BA new national analysis finds that counties with more black primary care physicians have people who live longer. This analysis provides the strongest evidence to date that increasing diversity in the health care workforce may be the key to eliminating deeply entrenched racial health disparities.
The study is the first to show that higher morbidity rates among black physicians are linked to longer life expectancies and lower mortality rates in the black population published Friday in JAMA Network Open. Other studies have shown that when black patients are treated by black doctor are more likely to have received preventive care, and as a result, there was an Increased satisfaction with healthcare. But none of that research has shown an impact on black people’s life expectancy.
A new study finds that black residents in counties with more black doctors have lower rates of death from all causes, regardless of whether they actually see the doctor, and that black residents and white residents in these counties have lower rates of death from all causes. It was shown that the difference in mortality between the two groups was small. Longer life expectancies persisted even in counties with one black doctor.
“The potential for just one Black doctor in a county to impact mortality rates for an entire population is staggeringly overwhelming,” said Dr. McConlogue, a primary care physician and health equity researcher at the University of California, Chicago Medicine. Monica Peake said “This confirms what people are saying in the health equity field about the importance of Black physicians, but when you look at the impact at the population level, it’s surprising.”
“This will further increase the diversity of the physician workforce,” said Michael Dill, director of workforce research at the Association of American Medical Colleges and one of the study’s co-authors, “What else can I ask for?”
Lisa Cooper is a primary care physician who directs the Johns Hopkins Center for Health Equity and has written extensively about the factors that may explain why Black patients do better under the care of Black doctors in which she called the study “groundbreaking” and “particularly timely given the recent decline in life expectancy and widening health disparities in the United States.”
“These findings should serve as a wake-up call to health care leaders and policy makers,” she told STAT.
A team of researchers from the U.S. Department of Health and Human Services Health Resources and Services Administration and AAMC began the study by analyzing the representation of black primary care physicians in more than 3,000 counties across the country in 2009, 2014, and 2014. 2019. This first step also yielded clear results. Just over half of the counties across the country had to be excluded from the analysis because they did not have a single black primary care physician.
“I knew there was a problem,” Dill said. “But, oh, these numbers aren’t good.”
The researchers analyzed 1,618 counties that had at least one black primary care physician over a three-year period and found that counties with more such physicians had longer life expectancies for Black residents. (They hope to repeat the analysis in the future to see how counties with black doctors fared during the COVID-19 pandemic.and people of color are disproportionately affected. )
The researchers found that for every 10% increase in black primary care physicians, life expectancy increased by about one month. Considering that the difference in life expectancy between black and white Americans is wide nationwide, a few extra months of life may not sound like a big deal picking up such signals at the population level is important, the authors said.
The study found that for every 10% increase in black primary care physicians, the gap in all-cause mortality between blacks and whites decreased by 1.2%. “The mortality gap between blacks and whites hasn’t changed,” said John Snyder, a physician who heads HRSA’s data governance and strategic analysis division and was one of the lead authors. “Perhaps we have found a way forward to closing these gaps.”
The study did not directly address why blacks were better treated in counties with more black doctors, nor did it prove cause and effect. Previous research has suggested that “culturally congruent” care is better and of higher quality for patients, but new research shows that black doctors are less likely to have low incomes and insurance. It has been shown that one factor may be that patients are more likely to be treated without cancer. For example, more than any other race or ethnicity. The study found that the improvements in life expectancy were greatest in counties with the highest poverty rates.
“We didn’t expect that, said Rachel Upton, a statistician and social science analyst at HHS and one of the report’s lead authors. We found that the presence of black physicians not only helps overall, but especially in high-poverty counties.”
Many studies have shown that communication improves when patients and doctors are of the same race. Owen Garrick is a co-author of a 2019 study conducted in Oakland, California, which found that: Black patients may be better able to control cardiovascular disease They see Black doctors because they are more likely to engage in preventive care. She noted in her research that Black patients were not only more likely to talk to Black doctors about topics like upcoming birthday parties and weddings, but also more likely to invite them to events.
Beyond the patient-doctor relationship, the study found that simply living in a county with a black doctor can make a patient’s life better, even if they don’t receive direct care from a black doctor. It has been shown. Having black doctors work and live in counties where they’re thriving “may be a marker for living in communities that are more supportive of Black lives,” Snyder said.
Another factor may be that Black doctors may be more likely to do unpaid health-related work outside the health system, such as providing expertise to community organizations, Peek said. political involvement Address health-related issues and encourage the medical community to advocate for public health.
Peek has worked for 20 years with a nonprofit that helps Black women in public housing become health navigators and health advocates. She also spends a lot of time providing second opinions to her friends and family, and her network of friends and family. They may not know their doctor personally and may have mistrust of the healthcare system.
“With my non-black colleagues, I’m like, ‘Both my parents were doctors!’ We’re all doctors!” she said. “When they enter the health care system, their social networks are not paranoid.”
He said the study also points to issues of racism in healthcare and bias against black patients, creating a “gap” between non-black doctors and black patients. After speaking at her local church, she was shocked at the number of black people who came to her to give her detailed medical history and ask for her opinion because she didn’t trust their medical team. He said he received it. She said, “I’m like them,” Peek said. “They trust that I have their best interests at heart.”
The authors of the new paper said they were not recommending segregated care and that all doctors need to improve their cultural competency. Increasing diversity in the physician workforce will help patients of all races and ethnicities, they said.
But increasing the number of black doctors remains a stubborn problem. Despite decades of attention to this issue, a 2021 study showed that the number of Black and Native American medical students, particularly men, has stagnated. AAMC reported a recent report. Perhaps due to a renewed focus on diversity in recent years, such an increase could be thwarted by future Supreme Court decisions expected to restrict race as a factor in admissions.
The study does not address how the presence of physicians from other groups underrepresented in medicine, such as Hispanics, Native Americans, and Pacific Islanders, may affect health outcomes. Upton hopes that in the future, other researchers will focus on such populations, and more researchers will look at how the population compares to other populations, as well as looking at a single He said he hopes to conduct “within-population” studies that look at the health status of people within racial or ethnic groups.
“A lot of times we focus on disparities,” she says. “I want people to pay attention to how they behave within their own groups and what works within those groups.”
Correction: An earlier version of this article misspelled Monica Peek’s name.
