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Blacks Not Getting Proper Medical Care, Research Shows

January 13, 1989

CHICAGO (AP) _ Blacks aren’t getting proper medical care because they lack insurance, have poor health coverage or have been disappointed by doctors, studies published today indicate.

The studies also show that blacks are included in fewer tests of new drugs and, in at least one state, tend to get less aggressive treatment for heart disease.

They were published in today’s Journal of the American Medical Association, a theme issue coinciding with the birthday Sunday of slain civil rights leader Martin Luther King Jr.

According to a nationwide survey of 10,130 U.S. residents, one in 11 blacks said they didn’t see a doctor for economic reasons in 1986, compared with one in 20 whites.

Blacks were less likely to have health insurance, and those who did were less likely to be covered by private insurance and more likely to live in a state with limited Medicaid benefits, said researchers led by Robert J. Blandon of the Harvard University School of Public Health in Boston.

Their report said 37.2 percent of blacks overall had not seen a doctor in a year, compared with 31.7 percent of whites.

The disparity was greater for people in poorer health, with 32.2 percent of blacks going a year without a doctor’s care, compared with 17.5 percent of whites, the researchers said.

″There continues to be a lack of parity in access to health care, and a consequent excess of unmet medical needs for blacks compared with whites,″ the authors said.

Blacks were more likely than whites to live in one-adult households, perhaps making it harder for them to get to a doctor, the researchers said.

″Blacks were more likely than whites to report that during their last visit, their physician did not inquire sufficiently about pain, did not tell them how long it would take for prescribed medicine to work, did not explain the seriousness of the illness or injury, and did not discuss test or examination findings,″ the study said.

This is true despite that blacks, on average, are in poorer health than whites, and continue to have a death rate 1 1/2 times higher than whites of the same age as well as double the white infant mortality rate, the researchers said.

″Medicine in some ways is no different than getting your car repaired or deciding whether to spend the night in a particular hotel,″ Howard E. Freeman, chairman of sociology at the University of California at Los Angeles and a co-author of the study, said Thursday. ″You’re not inclined to do it if past experiences have been negative. Our data suggest there’s a greater proportion of negative experiences for blacks and the poor in general than there are for the more affluent among us.″

A related study in the Journal found few blacks included in trials of new drugs.

A review of 50 medical studies published from 1984 through 1986 showed that blacks were included in fewer than two-thirds of the tests, said researcher Craig K. Svensson of Wayne State University in Detroit.

Svensson said researchers, particularly those from companies that are seeking government approval for new drugs, should include large numbers of blacks in clinical trials to determine if the medications have different effects, based on race.

A third study in the Journal examined the treatment of heart-disease patients in Massachusetts and found that whites had more angiography procedures and heart bypass operations.

In angiography, doctors take X-rays of the heart after injecting dye into it, allowing them to determine the extent of blood vessel blockage.

The researchers, Drs. Mark B. Wenneker and Arnold M. Epstein of the Harvard School of Public Health, were unable to say if their findings were typical nationally, but added their study ″suggests that substantial racial inequalities exist in the use of procedures for patients hospitalized with coronary heart disease.″

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