February 5, 2004 - Blacks, Hispanics and other minorities in desperate need of new kidneys are getting substantially more transplants since the U.S. criteria for matching up scarce donor organs and recipients were eased last year. Story from AP/Yahoo. (link is no longer available)

January 15, 2004 - The Washington Post is reporting that a federal report on racial disparities in health care was revised at the behest of top Bush administration officaials. Story from the Washington Post (no longer available).

January 13, 2004 - Government reports say quality health care is not universal and that differences exist along economic, racial, ethnic and geographic lines; that chances to provide preventive care are often missed; and that there is much to learn but progress is possible. Overview from American Medical News.

The National Healthcare Quality Report, developed by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, represents the first national comprehensive effort to measure the quality of health care in America. The report includes a broad set of performance measures that can serve as baseline views of the quality of health care. The report presents data on the quality of services for seven clinical conditions, including cancer, diabetes, end-stage renal disease, heart disease, HIV and AIDS, mental health, and respiratory disease. Report index from AHRQ.

Chapter 3. Effectiveness: End-Stage Renal Disease - document in pdf or WORD format

The National Healthcare Disparities Report, developed by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, represents the first national comprehensive effort to measure differences in access and use of health care services by various populations. Report index from AHRQ.

June 6, 2003 - When a person is diagnosed with diabetes, race and ethnicity can mean the difference between life and death says Ranjita Misra, a Texas A&M University professor who specializes in health and kinesiology in minority health disparities. Story from EurekAlert.

May 20, 2003 - On May 17, Senate Majority Leader Bill Frist announced legislation aimed at eliminating health disparities. The bill, Closing the Health Care Gap Act of 2003, would increase access to health care and boost funding for research and programs to combat health disparities for minority or low-income populations. Story from Kaiser Network.

January 10, 2003 - Senate Majority Leader Bill Frist said he will work to reduce racial disparities in the U.S. health care system. Story from Kaiser Network.

The health effects of racism are well documented. "Considering racism as a cause of ill health is an important step in developing the research agenda and response from health services," writes Kwame McKenzie, MD, in this week's issue of the British Medical Journal (BMJ).

"Racism and health" - full-text editorial from BMJ

Here is an article on racism's effect on health from WebMD.

December 10, 2002 - The American Medical Association (AMA) is considering a plan aimed at identifying and eliminating all racial and ethnic disparities in healthcare. Story from Reuters Health/Yahoo. (link is no longer available)

November 25, 2002 - The United Network for Organ Sharing (UNOS), which operates the national Organ Procurement and Transplantation Network for the federal government, tweaked its system for livers and reduced transplant waiting list deaths. UNOS also revised tissue-matching policy for kidneys, which will likely increase transplants among minorities. Story from AMNews.

November 19, 2002 - The Atlanta Journal-Constitution has examined the process of obtaining an organ for a transplant. The paper found it "isn't always as simple as getting a donor match" because it can require the potential recipient to demonstrate the "financial wherewithal" to maintain the organ and pay for follow-up treatment. Story from the Kaiser Network.

Does this partially explain the low transplant rates in the S.E. United States? (See Oct. 1 story below.)

November 15, 2002 - The OPTN/UNOS Board of Directors voted at its meeting today to increase minority access to kidney transplants by revising allocation priority for tissue matching. Story from PRNewswire/Yahoo. (link is no longer available)

November 14, 2002 - For primarily genetic reasons, blacks and Hispanics have to wait longer for organ transplants than do whites. A new proposal to be voted by the United Network for Organ Sharing (UNOS) board of directors today would take a scientific step toward evening those odds. Story from WebMD.

If passed, the proposal is expected to lead to the following changes in the number of kidney transplants by recipients:

• Black: 8% increase
  
  
• Asian: 7% increase
  
  
• White: 6% decrease
  
  
• Other ethnicity: 7% increase

The latest statistics from the United States Renal Data System (USRDS) show that in the U.S. blacks comprise 37.5 percent of the total dialysis patients, but make up only 18.0 percent of the "functioning graft" (transplant) patients.

Here is the board meeting agenda (WORD Document) from the UNOS web site.

October 1, 2002 - Two articles in the October issue of the American Journal of Kidney Diseases (AJKD) address the disparity in transplantation rates for differnent dialysis facilities in the U.S.:

"Variation in access to kidney transplantation across dialysis facilities: Using process of care measures for quality improvement" - abstract from AJKD

"The uneven distribution of kidney transplants: Getting at the root causes and improving care" - full-text editorial from AJKD

Disparities in transplantation rates in different ESRD Networks in the U.S. are reviewed here. (Data from RenalWEB's SUMMARY REPORT of the End Stage Renal Disease (ESRD) Networks� Annual Reports 2000):

• Network 11 (MI, MN, ND, SD) had 8.8% of its dialysis patients receive transplants.
  
  
• Network 6 (GA, NC, SC) had 3.5% of its dialysis patients receive transplants

Statistics from the United States Renal Data System (USRDS) show that black patients still lag far behind white patients in kidney transplants (From Table D3):

On December 31, 2000 there were 150,913 white dialysis patients, comprising 54.9 percent of the total.



There were 103,221 black dialysis patients, comprising 37.5 percent of the total.



There were 76,714 white patients with functioning kidney transplants, comprising 73.9 percent of the "functioning graft" patients.


There were 18,724 black patients with functioning kidney transplants, comprising only 18.0 percent of the "functioning graft" patients.

April 26, 2002 - Transplant surgeons at the University of Maryland Medical Center say they have increased kidney transplantation for African-Americans with a comprehensive program that includes patient education and efforts to increase living donation and improve overall kidney graft survival. Story from EurekAlert.

April 19, 2002 - From cradle to grave, for virtually every disease and for reasons that span lifestyle, economics and history, black Americans face massive health disparities in comparison to whites. Federal health officials called on American minorities to "take a loved one to the doctor" this fall as a way to narrow these health disparities. Story from AP/Yahoo. (link is no longer available)

March 20, 2002 - A report released today by the Institute of Medicine finds that African Americans continue to receive poorer quality healthcare compared with their white peers, and racial stereotyping by American doctors, nurses and other healthcare providers is at least partly to blame. Press release from the Institute of Medicine. (link is no longer available)

The congressionally mandated report says a large body of research underscores the existence of disparities. For example, minorities are less likely to be given appropriate cardiac medications or to undergo bypass surgery, and are less likely to receive kidney dialysis or transplants. Report summary from AP/Yahoo. (link is no longer available)

Here is a resource page on the report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care", from the Institute of Medicine.

March 13, 2002 - This week's issue of the Journal of the American Medical Association (JAMA) has a study from Harvard researchers who looked at federal quality-control records for patients in Medicare managed-care plans. In examining 305,000 cases, they found that blacks were less likely to receive adequate care in all four areas measured: eye exams for diabetics, preventive drugs after a heart attack, breast cancer screening, and follow-up care after leaving a mental hospital. They said the differences were not fully explained by socioeconomic gaps. Study summary from the Boston Globe. (link is no longer available)

Here is the abstract of the JAMA article entitled "Racial Disparities in the Quality of Care for Enrollees in Medicare Managed Care".

In terms of race, the vast majority of ESRD patients are white. However, the number of blacks with ESRD is disproportionately high compared to the U.S. population. While Black Americans comprise 13% of the population, they make up 37% of the total ESRD population (Source: ESRD Networks 2000 Annual Report Summary). Black Americans comprise only 18.3 percent of the "functioning graft" kidney transplant patients (Source: USRDS 2001).

The Michigan chapter of the National Kidney Foundation has a program called "Healthy Hair Starts with a Healthy Body". (link is no longer available) The campaign uses hair salons as health information centers to disseminate information about kidney disease prevention. Prevention steps are encouraged through informational brochures, risk surveys and incentives. In just over a year and a half, more than 2,500 African-American women have heard "health chats" from their stylists and more than 70 percent of those have taken a prevention step as a result of the program (stop smoking, eating better, more exercise).

Here is the Closing the Health Gap web site, part of a national campaign to bring the best health information to African American communities and help African American consumers take charge of their health.

November 1999 - The New England Journal of Medicine published a study (view abstract) entitled "The Effect of Patients' Preferences on Racial Differences in Access to Renal Transplantation". (Latest data used was March 1999.)

"Conclusions: In the United States, the preferences and expectations with respect to renal transplantation among patients with end-stage renal disease differ according to race. These differences, however, explain only a small fraction of the substantial racial differences in access to transplantation. Physicians should ensure that black patients who desire renal transplantation are fully informed about it and are referred for evaluation. (N Engl J Med 1999;341:1661-9.)"

In response to these studies, The Health Care Financing Administration (HCFA) announced that the Medicare program is taking new steps to ensure that all patients with renal failure, regardless of race or ethnicity, are being evaluated for kidney transplantation.


[This message has been edited by Gary Peterson (edited 03-16-2004).]