December 2023 that sheds light on the differences in surgical care and death rates in different parts of the country. The study suggests that surgical care is not necessarily worse in certain areas, but rather that population health and social and economic conditions, such as lower incomes and lack of education, may be linked to higher death rates.
The researchers are looking into the underlying causes for these regional variations and believe that a deeper examination may reveal the impacts of systematic underinvestment in public health, unequal access to primary healthcare services, and racism and medical mistreatment of minoritized groups. Fatima Rodriguez, MD, MPH, an associate professor of cardiovascular medicine at Stanford Health Care in California, agrees with the authors that the reasons for these disparities are most likely structural. Dr. Rodriguez’s own research focuses on racial, ethnic, and gender disparities in cardiovascular disease prevention.
She suggests that we address these structural factors, including racism, in order to improve the quality and resources at facilities where minoritized patients receive their care. Everyone deserves the opportunity to experience good surgical outcomes. It’s important to note that health disparities extend beyond surgery-related deaths and that racial and ethnic minority groups throughout America experience higher rates of illness across a wide range of health conditions, including diabetes, high blood pressure, obesity, asthma, and heart disease, compared with their white counterparts, according to data from the Centers for Disease Control and Prevention (CDC).
Rodriguez, who was not involved in the new study, has worked on previous research identifying high hospitalization rates for acute high blood pressure among Black people. Similar to the current study, that work recognized the lack of progress in reducing racial disparities in hospitalizations, and highlighted the need for new approaches to address both medical and nonmedical factors that contribute to such disparities.
Possible Solutions to a Long-Standing Problem
Mpody and his colleagues suggest that efforts to narrow this racial and ethnic gap in surgical outcomes may include:
- Increasing access to healthcare
- Enhancing cultural competency training for healthcare professionals
- Promoting diversity in the healthcare workforce
- Addressing social and economic factors such as insurance coverage and social support
- Fostering research and data collection on healthcare disparities
If such measures could produce even a 2 percent reduction in projected excess mortality rates among Black patients, the researchers predicted that roughly 3,000 post-surgery deaths could be prevented in the next decade.
Mpody stresses the real human toll behind these numbers.
“We should not become used to reading statistics about people dying,” he says. “It’s essential to remember that beyond the statistics, there are real people — brothers, sisters, mothers, and fathers. There are families and communities that are torn apart. It’s important to convey the gravity of the issue to policymakers, healthcare professionals, and the general public.”
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