Are Black-White Mortality Rates Converging? Acute Myocardial Infarction in the United States, 1993–2010
Racial and socioeconomic disparities are pervasive in U.S. health care. Recent research on trends in disparities has often shown a reduction in the magnitude of disparities in treatments. In this paper, we consider trends in racial disparities with a focus on health outcomes for acute myocardial infarction (AMI) in the elderly population. We find an overall decline in mortality between 1999 and 2010, but it was not associated with a reduction either in mortality differentials within hospitals, nor did we observe a significant reduction in mortality disparities associated with black AMI patients being admitted to hospitals with disproportionately high risk-adjusted mortality rates for whites. While there was some hint of a reduction in racial disparities between the middle (1999–2005) and late (2006–10) period, the improvement is very modest, and additional years of data would be necessary to discern whether there was a real long-term improvement.
We gratefully acknowledge funding from the National Institute on Aging: P01 AG005842 and P01 AG019783.
The author serves on the Panel of Health Advisors of the Congressional Budget Office (CBO). He is also a consultant for Precision Health Economics, a for-profit consulting firm, but the company has no financial interest in this paper.
Outside Professional Activities For Amitabh Chandra Disclosures for 2014:
Congressional Budget Office (Federal Government). Panel of Health Advisors. Unpaid.
Review of Economics and Statistics (journal). Editor Compensation.
Microsoft Research New England (research laboratory). Consultant.
Precision Health Economics (for profit). Consultant.
HealthEngine (for profit), Co-Founder. Equity position only.
Maxwell Health, OK-CoPay, Advisory Boards. Equity position only.
GI Roundable. Speaking Fee
MAHIP Speaking Fee
Institute of Medicine (IOM), Panel on Graduate Medical Education, Member of Panel. Unpaid.Jonathan Skinner
The author reports that he is a shareholder and advisor to Dorsata, Inc., a software startup that is developing physician decision tools for use in clinical settings.