Racial bias and discrimination may negatively impact heart disease care, risk factors

TKiarri N Kershaw, Ph.D, M.P.H.

American Heart Association Scientific Sessions, Oral Presentation 114 and Poster Presentation Sa3062

Racial and ethnic minorities are often disproportionately affected by heart disease and stroke. Subtle racial bias may creep into the decision-making process for approving black patients with heart failure for a heart transplant and African immigrants who have experienced discrimination are more likely to have three or more heart disease and stroke risk factors, according to two studies to be presented at the American Heart Association’s Scientific Sessions 2019 — November 16-18 in Philadelphia. The Association’s Scientific Sessions is an annual, premier global exchange of the latest advances in cardiovascular science for researchers and clinicians.

Does race influence decision-making for advanced heart failure therapies? (Oral Presentation 114)

In a first of its kind study, simultaneously published in the Journal of the American Heart Association, the open access journal of the American Heart Association, researchers at the University of Arizona, Tucson, explored whether health care professionals’ decision-making processes may contribute to racial disparities in heart failure treatment.

Researchers asked 422 physicians, nurses and other hospital decision-makers to determine whether hypothetical black male and white male patients should be referred for a heart transplant after reviewing patient photos and other patient health information. The hypothetical cases had identical medical and social history; race was the only variant.

When surveyed individually, there were few racial differences in recommendations for transplants. However, when a subgroup of 44 reviewers discussed the cases — a situation which more closely resembled actual advanced therapy selection meetings than a survey — researchers found racial bias. The reviewers perceived black patients as less healthy than whites, less likely to comply with follow-up care recommendations and less trustworthy. Thus, black patients were more likely to be recommended for ventricular assist devices than heart transplants, especially if the health care provider was over the age of 40.

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