Hospitals: One Reason COVID Is More Lethal for Black Americans

Black COVID-19 patients in the United States are more likely to die than white patients, but there would be 10% fewer deaths among Black patients if they could get the same level of hospital care as white people, according to new research.

“Our study reveals that Black patients have worse outcomes largely because they tend to go to worse-performing hospitals,” said study co-author Dr. David Asch. He is executive director of Penn Medicine’s Center for Health Care Innovation.

“Because patients tend to go to hospitals near where they live, these new findings tell a story of racial residential segregation and reflect our country’s racial history that has been highlighted by the pandemic,” Asch said in a University of Pennsylvania School of Medicine news release.

For the study, Asch and his colleagues examined data on more than 44,000 COVID-19 patients on Medicare treated at nearly 1,200 hospitals in 41 states and the District of Columbia. Nearly 11,000 patients were Black and about 33,500 were white.

The 30-day death rate was 13.5% among Black patients and just below 13% among white patients, the findings showed.

Lower incomes and a higher number of other health problems in Black patients partly explained this difference, but where the patients were treated also played a role, the researchers said.

According to study co-author Dr. Rachel Werner, executive director of Penn’s Institute of Health Economics, “People often assume that Black-white differences in mortality are due to higher rates of chronic health conditions among Black individuals. But time and time again, research has shown that where Black patients get their care is much more important and that if you account for where people are hospitalized, differences in mortality vanish.”

The researchers conducted computer simulations on what would happen if Black patients in the study had instead been admitted to the same hospitals as the white patients, and in the same proportion.

The model showed that the death rate among Black patients would fall from 13.5% to 12.2%. That translates into a 10% lower risk of death, according to the study authors.

The results were published online June 17 in JAMA Network Open.

Study co-author Nazmul Islam is a statistician at OptumLabs, part of UnitedHealth Group. He said, “Our analyses tell us that if Black patients went to the same hospitals white patients do and in the same proportions, we would see equal outcomes.”

Asch added, “It’s intolerable that we live in a society where Black patients are more likely to go to hospitals where death is also more likely. Centuries of racism got us to this level of residential segregation, but a step we can take today is to change policies so that all hospitals are not so dependent on local resources to maintain their quality. COVID-19 has provided a lens through which we can see how much more we must travel to reach justice.”

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19 and racial/ethnic disparities.

SOURCE: University of Pennsylvania School of Medicine, news release, June 17, 2021

Source: HealthDay