Ethnic Differences in Use of Cardiovascular Procedures: New Insights and New Challenges
Authors: Richard L. Kravitz
Journal: Annals of Internal Medicine (1999)

Editorials2 February 1999Ethnic Differences in Use of Cardiovascular Procedures: New Insights and New ChallengesRichard L. Kravitz, MDRichard L. Kravitz, MDUniversity of California, Davis; Sacramento, CA 95817Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-3-199902020-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Although we might wish it otherwise, ethnicity in the United States still matters. Over the past few decades, inequalities between Americans of European descent and those of African descent have been documented in the Jeffersonian domains of life, liberty, and the pursuit of happiness. Compared with white Americans, the rates of mortality, incarceration, and poverty are higher among black Americans (1-3). An extensive literature documents persisting differences between black persons and white persons with respect to both access to health care and health status. Although such reports are often greeted with short-term alarm, long-term action rarely follows. Such inertia cannot ...References1. Anderson RN, Kochanek KD, Murphy SL. Monthly Vital Statistics Report. v 45. Hyattsville, MD: National Center for Health Statistics; 1997:19. Google Scholar2. Klein S, Petersilia J, Turner S. Race and imprisonment decisions in California. Science. 1990;247:812-6. CrossrefMedlineGoogle Scholar3. Loury GC. Unequalized. (Race and income inequality). New Republic. 1998;218:10. Google Scholar4. Wenneker MB, Epstein AM. Racial inequalities in the use of procedures for patients with ischemic heart disease in Massachusetts. JAMA. 1989;261:253-7. CrossrefMedlineGoogle Scholar5. Carlisle DM, Leake BD, Shapiro MF. Racial and ethnic differences in the use of invasive cardiac procedures among cardiac patients in Los Angeles County, 1986 through 1988. Am J Public Health. 1995;85:352-6. CrossrefMedlineGoogle Scholar6. Escarce JJ, Epstein KR, Colby DC, Schwartz JS. Racial differences in the elderly's use of medical procedures and diagnostic tests. Am J Public Health. 1993;83:948-54. CrossrefMedlineGoogle Scholar7. Ayanian JZ, Udvarhelyi S, Gatsonis CA, Pashos CL, Epstein AM. Racial differences in the use of revascularization procedures after coronary angiography. JAMA. 1993;269:2642-6. CrossrefMedlineGoogle Scholar8. Peterson ED, Shaw LK, DeLong ER, Pryor DB, Califf RM, Mark DB. Racial variation in the use of coronary-revascularization procedures. Are the differences real? Do they matter? N Engl J Med. 1997;336:480-6. CrossrefMedlineGoogle Scholar9. Laouri M, Kravitz RL, French WJ, Yang I, Milliken JC, Hilborne L, et al . Underuse of coronary revascularization procedures: application of a clinical method. J Am Coll Cardiol. 1997;29:891-7. CrossrefMedlineGoogle Scholar10. Leape LL, Hilborne LH, Bell R, Kamberg C, Brook RH. Underuse of cardiac procedures: do women, ethnic minorities, and the uninsured fail to receive needed revascularization? Ann Intern Med. 1999;130:183-92. LinkGoogle Scholar11. Steingart RM. The decision for revascularization in the 1990s: between a rock and an expert panel [Editorial]. J Am Coll Cardiol. 1997;29:898-900. MedlineGoogle Scholar12. Kravitz RL, Park RE, Kahan JP. Measuring the clinical consistency of panelists' appropriateness ratings: the case of coronary artery bypass surgery. Health Policy. 1997;42:135-43. CrossrefMedlineGoogle Scholar13. Shekelle PG, Kahan JP, Bernstein SJ, Leape LL, Kamberg CJ, Park RE. The reproducibility of a method to identify the overuse and underuse of medical procedures. N Engl J Med. 1998;338:1888-95. CrossrefMedlineGoogle Scholar14. Kravitz RL, Laouri M, Kahan JP, Guzy P, Sherman T, Hilborne L, et al . Validity of criteria used for detecting underuse of coronary revascularization. JAMA. 1995;274:632-8. CrossrefMedlineGoogle Scholar15. Margolin B. Averting disaster: a conversation with the Los Angeles County 'Health Czar' [Interview]. Health Aff Millwood. 1996;15:86-91. CrossrefMedlineGoogle Scholar16. Hannan EL, Kumar D, Racz M, Siu AL, Chassin MR. New York State's Cardiac Surgery Reporting System: four years later. Ann Thorac Surg. 1994;58:1852-7. CrossrefMedlineGoogle Scholar17. Daumit GL, Hermann JA, Coresh J, Powe NR. Use of cardiovascular procedures among black persons and white persons: a 7-year nationwide study in patients with renal disease. Ann Intern Med. 1999;130:173-82. LinkGoogle Scholar18. Borowsky SJ, Kravitz RL, Laouri M, Leake B, Partridge J, Kaushik V, et al . Effect of physician specialty on use of necessary coronary angiography. J Am Coll Cardiol. 1995;26:1484-91. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of California, Davis; Sacramento, CA 95817Corresponding Author: Richard L. Kravitz, MD, University of California, Davis, Center for Health Services Research in Primary Care, 4150 V Street, PSSB 2500, Sacramento, CA 95817. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Return of Cyclospora in 1997: Another Outbreak of Cyclosporiasis in North America Associated with Imported Raspberries Barbara L. Herwaldt , Michael J. Beach , and Use of Cardiovascular Procedures among Black Persons and White Persons: A 7-Year Nationwide Study in Patients with Renal Disease Gail L. Daumit , Judith A. Hermann , Josef Coresh , and Neil R. Powe Underuse of Cardiac Procedures: Do Women, Ethnic Minorities, and the Uninsured Fail To Receive Needed Revascularization? Lucian L. Leape , Lee H. Hilborne , Robert Bell , Caren Kamberg , and Robert H. 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Krumholz, MD, SMGender and the treatment of heart disease in older persons in the United States, France, and England: a comparative, population-based view of a clinical phenomenonRacial Differences in the Use of Cardiac Procedures in Patients With Acute Myocardial InfarctionThe Effect of Race on the Referral Process for Invasive Cardiac ProceduresRace, Sex, and Physicians' Referrals for Cardiac Catheterization 2 February 1999Volume 130, Issue 3Page: 231-233KeywordsAngioplastyCardiac surgeryCoronary angioplastyHealth careHealth care qualityHealth insurancePopulation statisticsRenal failureRevascularizationSurgery ePublished: 15 August 2000 Issue Published: 2 February 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...