Study says unequal care fatal for blacks

WASHINGTON -- More than 886,000 deaths could have been prevented from 1991 to 2000 if African-Americans had received the same level of health care as whites, according to an analysis in the December issue of the American Journal of Public Health. The study estimates that technological improvements in medicine -- including better drugs, devices, and procedures -- averted only 176,633 deaths during the same period.

That means "five times as many lives can be saved by correcting the disparities [in care between whites and blacks] than in developing new treatments," Dr. Steven H. Woolf, lead author and director of research at Virginia Commonwealth University's Department of Family Medicine, said in a telephone interview.

Woolf and four coauthors compiled and examined the data, which they drew from the National Center for Health Statistics.

"We were trying to say that there was something you could do in medical research to improve health outcomes," said Dr. David Satcher, coauthor and former US surgeon general and the current director of the National Center for Primary Care at the Morehouse School of Medicine. "But if you didn't focus more on the translation of that into especially the populations that tended to be left behind . . . you were not going to get as much out of the research as you would otherwise."

Reduced access to health care doesn't account for all the racial disparity in preventable deaths. Blacks have greater incidence of some diseases; some of this greater morbidity results from education, income level, and environment as well as access to health care. The challenge, the authors said, is to deliver the same quality health care to everyone, despite these factors.

One of the Healthy People 2010 goals -- the nation's health priorities for the decade -- is to eliminate such inequities in health care.