Black and Hispanic patients are more likely to die after surgery than white patients by a significant degree, new research has found.
Black patients are 42 percent more likely than white patients to die within 30 days of surgery, while Hispanic patients are 21 percent more likely.
This was revealed in a study analyzing over a million surgical procedures at 7,740 U.S. hospitals between 2000 and 2020, presented at the medical journal Anesthesiology‘s 2023 annual meeting.
Non-white people suffer from a vast range of racial disparities in healthcare and treatment: Black patients, in particular, have the highest rates of diabetes, high blood pressure and heart disease compared to all other groups, and have the highest cancer mortality rates. Black children have a 500 percent higher death rate from asthma compared with white children and have nearly twice the national average infant deaths per 1,000 live births.
Additionally, 10.6 percent of Black Americans had no health insurance in 2017, compared with 5.9 percent of non-Hispanic white people.
“There are many causes of the higher mortality rates,” Ian James Kidd, an assistant professor of healthcare philosophy at the University of Nottingham, told Newsweek. “Prior to surgery, Black and Hispanic patients are, generally more likely to suffer from all the things that worsen health outcomes—lower wages, worse housing conditions, food insecurity, environmental pollution and (in the US) less access to quality healthcare. All these things, and others, worsen health outcomes and make recovery difficult.”
Health and recovery depend on a complicated long-term interaction of biological, psychological, social, environmental, and economic factors, all of which are impacted by the societal inequalities faced by minority groups.
“Consider environmental racism—Princeton reports that more than half the people who live close to hazardous waste are people of color—exposure to toxic materials that cause or exacerbate illnesses,” Kidd said. “Poor health is not a matter of one’s biology, lifestyle, and willpower. Individual illness is a complex product of social policies, political choices, economic arrangements and the condition of our environment.”
The study did not identify the causes of death of the patients and found that while all groups experienced decreased deaths over time, the disparities between groups did not narrow.
“What’s going on after the surgery is a direct and indirect result of ongoing structural violence that drives inequities in Black and Hispanic health outcomes. You can’t just expect an individual to thrive after a procedure when they are going back into the same conditions and environments that placed them at risk in the first place,” Amelia Noor-Oshiro, a Ph.D. researcher in public health at Johns Hopkins University, told Newsweek.
The authors of the study plan to further investigate the underlying causes for these disparities, and hope to highlight any preventable issues involved.
“This study represents the first effort to move beyond merely documenting the ongoing disparities in surgical outcomes in the U.S. by quantifying the aggregate human toll of these disparities,” Christian Mpody, lead author of the study and assistant professor of anesthesiology and pediatrics at The Ohio State University College of Medicine, Columbus, said in a statement. “We should not become used to reading statistics about people dying. It’s essential to remember that beyond the statistics, odds ratios and p-values, these are real people—brothers, sisters, mothers and fathers.”
“The findings bring to light the deaths that may have been preventable if people of various racial and ethnic backgrounds had comparable mortality rates to white patients,” he said. “That’s important for conveying the gravity of the issue to policymakers, health care professionals and the general public.”
There is no simple fix, however: Mpody and the other authors suggest a three-pronged approach to closing the gaps between ethnic groups, including increasing investment in disparity research, as well as incorporating race and racism lectures in medical and nursing school curricula.
“To fix this, there is no single solution. Health outcomes would be improved by significant investments in healthcare and social security, tacking food insecurity, improving wages, more equitable distributions of wealth—and more,” Kidd said. “None of that is easy. It is politically and economically difficult. And it means we need to get away from thinking of health in terms of individual choices or biological destiny.”
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