Thursday, June 12, 2008

Study Compares Diabetes Care Between Blacks and Whites

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Black patients have been found to have less success with diabetes control when compared to whites, according to a new study. The disparity is being attributed to individual differences in physician care, according to a report in the June 9 issue of the Archives of Internal Medicine. The study was led by Dr. Thomas D Sequist from Brigham and Women’s Hospital, Boston, Ma. The results show that blacks are less likely to achieve good cholesterol, blood pressure and blood sugar control than white patients treated by the same doctor. The findings raise questions about barriers that may exist between physicians and black patients.

Dr. Sequist says, “What we see is that the black patient does not achieve outcomes as good as the white patient, which suggests that there might be something going on differently in terms of the effectiveness of the interaction between the patient and their doctor and that there might be differences by race”. He says the findings revealed that “all physicians across the board contribute in a moderate way”.

It is not about health insurance either. The same testing was performed on whites as blacks - 95% of the patient records that were reviewed showed that the patients had insurance. The only conclusion that could be drawn is that blacks with diabetes don't achieve that same results as whites. To put the information to good use, the authors believe physician education might improve cultural competency and patient/physician communication among minority populations. The idea is to teach doctors to explore cultural differences so they can tailor the health care of minorities.

Dr. Sequist says it’s not an issue of blame. He suggests that variables probably exist, contributing to the problem. It’s about doctors becoming aware of patient resources, and neighborhoods, like exercise facilities, pharmacies, and grocery stores. To evaluate the effectiveness of improved education, physicians in Eastern Massachusetts completed an eleven-month educational program. The results will be published this fall.

As a nurse, I know that family members, case managers, and ancillary healthcare staff, such as respiratory therapists and other home healthcare staff are a ready source of patient information to physicians. The question then becomes, is there good communication between the physician and all team members?

It's also extremely important for patients to do all they can to let the physician know how active they are in managing their own health, and what obstacles they might be facing.

What factors do you think might be responsible for the findings of this study?

Source: Heartwire