Research finds segregation in hospital rates

BY MEGAN DIAL | MARCH 13, 2009 7:30 AM

A recent study released by two UI professors and a UI research scientist provides evidence for the existence of segregation and its potentially fatal effects.

The researchers found that in highly segregated communities, black Medicare patients are 35 percent more likely to go to high-mortality hospitals, said Mary Vaughan Sarrazin, an investigator in the Iowa City Veterans Affairs Medical Center.

In the study released March 3, she said researchers discovered black patients are also more likely than whites to be admitted to hospitals with high mortality, even when they live closer to lower-mortality hospitals.

“I think that one of the things that this points to is the fact that geography and financial access don’t explain all the differences in racial disparities,” she said. “There are some culture pressures that direct where and how patients receive care.”

Vaughan Sarrazin, along with Assistant Professor of sociology Mary Campbell and Professor of internal medicine Gary Rosenthal, compared hospitalization data from Medicare and looked at 118 markets for hospital services.

Vaughan Sarrazin said they ranked hospitals by heart attack mortality rates.

Although they mainly examined large markets with a minimum of 5,000 black Medicare enrollees, Campbell said the UI Hospitals and Clinics can learn some lessons from the study.

“Iowa City is an interesting case because we draw cases from all over the region, so this kind of study would definitely have implications for areas like ours,” Campbell said.

UIHC spokesman Tom Moore said the UIHC has a long tradition of providing high quality care to all patients.

Campbell emphasized the point that even after the civil-rights movement and the Supreme Court case Brown vs. the Board of Education, segregation still exists in the United States.

“Our schools are still very segregated, and this is in part because our communities are still very segregated,” Campbell said. She added the segregation of neighborhoods is the root of the problem in hospitals.

“There isn’t going to be an easy solution for this,” she said. “It’s rooted in our very system of how we live.”

Campbell also explained noted studies have shown blacks often wish they were not living in neighborhoods with as much segregation.

“A lot of people make the assumption that this is about choice, that people choose to live racially segregated,” she said. “This isn’t true. African Americans say they would rather live in more integrated communities.”

Vaughan Sarrazin said further steps to investigate other reasons for the relationship between segregation and hospital admission are being considered.

“We have another investigator here who is looking at the role the physician plays in determining where these patients are admitted,” she said.

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