By: Mit Chauhan
Epidemiology – HE 300
October 1st, 2014
America is a highly multicultural society. You can see there are Caucasians, Asians, south Asians, African Americans and many more who share the country. Everyone is equal and free. Yet, one can see the vast gap between the health of different races. African Americans are much more likely to die early than white Americans. African Americans are more likely to face chronic diseases. They will also get lower quality health care.
In spite of major efforts, the difference in race is not showing signs of improvement. Many recent studies have been centered on different practices used in surgery. A group of scientist wanted to see if African Americans are more likely to get blood transfusion compared to Caucasians. You might ask what is blood transfusion? It is process where the patient is injected with blood to replace the blood they lost during surgery. It is gaining much attention as an important factor in providing quality care. It is used a lot in surgeries, especially in Coronary artery bypass surgeries (CABG), total hip replacement and removal of a part of the large intestine. They used the data of these three surgeries in this study. They went a step ahead to determine the cause of high volumes of blood used in either ethnicity.
The scientists chose to collect data from the University Health System Consortium (UHC). It has detailed records of all patients and their treatments provided by the member hospitals (1). They followed specific criteria to select their subjects. For example, they only studies patients who were more than 18 year old, whether they have transferred in to the hospital mid-treatment and whether they transferred out without completing the treatment. In the end, they were able to get at least 10000 - 15000 patients in their sample. This is extremely good because it will give a better, overall picture of the population. The huge sample size will also increase the power. Power is whether or not the conclusions will be true for the society. One odd thing present in the study is that, there were far less people in the black Americans group compared to the number of patients in the Caucasians group. Also, this study only looked at two ethnicities. So, it might be difficult to apply the conclusions on the population because there are other ethnic groups in it as well.
After carefully studying the patient’s files, the results showed that African Americans had more than one chronic illness at a younger age than the Caucasians. They also have increased needs of blood transfusion for the CABG and total hip replacement but not for removal of a part of the large intestine. Even after adjusting for many variables like private insurance, African Americans were still more likely to get a blood transfusion than Caucasians. The scientist also found that these differences were caused by within hospital variation. This means that there has been a difference treatment for African American and Caucasians inside the hospital rather than differences between hospitals.
You might ask what does this mean for the society. This shows that black Americans lose more blood during surgeries. Some reason for blood loss maybe the low surgical practice, genetics and