Theories explaining racial differences in the utilization of diagnostic and therapeutic procedures for cerebrovascular disease.

R. D. Horner, E. Z. Oddone, D. B. Matchar

Research output: Contribution to journalReview articlepeer-review

67 Scopus citations

Abstract

Despite a higher risk of stroke, blacks are less likely than whites to receive the invasive procedures that are used to diagnose and treat cerebrovascular disease, particularly carotid endarterectomy. Explanations for the lower rate of procedural use include racial bias, racial differences in pathophysiology of cerebrovascular disease, affordability, and racial variation in patient decisions regarding care. Studies consistently indicate that blacks are less likely to have severe atherosclerotic lesions of the carotid arteries, reducing their likelihood of being appropriate candidates for carotid endarterectomy. Although ability to pay does not explain the observed variation in use of carotid endarterectomy, it may influence the evaluation process prior to hospitalization. A racial difference in patients' decisions about health care for cerebrovascular disease has never been investigated; it should be a topic of future studies.

Original languageEnglish (US)
Pages (from-to)443-462
Number of pages20
JournalMilbank Quarterly
Volume73
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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