Feature Story

June 9, 2008

Racial disparities in diabetes outcomes widespread across individual physicians

From EurekAlert! - Breaking News:

"Many studies have described racial differences in diabetes care across the American health care system, but there is very limited information regarding the potential role of individual physicians," says Thomas Sequist, MD, MPH, primary care physician at Harvard Vanguard Medical Associates and lead author of the study.

"This study suggests that the problem of racial disparities in diabetes care is pervasive in physician practices, and not limited to a small cluster of physicians providing particularly low quality care."

A related study published in the May 2008 issue of the Journal of General Internal Medicine, also led by Sequist, found that 88 percent of physicians surveyed acknowledged the existence of racial disparities in diabetes care within the U.S. health care system.

This discrepancy illustrates the need for widespread interventions, including those that increase awareness of the importance of racial disparities within the local health care environment.

Previous studies have examined the role of hospitals, health plans, and geography as mediators of racial disparities, but little is known about the role of variation among individual physicians.

Sequist's Archives study included 90 primary care physicians caring for at least five white and five black adults with diabetes across 13 ambulatory centers.

The study found that white patients were significantly more likely than black patients to achieve control of three critical health measures for diabetes patients: hemoglobin A1c, LDL cholesterol, and blood pressure.

"Racial disparities in diabetes outcomes are spread across entire health care systems, requiring the implementation of system-wide solutions," said John Ayanian, MD, MPP, co-author of the study and professor of medicine and health care policy at Harvard Medical School and Brigham and Women's Hospital.

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