Surprising conclusions in a study of racial, socioeconomic disparities in U.S. hospitals

About Emily Willingham

Emily Willingham (@ejwillingham) is AHCJ's core topic leader on the social determinants of health. She is a science journalist whose work has appeared in the Washington Post, San Francisco Chronicle, Wall Street Journal, Scientific American, and Forbes, among others, and co-author of "The Informed Parent: A Science-Based Guide to Your Child's First Four Years."

Racial and socioeconomic disparities in outcomes among hospitalized patients?

Don’t blame the hospitals, say the authors of this JAMA Network Open study. They looked at factors that might underlie known divergences in health outcomes based on socioeconomic status and race or ethnicity, with a focus on heart attacks, heart failure and pneumonia. Their findings suggest that hospitals perform similarly across socioeconomic and ethnic groups but that something “systemic” must explain the differences among these populations.

Worth noting, the researchers also found that black patients had lower mortality rates than white patients, which they say fits with previous findings, although an explanation is elusive. One possible explanation is the survivorship effect: people who live into old age do so because of overall good health. It may be that older black patients have overall better health than older white patients who reached that age for other, confounding reasons.

A major caveat for this study is that 75 percent of the hospitals that were candidates for inclusion were excluded because their patient populations weren’t diverse enough for analysis. That means that these findings represent only hospitals from areas that are sufficiently diverse for study inclusion. Hospitals where workers experience less patient population diversity might have very different outcomes in these comparisons.

Related coverage is limited.

Story ideas

How much do journalists attend to studies about racial or socioeconomic disparities relative to a trial for a blockbuster drug meeting its primary endpoint? Is media coverage itself a factor in these disparities?

The JAMA journals make tracking page views and shares easy by offering a tracker at the top of every published article. A look at this study, which was published on Sept. 7, shows just over 1,000 views and an Altmetric score, which indicates social media interest, of 35. A breakdown of that score shows that only one news outlet (Cardiovascular Business, natch) links back to the story and that the published study has gotten 45 tweets. Yet this is a story about major outcome differences for some of the most common, potentially fatal conditions US adults face: heart attacks, pneumonia, and heart failure.

Meanwhile, a report from the same day in the same journal about the hot topic of telemedicine-based monitoring — in this case, monitoring blood pressure in adults with uncontrolled hypertension, subpopulation of patients — has garnered more than 12,000 views and has an Altmetric score of 65 in the same amount of time. A breakdown of the Altmetric score shows that six news outlets picked this one up, including Politico and MedPage Today. And it’s a follow-up of an already reported study.

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